Toxic Shock Syndrome associated with use of superabsorbent tampons

Toxic Shock Syndrome (TSS) has been associated primarily with the use of superabsorbent tampons, though the incidents of TSS in menstruating women have declined since manufacturers pulled certain types of tampons off the market.

According to Kotex® health expert Dr Nokukhanya Khanyile: “Toxic Shock Syndrome is a very serious, life-threatening condition that is caused when the toxins produced by bacteria called Staphylococcus aureus or Streptococcus pyogenes get access to the bloodstream. Multiple organs are involved, and you may require surgery or prolonged hospital admission to help you recover. Both men and women, young and old, menstruating or not, can get TSS.”

What causes it?

Staphylococcus aureus is a bacteria that normally lives on the skin but because of barriers like the skin and mucous membranes as well as the body’s ability to fight infection, it is less likely to cause disease in a healthy person.

However, if there is a risk factor, you are more likely to develop this condition.

Risk factors include:

• Tampon use: use of highly absorbent tampons, using tampons for prolonged periods outside of menstruation and keeping one tampon in place for a long time
• Vaginal colonisation of toxin-producing Staphylococcus aureus
• Procedures involving the ears, nose or throat
• Inadequate cleaning of the skin before any invasive surgical procedure
• Weakened immune response: stress, HIV infection, diabetes, cancer, steroid use, immunosuppressant drugs, and chemotherapy

What are the symptoms?

Some clues that you might be experiencing TSS include:

• Sudden onset of symptoms within 5-7 days of menstruation, invasive surgical procedure, delivery of a baby, or an abscess of the skin
• Rash
• Fever
• Severe body pain or pain in a localised area
• Shortness of breath or difficulty breathing
• Changes in your mental health
• Low blood pressure or hypotension

How can I get help?

It is important to be aware of the symptoms that you or someone you know may be experiencing because the earlier you get help, the less chance of developing complications. The treatment will depend on many things but can include:

• Antibiotic treatment given up to 14 days or longer depending on your presentation and results of laboratory investigations

• Surgical cleaning or removal of infected wounds or dead tissue

• Intravenous fluids, steroids and other medication to help prevent shock due to low blood pressure

• If you are unable to breathe adequately, you may need to have a tube inserted into your airway to help you breathe

• You may initially need an admission to an intensive or high care unit but once you start improving, you will be sent to a general ward

Dr Khanyile said: “The rates of TSS associated with menstruation have been declining over the years due to increasing awareness about the symptoms, improved access to information about maintaining menstrual hygiene as well as better access to clean water and electricity. So, make sure that you change your tampon at least [every 6-8 hours] and more frequently if it is full, and that you strengthen your immune system through regular exercise, water intake, diet and eating healthy.”

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