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==Overview==
==Overview==
Approximately half the cases of staphylococcal TSS reported today are associated with tampon use during [[menstruation]], usually in young women and uptill now  42% of cases have occurred in females under the age of 19 years, though TSS also occurs in children, men, and non-menstruating women.
Approximately half the cases of [[Staphylococcus|staphylococcal]] [[Toxic shock syndrome|TSS]] reported today are associated with tampon use during [[menstruation]], usually in young women and up till now  42% of cases have occurred in females under the age of 19 years, though TSS also occurs in children, men, and non-menstruating women.


==Epidemiology and Demographics==
==Epidemiology and Demographics==
===General Incidence and Prevalance===
=== Incidence===
* Toxic shock syndrome (TSS) became a nationally notifiable disease in 1980. After the initial epidemic, the number of reported cases decreased significantly. Close observation during 1986 which was conducted in different parts of the United States, confirms the decreasing trend. The total incidence (0.5 per 100,000 population) confirmed the substantial decrease in the incidence of menstrual TSS observed in the passive surveillance system. Incidence rates declined from 6 to 12 per 100,000 among women 12-49 years of age in 1980 to 1 per 100,000 among women 15-44 years of age in 1986.<ref name="urlToxic Shock Syndrome in the United States: Surveillance Update, 1979–19961 - Volume 5, Number 6—December 1999 - Emerging Infectious Disease journal - CDC">{{cite web |url=https://wwwnc.cdc.gov/eid/article/5/6/99-0611_article#fn1 |title=Toxic Shock Syndrome in the United States: Surveillance Update, 1979–19961 - Volume 5, Number 6—December 1999 - Emerging Infectious Disease journal - CDC |format= |work= |accessdate=}}</ref> Apart from menstruation associated TSS, non-menstruating cases having a skin or soft tissue infection have also been identified.<ref name="pmid218606652">{{cite journal |vauthors=DeVries AS, Lesher L, Schlievert PM, Rogers T, Villaume LG, Danila R, Lynfield R |title=Staphylococcal toxic shock syndrome 2000-2006: epidemiology, clinical features, and molecular characteristics |journal=PLoS ONE |volume=6 |issue=8 |pages=e22997 |year=2011 |pmid=21860665 |pmc=3157910 |doi=10.1371/journal.pone.0022997 |url=}}</ref>  
* Toxic shock syndrome (TSS) became a nationally notifiable disease in 1983. After the initial epidemic, the number of reported cases decreased significantly. <ref name="urlToxic Shock Syndrome (Other Than Streptococcal) | Summary | NNDSS">{{cite web |url=https://wwwn.cdc.gov/nndss/conditions/toxic-shock-syndrome-other-than-streptococcal/ |title=Toxic Shock Syndrome (Other Than Streptococcal) &#124; Summary &#124; NNDSS |format= |work= |accessdate=}}</ref>
* In a study conducted during 2000-2006, the average annual incidence per 100,000 persons of all TSS cases was 0.52 cases (95% CI, 0.32–0.77), of menstrual cases was 0.69 (95% CI, 0.39–1.16), and of non-menstrual cases was 0.32 (95% CI, 0.12–0.67). Women aged 13–24 years had the highest incidence with an annual rate of menstrual TSS of 1.41 cases per 100,000.  <ref name="pmid218606653">{{cite journal |vauthors=DeVries AS, Lesher L, Schlievert PM, Rogers T, Villaume LG, Danila R, Lynfield R |title=Staphylococcal toxic shock syndrome 2000-2006: epidemiology, clinical features, and molecular characteristics |journal=PLoS ONE |volume=6 |issue=8 |pages=e22997 |year=2011 |pmid=21860665 |pmc=3157910 |doi=10.1371/journal.pone.0022997 |url=}}</ref>
* Incidence rates declined from 6 to 12 per 100,000 among women 12-49 years of age in 1980 to 1 per 100,000 among women 15-44 years of age in 1986.<ref name="urlToxic Shock Syndrome in the United States: Surveillance Update, 1979–19961 - Volume 5, Number 6—December 1999 - Emerging Infectious Disease journal - CDC">{{cite web |url=https://wwwnc.cdc.gov/eid/article/5/6/99-0611_article#fn1 |title=Toxic Shock Syndrome in the United States: Surveillance Update, 1979–19961 - Volume 5, Number 6—December 1999 - Emerging Infectious Disease journal - CDC |format= |work= |accessdate=}}</ref>
* Apart from menstruation associated TSS, non-menstruating cases having a skin or soft tissue infection have also been identified.<ref name="pmid218606652">{{cite journal |vauthors=DeVries AS, Lesher L, Schlievert PM, Rogers T, Villaume LG, Danila R, Lynfield R |title=Staphylococcal toxic shock syndrome 2000-2006: epidemiology, clinical features, and molecular characteristics |journal=PLoS ONE |volume=6 |issue=8 |pages=e22997 |year=2011 |pmid=21860665 |pmc=3157910 |doi=10.1371/journal.pone.0022997 |url=}}</ref>  
* In a study conducted during 2000-2006, the average annual incidence per 100,000 persons of all TSS cases was 0.52 cases (95% CI, 0.32–0.77), of menstrual cases was 0.69 (95% CI, 0.39–1.16), and of non-menstrual cases was 0.32 (95% CI, 0.12–0.67). <ref name="pmid218606655">{{cite journal |vauthors=DeVries AS, Lesher L, Schlievert PM, Rogers T, Villaume LG, Danila R, Lynfield R |title=Staphylococcal toxic shock syndrome 2000-2006: epidemiology, clinical features, and molecular characteristics |journal=PLoS ONE |volume=6 |issue=8 |pages=e22997 |year=2011 |pmid=21860665 |pmc=3157910 |doi=10.1371/journal.pone.0022997 |url=}}</ref>
* Women aged 13–24 years had the highest incidence with an annual rate of menstrual TSS of 1.41 cases per 100,000.  <ref name="pmid218606653">{{cite journal |vauthors=DeVries AS, Lesher L, Schlievert PM, Rogers T, Villaume LG, Danila R, Lynfield R |title=Staphylococcal toxic shock syndrome 2000-2006: epidemiology, clinical features, and molecular characteristics |journal=PLoS ONE |volume=6 |issue=8 |pages=e22997 |year=2011 |pmid=21860665 |pmc=3157910 |doi=10.1371/journal.pone.0022997 |url=}}</ref>


* MRSA strains have increased in prevalence during the last decade and MRSA have been reported as the cause of TSS.<ref name="pmid21860665">{{cite journal |vauthors=DeVries AS, Lesher L, Schlievert PM, Rogers T, Villaume LG, Danila R, Lynfield R |title=Staphylococcal toxic shock syndrome 2000-2006: epidemiology, clinical features, and molecular characteristics |journal=PLoS ONE |volume=6 |issue=8 |pages=e22997 |year=2011 |pmid=21860665 |pmc=3157910 |doi=10.1371/journal.pone.0022997 |url=}}</ref>
* MRSA strains have increased in prevalence during the last decade and MRSA have been reported as the cause of TSS.<ref name="pmid21860665">{{cite journal |vauthors=DeVries AS, Lesher L, Schlievert PM, Rogers T, Villaume LG, Danila R, Lynfield R |title=Staphylococcal toxic shock syndrome 2000-2006: epidemiology, clinical features, and molecular characteristics |journal=PLoS ONE |volume=6 |issue=8 |pages=e22997 |year=2011 |pmid=21860665 |pmc=3157910 |doi=10.1371/journal.pone.0022997 |url=}}</ref>


===Gender based differences===
===Gender ===
* Approximately half the cases of staphylococcal TSS reported today are associated with tampon use during [[menstruation]], usually in young women, though TSS also occurs in children, men, and non-menstruating women.  
* Approximately half the cases of staphylococcal TSS reported today are associated with tampon use during [[menstruation]], usually in young women, though TSS also occurs in children, men, and non-menstruating women.  


* Women aged 13–24 years had the highest incidence with an annual rate of menstrual TSS of 1.41 cases per 100,000 based on incidence data from 2000-2003.
* Menstruating females had the highest incidence with an annual rate of menstrual TSS of 1.41 cases per 100,000 based on incidence data from 2000-2003.<ref name="pmid218606654">{{cite journal |vauthors=DeVries AS, Lesher L, Schlievert PM, Rogers T, Villaume LG, Danila R, Lynfield R |title=Staphylococcal toxic shock syndrome 2000-2006: epidemiology, clinical features, and molecular characteristics |journal=PLoS ONE |volume=6 |issue=8 |pages=e22997 |year=2011 |pmid=21860665 |pmc=3157910 |doi=10.1371/journal.pone.0022997 |url=}}</ref>
* It has been estimated that each year 1 to 17 of every 100,000 menstruating females will get TSS. In the US in 1997, only five confirmed menstrual-related TSS cases were reported, compared with 814 cases in 1980, according to data from the [[Centers for Disease Control and Prevention (CDC).]]
* It has been estimated that each year 1 to 17 of every 100,000 menstruating females will get TSS. In the US in 1997, only five confirmed menstrual-related TSS cases were reported, compared with 814 cases in 1980, according to data from the [[Centers for Disease Control and Prevention (CDC).]]
* About 25 percent of non-menstrual cases of Toxic shock syndrome occur in males.
=== Age ===
* Women aged 13–24 years have the highest incidence with an annual rate of menstrual TSS of 1.41 cases per 100,000.<ref name="pmid218606656">{{cite journal |vauthors=DeVries AS, Lesher L, Schlievert PM, Rogers T, Villaume LG, Danila R, Lynfield R |title=Staphylococcal toxic shock syndrome 2000-2006: epidemiology, clinical features, and molecular characteristics |journal=PLoS ONE |volume=6 |issue=8 |pages=e22997 |year=2011 |pmid=21860665 |pmc=3157910 |doi=10.1371/journal.pone.0022997 |url=}}</ref>
* To date, 42% of cases have occurred in females under the age of 19 years. <ref name="pmid6643206">{{cite journal |vauthors=Litt IF |title=Toxic shock syndrome--an adolescent disease |journal=J Adolesc Health Care |volume=4 |issue=4 |pages=270–4 |year=1983 |pmid=6643206 |doi= |url=}}</ref>
* To date, 42% of cases have occurred in females under the age of 19 years. <ref name="pmid6643206">{{cite journal |vauthors=Litt IF |title=Toxic shock syndrome--an adolescent disease |journal=J Adolesc Health Care |volume=4 |issue=4 |pages=270–4 |year=1983 |pmid=6643206 |doi= |url=}}</ref>
* About 25 percent of non-menstrual cases of Toxic shock syndrome occur in males.


==References==
=== Race ===
* Epidemiology studies conducted in the late 1980s showed that women who develop [[Toxic shock syndrome|mTSS]] tended to be predominately white. <ref name="pmid2928646">{{cite journal |vauthors=Gaventa S, Reingold AL, Hightower AW, Broome CV, Schwartz B, Hoppe C, Harwell J, Lefkowitz LK, Makintubee S, Cundiff DR |title=Active surveillance for toxic shock syndrome in the United States, 1986 |journal=Rev. Infect. Dis. |volume=11 Suppl 1 |issue= |pages=S28–34 |year=1989 |pmid=2928646 |doi= |url=}}</ref>
* White population are more likely to be carriers of toxigenic ''[[Staphylococcus|S. aureus]]'' than black, Hispanic, or Asian population.<ref name="pmid16145118">{{cite journal |vauthors=Parsonnet J, Hansmann MA, Delaney ML, Modern PA, Dubois AM, Wieland-Alter W, Wissemann KW, Wild JE, Jones MB, Seymour JL, Onderdonk AB |title=Prevalence of toxic shock syndrome toxin 1-producing Staphylococcus aureus and the presence of antibodies to this superantigen in menstruating women |journal=J. Clin. Microbiol. |volume=43 |issue=9 |pages=4628–34 |year=2005 |pmid=16145118 |pmc=1234102 |doi=10.1128/JCM.43.9.4628-4634.2005 |url=}}</ref>
 
== References ==
{{reflist|2}}
{{reflist|2}}


Revision as of 19:41, 30 May 2017

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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

Approximately half the cases of staphylococcal TSS reported today are associated with tampon use during menstruation, usually in young women and up till now 42% of cases have occurred in females under the age of 19 years, though TSS also occurs in children, men, and non-menstruating women.

Epidemiology and Demographics

Incidence

  • Toxic shock syndrome (TSS) became a nationally notifiable disease in 1983. After the initial epidemic, the number of reported cases decreased significantly. [1]
  • Incidence rates declined from 6 to 12 per 100,000 among women 12-49 years of age in 1980 to 1 per 100,000 among women 15-44 years of age in 1986.[2]
  • Apart from menstruation associated TSS, non-menstruating cases having a skin or soft tissue infection have also been identified.[3]
  • In a study conducted during 2000-2006, the average annual incidence per 100,000 persons of all TSS cases was 0.52 cases (95% CI, 0.32–0.77), of menstrual cases was 0.69 (95% CI, 0.39–1.16), and of non-menstrual cases was 0.32 (95% CI, 0.12–0.67). [4]
  • Women aged 13–24 years had the highest incidence with an annual rate of menstrual TSS of 1.41 cases per 100,000.  [5]
  • MRSA strains have increased in prevalence during the last decade and MRSA have been reported as the cause of TSS.[6]

Gender

  • Approximately half the cases of staphylococcal TSS reported today are associated with tampon use during menstruation, usually in young women, though TSS also occurs in children, men, and non-menstruating women.
  • Menstruating females had the highest incidence with an annual rate of menstrual TSS of 1.41 cases per 100,000 based on incidence data from 2000-2003.[7]
  • It has been estimated that each year 1 to 17 of every 100,000 menstruating females will get TSS. In the US in 1997, only five confirmed menstrual-related TSS cases were reported, compared with 814 cases in 1980, according to data from the Centers for Disease Control and Prevention (CDC).
  • About 25 percent of non-menstrual cases of Toxic shock syndrome occur in males.

Age

  • Women aged 13–24 years have the highest incidence with an annual rate of menstrual TSS of 1.41 cases per 100,000.[8]
  • To date, 42% of cases have occurred in females under the age of 19 years. [9]

Race

  • Epidemiology studies conducted in the late 1980s showed that women who develop mTSS tended to be predominately white. [10]
  • White population are more likely to be carriers of toxigenic S. aureus than black, Hispanic, or Asian population.[11]

References

  1. ↑ "Toxic Shock Syndrome (Other Than Streptococcal) | Summary | NNDSS".
  2. ↑ "Toxic Shock Syndrome in the United States: Surveillance Update, 1979–19961 - Volume 5, Number 6—December 1999 - Emerging Infectious Disease journal - CDC".
  3. ↑ DeVries AS, Lesher L, Schlievert PM, Rogers T, Villaume LG, Danila R, Lynfield R (2011). "Staphylococcal toxic shock syndrome 2000-2006: epidemiology, clinical features, and molecular characteristics". PLoS ONE. 6 (8): e22997. doi:10.1371/journal.pone.0022997. PMC 3157910. PMID 21860665.
  4. ↑ DeVries AS, Lesher L, Schlievert PM, Rogers T, Villaume LG, Danila R, Lynfield R (2011). "Staphylococcal toxic shock syndrome 2000-2006: epidemiology, clinical features, and molecular characteristics". PLoS ONE. 6 (8): e22997. doi:10.1371/journal.pone.0022997. PMC 3157910. PMID 21860665.
  5. ↑ DeVries AS, Lesher L, Schlievert PM, Rogers T, Villaume LG, Danila R, Lynfield R (2011). "Staphylococcal toxic shock syndrome 2000-2006: epidemiology, clinical features, and molecular characteristics". PLoS ONE. 6 (8): e22997. doi:10.1371/journal.pone.0022997. PMC 3157910. PMID 21860665.
  6. ↑ DeVries AS, Lesher L, Schlievert PM, Rogers T, Villaume LG, Danila R, Lynfield R (2011). "Staphylococcal toxic shock syndrome 2000-2006: epidemiology, clinical features, and molecular characteristics". PLoS ONE. 6 (8): e22997. doi:10.1371/journal.pone.0022997. PMC 3157910. PMID 21860665.
  7. ↑ DeVries AS, Lesher L, Schlievert PM, Rogers T, Villaume LG, Danila R, Lynfield R (2011). "Staphylococcal toxic shock syndrome 2000-2006: epidemiology, clinical features, and molecular characteristics". PLoS ONE. 6 (8): e22997. doi:10.1371/journal.pone.0022997. PMC 3157910. PMID 21860665.
  8. ↑ DeVries AS, Lesher L, Schlievert PM, Rogers T, Villaume LG, Danila R, Lynfield R (2011). "Staphylococcal toxic shock syndrome 2000-2006: epidemiology, clinical features, and molecular characteristics". PLoS ONE. 6 (8): e22997. doi:10.1371/journal.pone.0022997. PMC 3157910. PMID 21860665.
  9. ↑ Litt IF (1983). "Toxic shock syndrome--an adolescent disease". J Adolesc Health Care. 4 (4): 270–4. PMID 6643206.
  10. ↑ Gaventa S, Reingold AL, Hightower AW, Broome CV, Schwartz B, Hoppe C, Harwell J, Lefkowitz LK, Makintubee S, Cundiff DR (1989). "Active surveillance for toxic shock syndrome in the United States, 1986". Rev. Infect. Dis. 11 Suppl 1: S28–34. PMID 2928646.
  11. ↑ Parsonnet J, Hansmann MA, Delaney ML, Modern PA, Dubois AM, Wieland-Alter W, Wissemann KW, Wild JE, Jones MB, Seymour JL, Onderdonk AB (2005). "Prevalence of toxic shock syndrome toxin 1-producing Staphylococcus aureus and the presence of antibodies to this superantigen in menstruating women". J. Clin. Microbiol. 43 (9): 4628–34. doi:10.1128/JCM.43.9.4628-4634.2005. PMC 1234102. PMID 16145118.


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