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Epidemiologic Studies |

Tri-State Toxic Shock Syndrome Study: Evaluation of Case Definition and Prevention of Recurrence

JEFFREY P. DAVIS, M.D.; MICHAEL T. OSTERHOLM, Ph.D., M.P.H.; CHARLES M. HELMS, M.D., Ph.D.; JAMES M. VERGERONT, M.D.; LAVERNE A. WINTERMEYER, M.D.; JAN C. FORFANG, B.A.; LAWRENCE A. JUDY, M.D.; JEAN RONDEAU, B.S.; WENDY L. SCHELL, M.S., THE INVESTIGATION TEAM
[+] Article and Author Information

▸Requests for reprints should be addressed to Jeffrey P. Davis, M.D.; Bureau of Community Health and Prevention, Division of Health; P.O. Box 309; Madison, WI 53701.


*Fred Appleton, Loretta Copper, Mary Jane Daugard, Carol Gannon, Marsha Ganoe, Louise Gialaska, Robert Gibson, Marjorie Holzhueter, Helen Jagger, Margaret Malone, Jack Mandel, Anita Michael, Connie Miley, Sharon Rewey, Nori Roden, Jane Seip, Frank Simmons, Susan Stolz, Sherry Taylor, Vicki Thelen, John Washburn, and Meg Ziarnik.▸From the Bureau of Community Health and Prevention, Wisconsin Division of Health and the Departments of Pediatrics and Preventive Medicine, University of Wisconsin Center for Health Sciences, Madison, Wisconsin; the Acute Disease Epidemiology Section. Minnesota Department of Health, Minneapolis, Minnesota; the Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa; the Division of Disease Prevention, Iowa State Department of Health, Des Moines, Iowa; the Bureau of Field Services, Centers for Disease Control, Atlanta, Georgia; and the School of Medicine, University of Minnesota, Duluth, Minnesota.Findings in the Tri-State Toxic-Shock Syndrome Study previously have been reported (J Infect Dis. 1982;145:441-8).

Madison, Wisconsin; Minneapolis, Minnesota; Iowa City, Iowa; Des Moines, Iowa; Atlanta, Georgia; and Duluth, Minnesota


Ann Intern Med. 1982;96(6_Part_2):903-905. doi:10.7326/0003-4819-96-6-903
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The clinical and laboratory findings in 80 nonfatal cases of toxic shock syndrome were examined as part of the Tri-State Toxic-Shock Syndrome Study conducted by the state health departments of Minnesota, Wisconsin, and Iowa. Symptom criteria included in the case definition were analyzed and certain criteria identified that may be helpful in screening febrile patients early in an episode of toxic shock syndrome or those with mild cases. We also report a 5-month follow-up of the 80 patients and have found that use of antistaphylococcal antibiotics during the initial episode and discontinued tampon use after the initial episode are significant and statistically independent factors in decreasing the rate of recurrent toxic shock syndrome.

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