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Feature

A photo of an old Rely tampon box.

In September 1980, the Centers for Disease Control reported that 70 percent of the women with toxic shock syndrome used Procter & Gamble's Rely tampons. Later that month, P&G took their tampon off the market.

Toxic shock syndrome on the rise again

Published June 24, 2004

Toxic shock syndrome (TSS) is an acute-onset illness caused by Staphylococcus aureus bacteria. Fever, sunburn-like rash, and flu-like symptoms, including vomiting, diarrhea, and generalized aches and pains are symptoms all menstruating women were told to watch out for in the early 1980s, when TSS roared into the news and was linked to tampon use, usually high-absorbency tampons. TSS can be deadly, but its incidence dropped in 1984, when the highest absorbency tampons were removed from the market, and women were educated to use lower absorbency tampons. Even though tampon boxes still carry a TSS warning, women don't give it much thought these days. But University of Minnesota researchers have documented a consistent rise in TSS after following menstruating women, nonmenstruating women, and men in the Twin Cities metro area, population 3 million, from 2000 to 2004. The results, published in this month's Journal of Clinical Microbiology, are consistent with the Centers for Disease Control's findings of an 18 percent increase over the same period.

"If the current rate continues to increase, by the end of the year the incidence of toxic shock syndrome will be approximately where it was at its peak in 1980-81," says Patrick Schlievert, professor of microbiology and principal investigator on the TSS study.

In the early 1980s, the yearly incidence of TSS was 10 per 100,000 women of menstrual age. By the late 1980s, the incidence had dropped to 1 per 100,000 women. The numbers have been on the rise, with 1.6 per 100,000 in 2001; 2.4 per 100,000 in 2002; 3.4 per 100,000 in 2003; and 5 per 100,000 to date in 2004. "If the current rate continues to increase, by the end of the year the incidence of toxic shock syndrome will be approximately where it was at its peak in 1980-81," says Patrick Schlievert, professor of microbiology and principal investigator on the study. "Although this study was done in the Twin Cities, this is a phenomenon across the United States," he says. The reason for the increase is unclear, said Schlievert, but doctors and women need to be aware that TSS is on the rise and should monitor tampon use. Another potential concern is the increased resistance to antibiotics used to treat TSS.