This is a severe but very rare illness that can occur in both men and women, but most often in young women who are menstruating and using tampons. The warning symptoms of toxic shock are ‘flu-like: headache; aching muscles; sore throat; chills. When TSS has fully developed, the characteristic symptoms are:
• sudden onset of high fever
• vomiting and/or diarrhoea
• faintness and shock
• sunburn-like rash that progresses to skin peeling.
If you develop these symptoms, remove the tampon and see a doctor without delay. Treatment is by taking antibiotics.
What causes TSS?
A toxin produced by the bacterium Staphylococcus aureus (‘golden staph’) enters the blood through a broken membrane. The staphylococcus, which is normally present in very small amounts on skin and in the vagina, can grow and produce its toxin anywhere where blood has collected and there isn’t much air, such as in wound dressings and tampons. TSS has also occurred soon after childbirth and in women who have left contraceptive cervical barriers in for a long time.
Most cases of TSS have occurred in the USA. This may be linked to the development of super-absorbent tampons containing fibres (other than cotton) that could scratch the vaginal lining. These materials are no longer used. In Australia there are now standards to regulate the contents and quality of tampons.
Protection against toxic shock syndrome
Though the risk is very low, the following simple precautions will make toxic shock even more rare.
• Wash your hands before inserting tampons.
• Unwrap each tampon just before insertion. Discard any that have damaged wrappers.
• Use the smallest tampon possible for your comfort and to collect the blood flow.
• It is recommended that tampons shouldn’t be used continuously, preferably not during the night.
• Tampons should be changed as often as needed and not left in the vagina for longer than eight hours.
• Take extra care if you use sea sponges in the vagina to collect menstrual flow. Sponges are more likely to be contaminated during storage and handling, and simple rinsing won’t remove bacteria. Before using they need to be thoroughly washed or soaked in nappy disinfectant, then thoroughly rinsed and dried. Sponges should be handled like tampons, and not left in for longer than eight hours.
• After childbirth, caesarean delivery or gynaecological surgery, consult your doctor before using tampons.
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