Reduced incidence of menstrual toxic-shock syndrome--United States, 1980-1990
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Reduced incidence of menstrual toxic-shock syndrome--United States, 1980-1990

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      In May 1980, investigators reported to CDC 55 cases of toxic-shock syndrome (TSS) (1), a newly recognized illness characterized by high fever, sunburn-like rash, desquamation, hypotension, and abnormalities in multiple organ systems (2). Fifty-two (95%) of the reported cases occurred in women; onset of illness occurred during menstruation in 38 (95%) of the 40 women from whom menstrual history was obtained. National and state-based studies were initiated to determine risk factors for this disease. In addition, CDC established national surveillance to assess the magnitude of illness and follow trends in disease occurrence; 3295 definite cases have been reported since surveillance was established (Figure 1). In June 1980, a follow-up report described three studies which detected an association between TSS and the use of tampons (3). Case-control studies in Wisconsin and Utah and a national study by CDC indicated that women with TSS were more likely to have used tampons than were controls. The CDC study also found that continuous use of tampons was associated with a higher risk of TSS than was alternating use of tampons and other menstrual products. Subsequent studies established that risk of TSS was substantially greater in women who used RelyPr* brand tampons than in users of other brands and that risk increased with increased tampon absorbency (4-6). In September 1980, RelyPr tampons were voluntarily withdrawn from the market by the manufacturer. In 1980, 890 cases of TSS were reported, 812 (91%) of which were associated with menstruation. In 1989, 61 cases of TSS were reported, 45 (74%) of which were menstrual. In 1980, 38 (5%) of 772 women with menstrual TSS died; in 1988 and 1989, there were no deaths among women with menstrual TSS. Reported by: Meningitis and Special Pathogens Br, Div of Bacterial Diseases, Center for Infectious Diseases, CDC.
    • Source:
      MMWR Morb Mortal Wkly Rep. 1990 Jun 29;39(25):421-3.
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