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Toxic Shock Syndrome: Relation to Catamenial Products, Personal Health and Hygiene, and Sexual Practices

MICHAEL T. OSTERHOLM, Ph.D., M.P.H.; JEFFREY P. DAVIS, M.D.; ROBERT W. GIBSON, Ph.D.; JAN C. FORFANG, B.A.; SUSAN J. STOLZ, M.A.; JAMES M. VERGERONT, M.D., THE INVESTIGATIVE TEAM
[+] Article and Author Information

▸Requests for reprints should be addressed to Michael T. Osterholm, Ph.D., M.P.H.; the Acute Disease Epidemiology Section, Minnesota Department of Health, 717 Delaware Street S.E.; Minneapolis, MN 55440.


*Members of the Investigative Team include Jack S. Mandel, La Verne A. Wintermeyer, Charles M. Helms, Jean Rondeau, Frank Simmons, Tim Church, Wendy Schell, Vicki Thelen, Louise Golaska, Helen Jagger, John Washburn, Lawrence A. Judy, Margaret Malone, Connie Miley, Fred Appleton, Sherry Taylor, Mary Jane Dangard, Anita Michael, Lorretta Copper, Jane Seip, and Marsha Ganoe.▸From the Acute Disease Epidemiology Section, Minnesota Department of Health, and the School of Public Health, University of Minnesota, Minneapolis, Minnesota; the School of Medicine, University of Minnesota at Duluth, Duluth, Minnesota; the Bureau of Community Health and Prevention, Wisconsin Division of Health, and the Department of Preventive Medicine, University of Wisconsin Health Sciences, Madison, Wisconsin; the Division of Disease Prevention, Iowa State Department of Health, Des Moines, Iowa; and the Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa.

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


© 1982 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1982;96(6_Part_2):954-958. doi:10.7326/0003-4819-96-6-954
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In 1980, the discovery of an association between vaginal tampon use and toxic shock syndrome affected the lifestyles of menstruating women and the catamenial products industry. It made both the general public and the medical community more aware of all aspects of menstruation. The relation between developing toxic shock syndrome and tampon use is unclear; tampon fluid capacity (absorbency) remains the best predictive measure of that risk. No unique aspect of tampon use other than absorbency seems to increase the risk of developing toxic shock syndrome, and numerous hygiene and medical history factors do not seem to play a role in the pathogenesis of the disease. Studies in Minnesota, Wisconsin, and Iowa indicate that 70% to 75% of women between the ages of 15 and 24, the group with the highest risk of developing menstrual toxic shock syndrome, continued to use tampons after news media attention in 1980 on the association of the syndrome with tampon use. This rate of use is higher than the rate found for the general population by recent tampon market research.

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