What is toxic shock syndrome (TSS)?
The toxic shock syndrome (usually abbreviated to: TSS) is a rare but severe form of infection with certain strains of Staphylococcus aureus and Streptococcus pyogenes. The media is sometimes referred to as the 'tampon disease "but this is certainly not the only form in which the disease manifests itself.
This disease can occur in men, women and children. The bacterium which causes the disease, Staphylococcus aureus, is very common and is familiar to everyone sometimes present on the skin or in the nose but usually does not cause serious infections, although many pimples and other superficial inflammation of the skin there are caused by as well as boils. In hospitals, the bacterium is feared because of wound infections.
This disease can originate from improper use of a tampon, especially the habit too long in keeping highly absorbent tampons. This allows the vaginal fluid may accumulate in the tampon form a breeding ground. Staphylococcus aureus can multiply it over easily. Hence it is not recommended the use of highly absorbent tampons. The disease can be fatal (5% of the victims dies of it), but it is now extremely rare. The name is derived from the fact that the symptoms can lead to shock. The disease is most common among girls at puberty and women under 30. Toxic shock syndrome can occur during menstruation and after. It may be that not all symptoms occur simultaneously.
Toxic shock syndrome symptoms include:
- flu symptoms (diarrhea, muscle aches, chills)
- vomiting;
- high fever;
- sunburn symptoms on the skin;
- dizziness, disorientation;
- low blood pressure / tachycardia.
- peeling of the skin, in a further stage of the disease
The disease affects organs. The disease may eventually lead to organ failure, which is the cause of death for people who die from the disease.
If the disease is detected in time, they can be fairly easily treated with antibiotics. People who are in shock, are transferred to the intensive care unit, where the organ functions properly be held in the holes. If the patient is there on top again, is the probability that the disease returns quite large (30%).
In people with toxic shock syndrome, growing bacteria which are harmless in normal amount (Staphyloccoccus aureus) so quickly, that they leave on the immune system to respond. The Staphylococcus aureus was isolated at more than 90% of the TSS patients. A specific exotoxin (TSST-1) which is produced by this specific S. aureus strains, appears to be responsible for the (sometimes fatal) effect. Until now, one has obtained all cultures resistant to ordinary penicillin.
Toxic shock syndrome tampons
At the end of the 1970s were mainly the users of tampons by the brand Rely affected by TSS. This tampons were made from synthetic fibers and had a high absorption rate. The tampons were taken off the market in 1980, and other brands of tampons make safer went less absorbed and natural cotton were made.
The risk of toxic shock syndrome is not entirely eliminated. One should therefore replace the tampon regularly (at least 3 times a day).
Studies have shown that there is a relationship between TSS and the use of tampons. It is important not to infect the tampon before he is inserted. Staphylococci are usually present on the vulva; contact the pubic area must therefore be avoided. If mouth sores on the fingers should touch the tampon has to be avoided. These suspicions were confirmed in a study dating from 1982 which studied the changes that occur in the bacterial flora of the vagina during the menstrual cycle in order to establish a relationship with TSS. Cultures were taken in the middle of the cycle and during menstruation at twelve women who sanitary napkins and forty women who used tampons.
Staphylococcus aureus was in the middle of the cycle and detected during the menstruation in three women, during menstruation only in six women and in none of them in the middle of the cycle. This result confirms that there is a link between S. aureus and menstruation. No difference was found in the incidence of S. aureus' at tampon users (18%), and users of sanitary napkins (17%).
In a similar study, samples were taken of the Staphylococcus aureus and other bacteria at 58 and 25 tampon users users of zeesponsjes. The population of S. aureus increased during menstruation in both groups, but to the users of the zeesponsjes more clearly than in the tampon users. Zeesponsjes are not a good alternative to tampons.
Forty percent of the women had never used tampons. Significantly more whites than blacks used only tampons (26 percent) or together with sanitary napkins (36 percent). Proportionally more blacks used alone tampons (16 percent) in combination with tampons or sanitary napkins (27 percent), compared with the Mexican Americans of which 11 percent were using only tampons and tampons 21 percent in combination with sanitary napkins.
As used much of the black women tampons, ethnic differences are cited in some studies TSS not the only explanation why TSS is less prevalent in black women.
From a study published in 1985 shows that tampons can damage the vaginal mucosa. In their study, one hundred women were studied for three consecutive menstrual cycles. Three groups of twenty women used each have the normal, super and super-plus tampon variants that had to be inserted by hand. Two other groups of twenty women used sanitary napkins, or a tampon which has been inserted with an applicator.
For all tampon users dried the vaginal mucosa more clearly than in users of sanitary napkins. This can result in microscopic cracks, through which bacteria can enter. The risk of dehydration of the mucous membrane was greater among women who tampon brought in manually. Furthermore, it also revealed a correlation between the strength of absorbatie and TSS exists: the more moisture the pad can absorb, the greater the risk of toxic shock syndrome.