FREE ESSAY ON TOXIC SHOCK SYNDROME

TOXIC SHOCK SYNDROME

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
-  diarrhea. 
-  disorientation. 
-  fainting. 
-  high fever (101o F or higher). 
-  kidney or liver problems. 
-  muscle pain. 
-  nausea and vomiting. 
-  peeling skin. 
-  shock (severely low blood pressure, which affects the body's functioning). 
-  sore throat. 
-  sunburn-like rash (usually after a day or two). 
PREVENTION 
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're a diaphragm user, don't leave it in place longer than the recommended time -
and don't use it during your period or in the first 12 weeks after you've had a baby.
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.
HOW TO CITE THIS ARTICLE
Toxic Shock Syndrome, Microsoft? Encarta? Online Encyclopedia 2000
http://encarta.msn.com ? 1997-2000 Microsoft Corporation. All rights reserved.
/home.html/home.html
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. 
The Concise Columbia Electronic Encyclopedia, Third Edition Copyright ? 1994, Columbia
University Press. 
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. 
3. Vomiting. 
4. Diarrhea. 
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
WARNING: 
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 Cash was 13 years old at the time. A happy, active teenager, she enjoyed the things
that young women enjoy: music, school, friends, sports, and especially, swimming.
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. 
In sheer terror, her mother cried, Get back here, Jamie Cash! I've never raised a
quitter! This will be the longest marathon of your life, but I'll be with you every step
of the way!
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. 
In health,
Willi Nolan
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 
-  Diarrhea 
-  Vomiting 
-  Dizziness 
-  Muscular pain or weakness 
-  Fainting 
-  Suddenly feeling unwell (flu-like symptoms) 
-  Disorientation 
-  Skin rash resembling a sunburn particularly on the palms and the soles of the feet 
-  Peeling skin 
-  Headache 
-  Sore throat 
-  Bloodshot eyes 
-  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. 
Bibliography
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. 
5. The Price of A Life, Tom Riley, Adler & Adler Publishers, Bethesda Maryland, 1986.