Device-Associated Menstrual Toxic Shock Syndrome

In the 1980s, menstrual toxic shock syndrome (mTSS) became a household 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 biomedical community, in a major way, to understanding disease progress...

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Bibliographic Details
Published in:Clinical microbiology reviews 2020-06, Vol.33 (3)
Main Authors: Schlievert, Patrick M, Davis, Catherine C
Format: Article
Language:English
Subjects:
Bacterial Toxins - toxicity
Enterotoxins - toxicity
Female
Humans
Menstrual Hygiene Products - adverse effects
Menstruation
Review
Risk Factors
Shock, Septic - epidemiology
Shock, Septic - microbiology
Staphylococcal Infections - microbiology
Staphylococcus aureus - pathogenicity
Superantigens - toxicity
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Summary:In the 1980s, menstrual toxic shock syndrome (mTSS) became a household 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 biomedical community, in a major way, to understanding disease progression and investigation. Those studies led to the identification of the cause, 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 worldwide of tampon absorbency labeling. This review addresses our understanding of the development and conclusions related to mTSS and risk factors. We leave the final message that even though mTSS is not commonly in the news today, cases continue to occur. Additionally, strains cycle in human populations in roughly 10-year intervals, possibly dependent on immune status. TSST-1-producing bacteria appear to be reemerging, suggesting that physician awareness of this emergence and mTSS history should be heightened.
ISSN:0893-8512
1098-6618
DOI:10.1128/cmr.00032-19