Is Toxic Shock Syndrome Something To Worry About?

by Gina M. Florio

After 24-year-old LA model Lauren Wasser contracted Toxic Shock Syndrome (TSS) and subsequently lost her leg, she has been raising awareness about the condition — and suing Kotex Natural Balance — to ensure no other female has to suffer in the same way. In 2012, she went to bed feeling under the weather, only to wake up shortly after to survive a massive heart attack that shut down her organs. She claimed to have changed her tampon three times that day, but the one that was being used at the time tested positive for TSS. This frightening story has sparked a whole new conversation about TSS; for a while there, it flew under the radar as a major health concern. But the doors have been blown wide open, and we can't help but wonder how much of a risk TSS really is for women everywhere.

I know that I'm certainly not the most responsible when it comes to keeping track of how long my tampon or menstrual cup has been sitting in there, and I'm sure I'm not the only female in the world who has forgotten to switch them out after sleeping in on a Saturday morning. Thinking about how much of our lives we spend with a tampon inserted, the topic is certainly worth our time and attention.

Tracy Stewart, director of the Absorpent Hygeine Products Manufacturers Association, told the Huffington Post that tampons shouldn't be our only concern when it comes to worrying about this syndrome. Anything internally worn device holds risk, and an effective way to move forward is to build awareness of TSS in general — because sometimes the warnings on the packaging just isn't enough.

So it pays to start from the beginning, ensuring we have all the information we need to prevent Lauren Wasser's tragedy from happening to another innocent woman. Here are the facts you need to know about TSS.

What Is Toxic Shock Syndrome (TSS)?

Toxic Shock Sydrome is a rare bacterial infection caused by Staphylococcus aureus and Streptococcus pyogenes bacteria. That's basically a very scientific way of saying that there are certain toxins that come from either staph or strep bacteria. These two are different in the way they divide cells and form; the former is found on the skin while the latter lives in the respiratory tract. This syndrome is very rare, but it can be extremely dangerous — life-threatening, even. There are two things that have to happen for TSS to develop and harm the body: First, staph bacteria must be in an environment where it can thrive and grow at a rapid pace, and release harmful toxins; second, those same toxins must get into the bloodstream.

The condition was first named in 1978 when a pediatrician saw the same illness in seven children, boys and girls alike, between the ages of eight and 17. Years later, doctors would make the connection between the females and the fact that they were menstruating and using tampons. However, the exact cause for the boys' condition remains unknown. Reports note that it might have been around as early as 1927, but there simply weren't enough documentation to know for sure.

Are Tampons The Only Cause Of TSS?

Although our trusty tampons are the most common cause of TSS, we would be silly to think that they are the only ways to contract it. Localized infections such as insect bites, burns, and boils can also cause TSS — the chicken pox can even spark it. The bacteria that acts as the culprit usually just resides on the skin, nose, and mouth; they only become dangerous, though, when they enter the bloodstream to emit the poisonous toxins, which is why the topical, shallow injuries can result in TSS just as much as tampons can.

The exact link between tampons and TSS is actually unclear. Dr. Samadi says staph is naturally present in the vagina without causing harm. Tampons left in too long definitely increase the risk because they become highly saturated with blood, making it a prime place for bacteria to grow and insert its way into the bloodstream. Said bacteria is more likely to be an enemy among polyester foam, so look for tampons that are made of cotton or rayon fibers instead.

How Common Is It?

According to the Center for Disease Control and Prevention, the United States saw 59 cases of TSS in 2014, and, so far, there have been 26 cases this year. The precise number of cases that are related to tampons isn't clear, but experts assume that about half of them are connected with menstruation. Dr. Mary Jane Minkin, OBGYN professor at the Yale School of Medicine, reminds us that these statistics are extremely low, especially compared to the injuries we see in car accidents and other everyday activities we take part in.

Because cases are so few and far in between, we are usually made aware of them when they happen. In 2013, a 14-year-old girl named Natasha Scott-Falber in the UK died in her sleep after she forgot to check on her tampon. Doctors claim the syndrome is much more common in young people; it's even said that we develop an immunity to the bacteria as we get older, so the elderly rarely face from TSS.

What Are The Symptoms?

Pay close attention, because the signs don't start where you'd think they would. You might just think you're coming down with a stomach bug, like Natasha Scott-Falber did — common signs are fever, headache, nausea and vomiting, low blood pressure, and diarrhea. Other symptoms include confusion, red eyes, and a sunburn-like rash that appears on the palms of your hands and the soles of your feet. There won't be any signals coming from your vaginal region.

As it did for Lauren Wasser, who was only 10 minutes away from death, the infection can spread quite quickly, resulting in multiple organ failure and fatality. Because the symptoms are not what we expect, it's important to keep them in mind — that way, if you're in trouble, you can stop the toxins from spreading before it's too late.

How Can I Avoid It?

Even though all this talk doesn't give tampons the best rap, many professionals say it is still safe to use them — as long as you are smart about how you do it. Follow the directions on the box, to start, and only use one tampon for four to eight hours at a time. If you sleep for longer, use a maxi pad. Women are also urged to avoid tampons that are higher absorbency so that you encourage yourself to change it more often; also, experts say it's best not to have a dry tampon inside of you.

Instead of reaching for tampons on your lighter days, go with a panty liner. Wash your hands as frequently as possible, and keep any cuts clean to avoid the bacteria from getting into the bloodstream.

The bottom line? TSS is rare, but worth being aware of. That said, when it comes to using tampons and our health, we might want to be more concerned about the pesticides and bleach used to make them — ingredients which remain largely unregulated. But that's a whole other story.

Images: orbakhopper /Flickr; theimpossiblemuse, tampax (2), visionlosangeles, ubykotex/Instagram