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Toxic Shock Syndrome

Risk Factors For Toxic Shock Syndrome

In 1980, several women in the United States were diagnosed with TSS; a few of these women died. When researchers investigated these cases, they found that all the women had been menstruating and using high-absorbency tampons. Since that time, toxic shock has been associated with the use of tampons in menstruating women, who comprise about 50% of the cases of TSS per year. Researchers speculate that tampons provide a suitable environment for bacteria such as S. aureus to grow.

To reduce the risk of TSS, experts recommend that women who use tampons change them frequently (about every two to four hours) and use the lowest-absorbency tampon that's practical. To avoid all tampon-associated risk of TSS, avoid using tampons altogether. Since instituting these guidelines, the incidence of toxic shock has fallen significantly over the past ten years. Currently, the incidence of toxic shock syndrome in menstruating women is between 1 and 17 cases per 100,000. However, some cases of TSS in women have been associated with the use of contraceptive sponges and diaphragms. Like tampons, these devices should be worn for the shortest time recommended on the package directions, and for no longer than eight hours.

Cases of TSS are also found in people with pre-existing skin infections, such as boils and wound infections. Prompt treatment of these conditions can usually prevent TSS.



Berkley, Seth F., et al. "The Relationship of Tampon Characteristics to Menstrual Toxic Shock Syndrome." Journal of the American Medical Association 258 (August 21, 1987): 917-20.

Bryner, Charles L., Jr. "Recurrent Toxic Shock Syndrome." American Family Physician 39 (March 1989): 157-64. Kleinman, Leanne. "Toxic Shock Revisited." Health 20 (April 1988): 8.


Toxic Shock Syndrome and Tampons. Rockville, MD: United States Department of Health and Human Services, Food and Drug Administration, 1990.

Toxic Shock Syndrome: Assessment of Current Information and Future Research Needs: Report of a Study. Institute of Medicine (United States), Division of Health Sciences Policy. Washington, DC: National Academy Press, 1982.

Kathleen Scogna


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—A molecule, usually a protein, that the body identifies as foreign and toward which it directs an immune response.

Helper T cell

—The "lynch pin" of specific immune responses; helper T cells bind to APCs (antigen-presenting cells), activating both the antibody and cell-mediated immune responses.


—A set of diseases or symptoms that are traced to one specific cause; examples include Acquired Immune Deficiency Syndrome (AIDS) and toxic shock syndrome (TSS).


—A poisonous substance.

Additional topics

Science EncyclopediaScience & Philosophy: Thallophyta to ToxicologyToxic Shock Syndrome - Toxic Shock Syndrome Toxins, Symptoms Of Toxic Shock Syndrome, Risk Factors For Toxic Shock Syndrome