Toxic shock syndrome historical perspective: Difference between revisions
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==Historical Perspective== | |||
===Initial description of toxic shock syndrome=== | |||
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.<ref>{{cite journal |author=Todd J, Fishaut M, Kapral F, Welch T |title=Toxic-shock syndrome associated with phage-group-I staphylococci |journal=Lancet |volume=2 |issue=8100 |pages=1116-1118 |year=1978 |pmid=82681}}</ref> 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.<ref>{{cite journal |author=Todd J |title=Toxic shock syndrome--scientific uncertainty and the public media |journal=Pediatrics |volume=67 |issue=6 |pages=921-923 |year=1981 |pmid=7232057}}</ref> | |||
===Rely tampons=== | |||
Following a controversial period of test marketing in Rochester, New York and Fort Wayne, Indiana<ref name="MUM-Rely">{{cite web|author=Finley, Harry|url=http://www.mum.org/Rely.htm|title=Rely Tampon: It Even Absorbed the Worry!|work=Museum of Menstruation|accessdate=2006-03-20}}</ref>, in August of 1978 Procter and Gamble introduced superabsorbent Rely tampons to the United States market<ref>{{cite journal|author=Hanrahan S|title=Historical review of menstrual toxic shock syndrome|journal=Women Health|volume=21|issue=2-3|pages=141-65|year=1994|pmid=8073784}}</ref> in response to women's demands for tampons that could contain an entire menstrual flow without leaking or replacement.<ref name="Collegian2003-Citrinbaum"/> Rely used [[Carboxymethyl cellulose|carboxymethylcellulose]] (CMC) and compressed beads of [[polyester]] for absorption. This tampon design could absorb nearly 20 times its own weight in fluid<ref name="TTS1997-Vitale">{{cite web|author=Vitale, Sidra|year=1997|url=http://www.io.com/~wwwomen/menstruation/tss.html|title=Toxic Shock Syndrome|publisher=Web by Women, for Women|accessdate=2006-03-20}}</ref>. Further, the tampon would "blossom" into a cup shape in the vagina in order to hold menstrual fluids. | |||
In January 1980, epidemiologists in Wisconsin and Minnesota reported the appearance of TSS, mostly in menstruating women, to the CDC.<ref>CDC 1980. "Toxic-shock syndrome--United States." ''MMWR'' '''29'''(20):229-230.</ref> [[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.<ref>CDC 1980. "Follow-up on toxic-shock syndrome." ''MMWR'' '''29'''(37):441-445.</ref> | |||
On September 22, 1980, Procter and Gamble recalled Rely<ref>{{cite journal|author=Hanrahan S|title=Historical review of menstrual toxic shock syndrome|journal=Women Health|volume=21|issue=2-3|pages=141-165|year=1994|pmid=8073784}}</ref> following release of the [[Centers for Disease Control and Prevention|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".<ref name="History2001-Kohen">{{cite web|author=Kohen, Jamie|year=2001|url= http://www.google.com/searchq=cache:wqVsFR5FlQwJ:leda.law.harvard.edu/leda/data/359/Kohen.rtf+rely+tampons&hl=en&gl=us&ct=clnk&cd=15|title=The History and Regulation of Menstrual Tampons|work=[http://leda.law.harvard.edu/leda/data/359/Kohen.rtf RTF document]|accessdate=2006-03-30}}</ref> 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.<ref>{{cite journal|author= Petitti D, Reingold A, Chin J|title=The incidence of toxic shock syndrome in Northern California. 1972 through 1983|journal= JAMA|volume=255|issue=3|pages=368-72|year=1986|pmid=3941516}}</ref> 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.<ref>{{cite journal |author=Berkley S, Hightower A, Broome C, Reingold A|title=The relationship of tampon characteristics to menstrual toxic shock syndrome|journal=JAMA|volume=258|issue=7|pages=917-20|year=1987|pmid=3613021}}</ref> The ability of carboxymethylcellulose to filter the ''S. aureus'' toxin that causes TSS may account for the increased risk associated with Rely.<ref name="TTS1997-Vitale"/> | |||
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. | |||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Historical Perspective
Initial description of toxic shock syndrome
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] 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.[2]
Rely tampons
Following a controversial period of test marketing in Rochester, New York and Fort Wayne, Indiana[3], in August of 1978 Procter and Gamble introduced superabsorbent Rely tampons to the United States market[4] in response to women's demands for tampons that could contain an entire menstrual flow without leaking or replacement.[5] Rely used carboxymethylcellulose (CMC) and compressed beads of polyester for absorption. This tampon design could absorb nearly 20 times its own weight in fluid[6]. Further, the tampon would "blossom" into a cup shape in the vagina in order to hold menstrual fluids.
In January 1980, epidemiologists in Wisconsin and Minnesota reported the appearance of TSS, mostly in menstruating women, to the CDC.[7] 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.[8]
On September 22, 1980, Procter and Gamble recalled Rely[9] 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".[10] 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.[11] 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.[12] The ability of carboxymethylcellulose to filter the S. aureus toxin that causes TSS may account for the increased risk associated with Rely.[6]
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.
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.
- ↑ Todd J (1981). "Toxic shock syndrome--scientific uncertainty and the public media". Pediatrics. 67 (6): 921–923. PMID 7232057.
- ↑ Finley, Harry. "Rely Tampon: It Even Absorbed the Worry!". Museum of Menstruation. Retrieved 2006-03-20.
- ↑ Hanrahan S (1994). "Historical review of menstrual toxic shock syndrome". Women Health. 21 (2–3): 141–65. PMID 8073784.
- ↑
- ↑ 6.0 6.1 Vitale, Sidra (1997). "Toxic Shock Syndrome". Web by Women, for Women. Retrieved 2006-03-20.
- ↑ 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.