Toxic shock syndrome is a relatively rare health problem. However, the seriousness of the condition warrants a better understanding of its causes, so it can be prevented.

Toxins that cause quite a shock

Toxic shock syndrome (TSS) is a disease that occurs after a bacterial infection. Although it is very rare, it requires emergency hospitalization. TSS can seriously affect organs such as the liver, lungs, heart, and kidneys, and can be fatal if it is not treated quickly.

TSS occurs when toxins are released by bacteria that has successfully penetrated the skin through a wound or mucous membrane and has spread in the blood. The bacteria responsible for TSS can be present in the nose, mouth, throat or vagina of a great number of people.

Often, this bacteria is not very threatening and does not cause infection, or causes only minor ones. However, in some circumstances, it can cause severe infection such as TSS.

Among the main causes of TSS, we typically find:

• a wound infection following injury, a burn, surgery or childbirth
• a skin infection
• improper use of tampons
• extended wear of a diaphragm, contraceptive sponge or cervical cap

Certain people have a higher risk of suffering from TSS, such as those with:

• a weakened immune system (i.e., HIV, chemotherapy, radiation therapy, etc.)
• a chronic disease (i.e., diabetes, cancer, alcoholism, kidney failure, etc.)

Signs and symptoms of TSS

The signs and symptoms of TSS may resemble those of the flu and typically include:

• fever
• nausea
• vomiting
• diarrhea
• dizziness
• confusion
• hypotension (low blood pressure)
• sore throat
• muscle pain
• desquamation (scaling) and skin eruption

TSS symptoms generally manifest themselves within twelve hours following surgery, childbirth, and after three to five days of tampon or intrauterine device use.

Prevention of TSS associated with tampon use

Inappropriate use of tampons is one of the most frequent causes of TSS. Extended wear of the same tampon or a tampon with a higher absorption capacity than what is actually needed can increase the risk of TSS, as it can cause vaginal dryness, irritation or lesions, creating a point of entry for bacteria.

Caution! It is important to understand that TSS is not due to tampons themselves, but to a combination of circumstances surrounding their improper use. There is no indication suggesting that the material used in tampons is at issue.

Here is some advice to take into consideration to prevent toxic shock due to the use of tampons:

• Use tampons only when you have your period.
• Choose tampons with an absorption capacity that corresponds to your actual needs (avoid "super absorbent" tampons if possible).
• Avoid wearing a tampon during the night; wear sanitary napkins instead.
• Change tampons every four to eight hours.
• Alternate between wearing a tampon and a sanitary napkin.
• Make sure you remember to remove a tampon, whether or not it is soiled.
• Wash your hands before and after manipulating tampons.

Don’t hesitate to speak to your pharmacist for additional information about toxic shock syndrome and the ways to prevent it.