Toxic shock syndrome historical perspective
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Syed Hassan A. Kazmi BSc, MD [2]
Overview
The term toxic shock syndrome was first used in 1978 by a Denver pediatrician, Dr. J.K. Todd, to describe the staphylococcal illness in three boys and four girls aged 8-17 years.[1] In January 1980, epidemiologists in Wisconsin and Minnesota reported the appearance of TSS, mostly in menstruating women, to the CDC.[2]
Historical Perspective
Initial Description
The term toxic shock syndrome was first used in 1978 by a Denver pediatrician, Dr. J.K. Todd, to describe the staphylococcal illness in three boys and four girls aged 8-17 years.[3] Even though S. aureus was isolated from mucosal sites from the patients, bacteria could not be isolated from the blood, cerebrospinal fluid, or urine, raising suspicion that a toxin was involved. The authors of the study noted that reports of similar staphylococcal illnesses had appeared occasionally as far back as 1927. Most notably, the authors at the time failed to consider the possibility of a connection between toxic shock syndrome and tampon use, as three of the girls who were menstruating when the illness developed were using tampons.[4]
- In January 1980, epidemiologists in Wisconsin and Minnesota reported the appearance of TSS, mostly in menstruating women, to the CDC.[5]
- S. aureus was successfully cultured from most of the women. A CDC task force investigated the epidemic as the number of reported cases rose throughout the summer of 1980, accompanied by widespread publicity. In September 1980, the CDC reported that users of Rely were at increased risk for developing TSS.[6]
- On September 22, 1980, Procter and Gamble recalled Rely[7] following release of the CDC report. As part of the voluntary recall, Procter and Gamble entered into a consent agreement with the FDA "providing for a program for notification to consumers and retrieval of the product from the market".[8] However, it was clear to other investigators that Rely was not the only culprit. Other regions of the United States saw increases of menstrual TSS before Rely was introduced.[9] It was shown later that higher absorbency of tampons was associated with an increased the risk for TSS, regardless of the chemical composition or the brand of the tampon. The sole exception was Rely, for which the risk for TSS was still higher when corrected for its absorbency.[10] The ability of carboxymethylcellulose to filter the S. aureus toxin that causes TSS may account for the increased risk associated with Rely.[11]
- By the end of 1980, the number of TSS cases reported to the CDC began to decline. The reduced incidence was attributed not only to the removal of Rely from the market, but also from the diminished use of all tampon brands. According to the Boston Women's Health Book Collective, 942 women were diagnosed with tampon-related TSS in the USA from the March 1980 to March 1981, 40 of whom died.
Association with Rely Tampons
- In August of 1978 Procter and Gamble introduced superabsorbent Rely tampons to the United States market[12] in response to women's demands for tampons that could contain an entire menstrual flow without leaking or replacement Rely used carboxymethylcellulose (CMC) and compressed beads of polyester for absorption. This tampon design could absorb nearly 20 times its own weight in fluid[11].
- It was later found that use of Rely tampons was associated with development of toxic shock syndrome.[13]
References
- ↑ Todd J, Fishaut M, Kapral F, Welch T (1978). "Toxic-shock syndrome associated with phage-group-I staphylococci". Lancet. 2 (8100): 1116–1118. PMID 82681.
- ↑ CDC 1980. "Toxic-shock syndrome--United States." MMWR 29(20):229-230.
- ↑ Todd J, Fishaut M, Kapral F, Welch T (1978). "Toxic-shock syndrome associated with phage-group-I staphylococci". Lancet. 2 (8100): 1116–1118. PMID 82681.
- ↑ Todd J (1981). "Toxic shock syndrome--scientific uncertainty and the public media". Pediatrics. 67 (6): 921–923. PMID 7232057.
- ↑ CDC 1980. "Toxic-shock syndrome--United States." MMWR 29(20):229-230.
- ↑ CDC 1980. "Follow-up on toxic-shock syndrome." MMWR 29(37):441-445.
- ↑ Hanrahan S (1994). "Historical review of menstrual toxic shock syndrome". Women Health. 21 (2–3): 141–165. PMID 8073784.
- ↑ Kohen, Jamie (2001). "The History and Regulation of Menstrual Tampons". RTF document. Retrieved 2006-03-30. External link in
|work=(help) - ↑ Petitti D, Reingold A, Chin J (1986). "The incidence of toxic shock syndrome in Northern California. 1972 through 1983". JAMA. 255 (3): 368–72. PMID 3941516.
- ↑ Berkley S, Hightower A, Broome C, Reingold A (1987). "The relationship of tampon characteristics to menstrual toxic shock syndrome". JAMA. 258 (7): 917–20. PMID 3613021.
- ↑ 11.0 11.1 Vitale, Sidra (1997). "Toxic Shock Syndrome". Web by Women, for Women. Retrieved 2006-03-20.
- ↑ Hanrahan S (1994). "Historical review of menstrual toxic shock syndrome". Women Health. 21 (2–3): 141–65. PMID 8073784.
- ↑ Schuchat A, Broome CV (1991). "Toxic shock syndrome and tampons". Epidemiol Rev. 13: 99–112. PMID 1662639.