TOXIC SHOCK SYNDROME (TSS) was discovered almost 20 years ago. At first no one knew what was causing it, although it was quickly linked with “superabsorbent” tampons (which are no longer on the market). Eventually researchers discovered that a poison produced by a type of bacteria known as Staphylococcus aureus is responsible for TSS. Some theorized that tampons may produce small ulcerations, which allow bacteria to enter the body. Another theory is that stagnating blood within or behind the tampon may permit the bacteria to grow. Most cases of toxic shock syndrome have been associated with tampon use. However, a few have been reported in women who use a diaphragm for birth control, or during the first few weeks after childbirth. A very few cases have occurred in men and in children. SYMPTOMS
Several signs and symptoms can accompany TSS, including
high fever (101o F or higher).
kidney or liver problems.
nausea and vomiting.
sunburn-like rash (usually after a day or two).
To prevent TSS, make sure you change your tampons frequently, wash your hands before inserting one, and wear sanitary napkins some of the time ? especially at night. If you?ve ever had TSS, it?s best to stop using tampons and the diaphragm, as the condition can recur.
If you suspect you might be starting to have TSS symptoms and are wearing a tampon, remove it right away. This stops bacterial growth in 80% of cases. Also make sure you visit a doctor as soon as possible.
Toxic Shock Syndrome
Toxic Shock Syndrome (TSS), rare disease associated with strains of the bacterium Staphylococcus aureus, a common inhabitant of the skin, oral cavity, and vagina. Under certain conditions the bacterium produces a toxin that apparently attacks the immune system through the bloodstream, in turn permitting more toxin to be produced. Liver function is also altered, resulting in liver and kidney damage. Symptoms of TSS include rash, high fever, lowered blood pressure, diarrhea, and vomiting. TSS has caused death in about 3 percent of reported cases. The disease can be treated with antibiotics.
The first identifiable case of TSS dates back many years, but the disease only drew great attention in the United States in the late 1970s, when an outbreak led to fears of an epidemic. A few thousand victims were eventually involved, about 80 percent of whom were menstruating women. Almost all of them were using superabsorbent tampons, which apparently provided a more oxygen-rich atmosphere in which vaginal bacteria could readily produce their toxin. When women began to use such tampons only intermittently or not at all, the outbreak subsided.
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toxic shock syndrome
acute, sometimes fatal, disease characterized by high fever, nausea, diarrhea, lethargy, blotchy rash, and sudden drop in blood pressure. It is caused by several toxin-producing strains of bacteria, particularly streptococcal and staphylococcal bacteria. Streptococcal forms, in which the bacterium typically enters the body through a cut, are more common. Staphylococcal toxic shock is most prevalent among menstruating women using high absorbency tampons.
Toxic Shock Syndrome
In the 1980’s, an undiagnosed illness struck young menstruating women. The illness was serious and some of these women died. They had toxic shock syndrome, or TSS. Since the 1980’s, scientists have learned about toxic shock syndrome, and fortunately the number of cases has dropped dramatically.
TSS is a rare but lethal illness. It is caused by a toxin released by a common bacteria found on people’s hands and in their mouths. TSS is a toxic poisoning, rather than an infection. The syndrome develops when the proper conditions are present to allow the bacteria to grow and produce the deadly toxin.
Women who are under 30 and who use high absorbency tampons during menstruation are most at risk. The relationship between tampon use and TSS is still under investigation. It was discovered that TSS occured in males and females who had bacterial infections (such as infected wounds, skin abscesses or vaginal infections) which produced the lethal toxin.
The six symptoms of TSS are:
1. Fever greater than 38.9 degrees Celsius.
2. Low blood pressure, which may cause fainting when standing up.
5. Aching muscles.
6. Sunburn-like rash which results in severe peeling in 1-2 weeks.
The symptoms can occur suddenly and may be confused with illness like the flu or measles. If the toxin gets into the nervous system, it may cause headaches, confusion or unconsciousness. It may lead to shock, or invade the heart or kidneys.
If your health care practitioner suspects TSS, immediate admission to the hospital is vital as a TSS victim may die without proper medical attention. Today, almost all TSS victims recover because the symptoms and diagnosis are available to medical personnel.
Preventative health measures have resulted in public education and the reduction of the number of cases of TSS. To prevent TSS, follow the warning inserts enclosed in tampon boxes or don’t use tampons at all.
Toxic Shock is a Nightmare:
The Story of a Survivor
The story and pictures below may be disturbing to sensitive persons. I take this opportunity to present important, yet lesser-known truths about preventable health risks to women from lack of information about tampon ingredients and use.
After nearly 5 years of gathering this information, it is my opinion that the leading manufacturers of tampons are well aware that many women will become gravely ill, suffer and die after using their products. It is in their power to reduce the incidence of tampon-related Toxic Shock Syndrome (TSS) in women.
Because of its relationship to menstruation and the use of tampons, TSS has not received adequate attention from medical and government authorities, as have other fatal diseases. It is classified as a “rare” disease. This classification gives women a false sense of security about our chances of getting Toxic Shock. The truth is, that it is no more “rare” than certain forms of cancer and AIDS.
Market research professionals are hired by tampon companies to find out why people buy products. The companies spend millions of dollars for “consumer surveys” and “focus groups” to find out what women think about tampons. They know very well that menstruation is a taboo topic of conversation for many people (How many of us talk about our periods with co-workers or classmates?). Strangely, we talk about perspiration, pimples, having “to go to the bathroom” and other normal bodily functions in mixed company without embarassment, while treating conversation about the miracle of female fertility as shameful. Using this kind of information has given companies power to keep potentially damaging information about their products away from people, and enables them to twist the “facts” so that most of us might never know what kinds of chances we are really taking.
Women, all of us, need to think about the products that we buy, why they are (or are not) available in stores, who decides what we can buy, and the consequences of those decisions. Every dollar that we spend on products made by companies who refuse to take responsibility for problems with their products, lets these companies “get away” with creating pollution, death and suffering.
Dioxin, a by-product of chlorine, is a proven killer; chlorine-treated rayon fibers are contained in all leading brands of tampons. What’s really scary about this, is that dioxin also weakens the immune system, our ability to fight disease. This means that a woman with dioxin in her body who gets TSS, may have even less ability to fight the disease. All women who grow up in North America have already accumulated dioxin in the fatty tissue in their bodies. Of course, tampon companies must know this too, musn’t they?
Cigarette manufacturers were forced to admit that cigarettes cause death and illness only after enough people knew the facts and demanded that appropriate action be taken. Now, every package of cigarettes sold in North America has a warning about the dangers of smoking. We know that smoking is dangerous, and we can choose for ourselves whether or not we want to take that risk.
The damage caused by tampons isn’t so clear yet; consequently, about 90% of cases of tampon-related TSS are never diagnosed. This means that a woman can suffer or die from the disease, and neither she nor her family will ever really know why.
This story is about the miracle of a mother and daughter’s continuing struggle to survive the effects of this deadly disease. It offers the reader an opportunity to see, first-hand, the real consequences of decisions to buy products from companies who care more about their shareholders than their customers.
Jamie Cash: Abaco’s Miracle Teenager
Jamie’s parents loved their daughter and her 7-year old brother; they were working hard to give their family a good life. Carrie Cash, Jamie’s mother, found a business that allowed her the flexibility to be there for her children. She was proud that Jamie was an excellent swimmer with potential scholarship abilities. As a matter of fact, she was her swim coach! The family lived well, loved each other, and were happy.
One day, Toxic Shock Syndrome changed their happy lives. At first, it seemed to be a bad flu or cold, and Jamie was to spend a few days in bed. But it got worse…Jamie became disoriented and the slightest movement caused her to feel faint as her blood pressure sank lower. A fine red rash covered her torso; her kidneys had failed. She grew weaker and weaker. Her mother rushed her by boat to the doctor. They had to call an air ambulance. The paramedics were scared; they’d never seen anything like this before. It was clear that Jamie’s condition was critical.
Jamie was flown to the nearest hospital, over a 100 miles away, and admitted to pediatric intensive care. Luckily, the attending doctor was aware enough of her symptoms to make a crystal-clear diagnosis: Menstrual Toxic Shock Syndrome. Every vital organ system except her brain had failed. An arsenal of drugs and life support equipment were rushed into the room to try and save Jamie’s life. After a heroic 14 hour effort during which Jamie “coded” twice, the doctors brought her parents in to say goodbye. The third time Jamie “coded” there was nothing left to do.
Fortunately for Jamie and her family, they are born fighters. Her mother has been a dedicated activist since the 1960s. She also knew a lot about tampon manufacturers, having formerly worked on their advertising campaigns! Carrie Cash is not one to accept failure, or to accept “facts” at face value; she fought for her daughter’s life then, as she continues to fight for her today. Somehow, she knew that her family could overcome this crisis.
The first miracle of many more miracles happened – Jamie started to come back, just a little. The sense of hope felt by Jamie’s family and the medical staff was bigger than their pain, shock or disbelief. They did not know that they would go through this ordeal again and again over the next three months. But they had hope. They still do.
Although Jamie has regained much of her former health, she will never be the same. Now, she, her friends and family have to be incredibly careful about her health. Toxic Shock Syndrome has robbed her of the full use of her body and she is still occasionally rushed to the hospital with one or another threatening condition; the last time I heard about, it was mononucleosis. Other times …. the list goes on and on…Jamie has been regularly suffering health problems related to Toxic Shock four years later!
The suffering of the Cash family could have been prevented. They are not to blame for what happened. The blame lies with the tampon companies and decision makers who continue to allow the conspiracy of silence about the true health risks from tampons: rayon, chlorine, dioxin, additives, absorbency enhancers, applicators, the risks of tampon use in certain sports activities – the list goes on and on. (For more information about health risks and tampons, please see our web page Tampons and Health.) Women need to hear the truth, all the truth, right now, before one more woman dies an unnecessary death at the hands of the blind and greedy people who run these companies.
It’s high time that the companies and the “nameless bureaucrats” who have been allowing this deception to continue came clean, wouldn’t you say? And I’d say it’s a safe bet that, like other big corporations that spend a lot of money covering up their “dirty secrets” (remember the cigarette companies?), they won’t tell the truth until they’re forced to.
At the time of this writing, a tampon company is advertising that it’s safe to use tampons overnight, “up to 8 hours.” I’ve heard that they will spend over $60 million dollars in one year to sell this message to women. They, like you and I, know that many young women (young women are at highest risk of Toxic Shock) will sleep much longer than 8 hours if they’re given a chance. They also know that it’s safer for a woman not to use tampons at all, or if she does, for no longer than 3 to 6 hours. But advertising these kinds of facts won’t sell as many tampons, will it? Besides, women are told they can “trust” tampons.
Mothers, daughters, sisters, friends – let’s get those companies, their advertising and their dangerous tampons out of our lives right now! Tell the store managers that those tampons are dangerous, that what they’re buying is destroying women’s lives and the environment; tell them that women can sue stores for selling products that have harmed them (and have!). Tell them that one woman’s suffering and death from toxic tampons is too many. Let’s speak freely about our periods, about the pollution and it’s effects on our health, and tell all the women we know to do the same.And let’s speak really loudly about companies that treat lawsuits from victims of their products as a “cost of doing business.”
You’ve heard the story of one family’s suffering with the disease. The Cash family is intact; Jamie lives. Sadly, other women have died, some that we know about (see references to research). But there have been some women whose doctors weren’t taught enough about TSS in medical books. We’ll never know about those women.
We have the power to stop the manufacturers from taking chances with our lives – we can tell the truth. We can keep telling it. And we can stop buying their products.
P.S. As always, your comments, stories and suggestions are welcome. Thank you for taking time to share the information that we offer; we ask that you share it with others, and tell them how you found the information. Be well.
Toxic Shock Syndrome (TSS)
Toxic Shock Syndrome (TSS) is a bacterial illness that has been associated with the use of tampons since late in the 1970s. Tampon-induced TSS is a relatively rare, potentially lethal disease, caused by a strain of Staphylococcus aureus bacterial toxin known as TSST-1. The TSST-1 toxin enters the bloodstream, and has been found in vaginas, and almost exclusively affects women who use tampons.
Most officially diagnosed cases of tampon-related TSS occur in women under 30 years of age, especially teenage women 15 to 19 years of age. Sixty percent of tampon-induced TSS fatalities are reported to be in women 15 to 24 years, 98 percent of these being white women. U.S. estimates of the incidence of TSS are between 1 and 17 cases per 100,000 menstruating women per year. The U.S. Center for Disease Control and Prevention (CDC) in Atlanta received 216 reports of TSS in 1993, 244 cases in 1992. The CDC reports that 99 percent of all TSS cases were in women and 98 percent of these women suffered the onset of the disease during a menstrual period. The case fatality, or death rate, for tampon-induced TSS is about 6 percent. Experts say that only 10 percent of all cases are recorded.
Women and girls suffer and die every year from tampon-induced Toxic Shock Syndrome. Women who have survived TSS have suffered, among other problems, miscarriages, loss of hair, loss of limbs and paralysis.
Recent studies, released at the 1994 convention of the American Society for Microbiology have demonstrated a link between the use of tampons containing rayon and TSS. The research demonstrates a propensity for tampons containing rayon fibers to amplify the production of the TSST-1 toxin, known to be responsible for tampon-induced Toxic Shock Syndrome.
These studies also show that the TSST-1 toxin is not produced on the cotton used to produce terra femme tampons.
TSS Symptoms and Prevention
Symptoms of toxic shock syndrome:
Sudden onset of a fever of 102 degrees or higher
Muscular pain or weakness
Skin rash resembling a sunburn particularly on the palms and the soles of the feet
Rapid fall of blood pressure
If you experience high fever, vomiting and diarrhea together or suspect toxic shock while wearing a tampon, immediately remove the tampon and consult a physician. Tell the physician your symptoms, how long you have had them, and when your period started. Keep the tampon in case your doctor wants to test it.
Tampon-related Toxic Shock Syndrome is fatal in about 6 percent of cases. Women who do not die may suffer a range of serious and painful injuries, including severe organ damage, loss of hair, limbs and fingertips, reduced lung capacity and various other conditions.
Reduce the risk of TSS with these preventive measures:
USE ONLY ALL COTTON TAMPONS!
Refrain from using tampons overnight or between menstrual periods.
Use the lowest absorbency tampon necessary to absorb your menstrual flow.
Change tampons at least every 3 to 6 hours.
Wash your hands and fingernails well before and after inserting a tampon.
Alternate the use of tampons with menstrual pads.
Don’t use tampons between menstrual periods.
1. A Medical Time Bomb, Robb Cribb, Hamilton Spectator, September 10, 1994, p. A6.
2. Emerging Patterns of Tampon Use in the Adolescent Female: The Impact of Toxic Shock Syndrome, Charles E. Irwin, Jr., MD and Susan G. Millstein, MS, American Journal of Public Health, May 1982, Vol. 72, No. 5, pp. 464-467.
3. Analysis of New Generation Tampons for Propensity to Amplify Staphyloccocus aureus Toxic Shock Syndrome Toxin 1 (TSST 1), Philip M. Tierno, Jr., Bruce A. Hanna, Departments of Microbiology and Pathology, NYU School of Medicine. Presented at the 94th General Meeting of the American Society for Microbiology, May 24, 1994.
4. “Truth about tampons needs to be told: These convenient little fluff balls are not as benign as everyone believes.”, Ann Montgomery, Ottawa Citizen, Sept. 1, 1992.