Everything You Need To Know About Toxic Shock Syndrome

What is toxic shock syndrome?

Toxic shock syndrome, or TSS, is a rare condition caused by bacteria getting into the body and releasing harmful toxins. According to the NHS, it can affect anyone of any age – including men and children – and can be caused by female barrier contraceptives such as diaphragms or caps, a break in the skin (like a cut or a burn) or even childbirth. But the most common cause of toxic shock syndrome is through using tampons.

Tampons, particularly those with high absorption, can provide the right conditions for that bacteria to grow, especially if the tampon is left in far longer than recommended. This is because the blood that accumulates in the tampon can act as a ‘culture medium’ for the bacteria – kind of like a petri dish. Back in the 1970s and 80s, there was a rise in cases of TSS due to superabsorbent tampons, which prompted manufacturers to remove them from shop shelves. As soon as these types of tampons had been taken off the market, the rate of toxic shock syndrome among women decreased.

TSS mostly occurs in women between the ages of 15 to 25 who use tampons. According to Dr Michael Cackovic, this is because younger women are less likely to have antibodies against Staphylococcus aureus – the pathogen that is most commonly linked to TSS – than older women.

How dangerous is it?

Although rare, it can be life-threatening. Just last month, coroners ruled that Canadian teenager Sara Manitoski, who died during an overnight trip with her school, had suffered from TSS. The British Columbia Coroners Service confirmed that the 16-year-old had a strain of staphylococcus aureu on her tampon, as well as other symptoms consistent with the disorder.

If not fatal, then TSS can still have major repercussions for sufferers. Model Laura Wasser’s nightmarish story started when she woke up in hospital to discover she was scheduled in to have her right leg amputated after her tampon caused TSS. Later, she also had to have the toes from her left foot removed.

What are the symptoms?

Firstly, before you go burning all your tampons on a bonfire in the back garden, it’s important to remember that toxic shock syndrome is extremely rare. Today, the rate of TSS in menstruating women currently sits at around one in 100,000. But, for peace of mind, the tell-tale signs of TSS, according to the NHS, are as follows:
•  A high temperature of 39C (102.2F) or above
•  Flu-like symptoms, such as a headache, chills, muscle aches, a sore throat and a cough
•  Feeling and being sick
•  Diarrhoea
•  A widespread sunburn-like rash
•  The whites of the eyes, lips and tongue turning a bright red
•  Dizziness or fainting
•  Breathing difficulties
•  Confusion
•  Drowsiness

The symptoms can start suddenly and get worse quickly, so if you feel you might have TSS, the NHS stresses that it’s important to contact your local GP, local out of hours service or NHS 111 as soon as possible, and if you feel your symptoms are severe of worsening quickly, call 999.

It’s imperative you tell your doctor or a medical professional you’ve been using a tampon, and if you’re wearing one when the symptoms occur, take it out immediately.

Once in the hands of medical professionals, there are a number of ways TSS can be treated. These can include antibiotics; fluids to help prevent dehydration and organ damage; medication to help control blood pressure; dialysis if the kidneys stop functioning; and, in very severe cases (again, which are very rare), surgery to remove dead tissue.

How can you prevent TSS?

According to NHS guidelines, it’s important to ensure you always use tampons with the lowest absorbency suitable for your menstrual flow, and alternate your sanitary wear from tampons to towels or liners regularly. Make sure you wash your hands before and after inserting a tampon, don’t insert more than one at a time, and change them regularly – which means, if you’re just about to go to bed, inserting one right before you go to sleep and changing it as soon as you wake in the morning.

It might seem like standard advice for tampon use, but it’s important to be educated on how to avoid TSS. As Manitoski’s sister said on Facebook after her sibling’s death: “There is such little education on this and it needs to be brought to light… I wouldn’t want this to happen to anyone else and if this post makes even one person aware and go look up and educate themselves on TSS then I am grateful.”