Device-associated menstrual toxic shock syndrome

Abstract

In the 1980s, menstrual toxic shock syndrome (mTSS) became a house-hold topic, particularly among mothers and their daughters. The research performed at the time, and for the first time, exposed the American public as well as the bio-medical community, in a major way, to understanding disease progression and in-vestigation. Those studies led to the identification of the cause, Staphylococcus au-reus and the pyrogenic toxin superantigen TSS toxin 1 (TSST-1), and many of the risk factors, for example, tampon use. Those studies in turn led to TSS warning labels on the outside and inside of tampon boxes and, as important, uniform standards world-wide of tampon absorbency labeling. This review addresses our understanding of the development and conclusions related to mTSS and risk factors. We leave the fi-nal message that even though mTSS is not commonly in the news today, cases continue to occur. Additionally, S. aureus strains cycle in human populations in roughly 10-year intervals, possibly dependent on immune status. TSST-1-producing S. aureus bacteria appear to be reemerging, suggesting that physician awareness of this emergence and mTSS history should be heightened.