nearly forgotten, toxic shock may be on the rise - highly absorbent
The toxic shock syndrome associated with the use of tampon, 25 years ago, when the dangerous disease sickened thousands of Americans, tampon made headlinesS.
Women and dozens of deaths, according to doctors and other experts, could again be a public health threat.
Two leading researchers said that the number of cases reported to them by doctors across the country has increased over the past three years, although it is believed that this level is not as high as in 1980, peak years of toxic shock cases. And a U. S.
Food and Drug Administration officials recently said the agency received more and more reports of toxic shock syndrome related to the use of cotton strips.
The growth of this suspicion remains largely anecdotal, and government statistics are not available as federal researchers stopped active monitoring of TSS cases in 1987.
In Los Angeles County, five TSS were found last year among teenage girls using tampon-
According to doctors treating the girls, there have been four times since September.
Some health officials are concerned that the disease may reappear, and it is believed that when a TSS-related tampon brand withdrew from the market in 1980, the disease had basically disappeared.
This disease can happen quickly if people think tampon-
Experts say the relevant TSS is no longer a threat.
The apparent increase in TSS cases was "really surprising," the doctor said. Jay M.
Lieberman, director of pediatric infectious diseases at Long Beach Miller Children's Hospital, 4 of whom were treated.
"It will be fatal soon.
I think it is important that girls and their parents realize the potential of TSS if they wear tampon.
I don't want to scare people, but the disease is still there.
"At the University of California, Los Angeles Medical Center, doctors who treated a juvenile toxic shock syndrome last fall believe the diagnosis is very unusual, and they submitted a report to the medical journal.
"People don't think it's a diagnosis today," the doctor said . "
James Cherry is a professor of pediatric infectious diseases at the University of California, Los Angeles, David Geffen School of Medicine.
All the teenagers at the University of California, Los Angeles and Miller Children's Hospital are in critical condition, but survived. However, a 16-year-
According to a forensic doctor in Santa Clara County, a little girl in Santa Clara County died in a possible TSS on November.
"I have received calls from doctors from all over the country," said Patrick schleffter, professor of microbiology and immunology at the University of Minnesota who studied TSS.
"They said, 'Oh, I suddenly saw the case again, 'and they asked me what happened.
Basically, what we are seeing is a steady increase in the incidence rate that makes [Speed of TSS]is one-third to one-
When the incidence reaches a peak of about 1980, half.
"Although the incidence may increase, TSS is still a rare disease.
During the peak period in the early 80 s, about 10 cases were reported for every 100,000 menstrual women. In 1980, 772 U. S.
The development of women suffering from the disease and 38 deaths has caused headlines and has led many women to question the safety of tampon.
The cause of this disease is ultimately a high absorbent tampon made of synthetic materials.
After the Rely tampon was removed from the market, the price dropped to about 1 case per 100,000.
Schlievert now estimates that there are 3 to 4 out of every 100,000 menstrual women.
Schlievert studied the TSS for decades and last year reported cases of this disease in Minni aporiis, both menstrual women and othersSt.
The Paul area rose from 15 in 2000 to 50 in 2003.
The study was published in the Journal of Clinical Microbiology. The U. S.
The Centers for Disease Control and Prevention, which is responsible for infectious disease statistics, said there was no evidence of tampon-
The associated TSS is increasing. Dr.
Nancy Rosenstein of the CDC National infectious disease center acknowledged that the agency's approach to tracking TSS rates-
On 1987, states withdrew the provisions of the state for compulsory reporting of cases ---
Not enough to detect an increase in a relatively rare disease.
On last May, in a speech by the Society of gynecology for children and adolescents in North America, Ph. D. Judith U.
The director of the FDA's equipment and Radiation Health Center told the doctor's audience that tampon-
The relevant TSS reports submitted to the FDA are increasing, although the overall rate is still very small.
The comments were published in the June issue of the Association's medical journal.
When asked about a recent assessment by the CRA, an official at the Food and Drug Administration's equipment and Radiation Health Center said the TSS rate had not risen.
The unnamed official did not explain the apparent differences.
According to an FDA spokesman, the FDA did not comment.
Poisoning shock syndrome is caused by the common staphylococcus aureus on the skin and mucosa.
Some strains of S
However, S. aureus can cause infection, tampon--
Especially sanitary cotton with high water absorption-
When S of certain strains.
S. aureus that produces toxins enters the blood.
Another type of TSS, known as non-menstrual TSS, can occur in people undergoing surgery or post-operative wound infections.
According to Schlievert, these types of TSS cases are also considered to be increasing.
Women with cotton strips
The associated TSS usually has two natural illnesses during the menstrual period or before and after menstruation.
From the flu-
Similar symptoms: high fever, cold hair, vomiting, diarrhea, dizziness.
In just two days, however, toxins attack the organs of the body.
According to the CDC, the disease is fatal in 5% of cases.
Megan Duron, 14, will start her freshman year at Mira Costa High School in Manhattan Beach on last September, when she starts to get flu
Like symptoms and rashes, the condition deteriorated seriously two days later.
When the doctor sent Megan to Miller Children's Hospital, she was experiencing septic shock, in which case there was not enough blood to flow through the body.
"I was in high school when toxic shock syndrome first happened.
"I don't even think it's anymore," said Kathy Duron, Megan's mother . ".
In the years since the 1980 panic, the TSS has slipped from the radar screens of many doctors, especially those young doctors who may have never seen a case, Lieberman said.
Lieberman said that in the two cases recently treated at Miller Children's Hospital, doctors who saw the girls before they were hospitalized did not immediately realize the signs of TSS, although the girls had been wearing tampon.
"They are very ill," he said . " Any further delay could be fatal, he added.
Although no one knows why tampon
The relevant TSS appears to happen again, and there are several factors suspected, the doctor said.
One explanation is that bacteria that cause TSS can become more lethal over time.
Schlievert's research shows that one type
S. aureus resistant to methoxins and antibiotics may result in up to 30% of new cotton strips
Relevant information of TSS. Methicillin-resistant S.
S. aureus may also be responsible for the rise in non-menstrual TSS cases, Schlievert said.
Other experts are concerned that changes in tampon may lead to more cases of toxic shock syndrome.
In 2000, the FDA allowed more
The market is marked with "ultra" absorbent cotton strips.
"In the past, the increase in absorption capacity was shown to be directly related to the incidence of TSS," said Dr. Philip M.
Tilno, a microbiology at the New York University Medical Center.
Girls today usually start menstruation younger than they used.
By the time of adulthood, most people have produced antibodies to S.
But only about half of 13-year-
This antibody is available in older people, says Schlievert.
Most of the TSS cases reported to him belong to 12-to 15-year-
The FDA recommends that women change tampon every 4 to 8 hours and use only the water absorbent tampon that is most suitable for menstruation.
While tampon is usually safe to sell on the market, some health experts think it is a bad idea.
"FDA will allow [labeling]of an eight-
"One hour, overnight use of tampon is outrageous," Tierno said . " Teenagers often sleep for 10 to 12 hours, he noted.
According to FDA officials, current production and marketing practices related to tampon are safe.
The FDA asked the cotton strip manufacturer to provide information about toxic shock syndrome, usually found in a booklet in the box.
Meghan Duron, however, said she had never heard of TSS.
Her mother said, "there should be more of such a serious and dangerous thing --
Prominent warning outside the box.