ArtsAutosBooksBusinessEducationEntertainmentFamilyFashionFoodGamesGenderHealthHolidaysHomeHubPagesPersonal FinancePetsPoliticsReligionSportsTechnologyTravel
  • »
  • Health»
  • Diseases, Disorders & Conditions

Toxic Shock Syndrome – The story of an unlikely culprit in the 1980s

Updated on May 13, 2013

What is Toxic Shock Syndrome?

This post combines two subjects that absolutely fascinate me, and hopefully you; the history of a disease, and its pathophysiology (medical observations + mechanism acting within the organism).

Toxic Shock Syndrome, or TSS, is an illness characterized by the body’s response with high fever, low blood pressure, confusion and/or stupor. The sudden drop in blood pressure is capable of depriving organs of oxygen, and can lead to death.

A rash accompanies these symptoms, resembling a sunburn around the lips, mouth, eyes, palms and soles.

It’s caused by a bacterial toxin; usually originating from overgrown Staphylococcus aureus or Streptococcus pyogenes, the organisms that we associate with “Staph” or “Strep”.

The manifestation of this illness is somewhat of a horror story; its severity frequently warrants hospitalization, even the emergency room, for aggressive fluid regulation, ventilation, kidney replacement or removal, and treatment of multiple organ failure. Yikes! The outcome can be fatal in a matter of hours.

The term toxic shock syndrome was first used in 1978 by a Denver pediatrician to describe the illness in seven of his patients, ages 8-17. Long story short, the pediatrician suspected that a bacterial toxin may be involved, since the bacterium could be isolated from the patients’ mucous, but not the blood. A study, and literature search, ensued, revealing similar cases as far back as 1927 that hadn’t been diagnosed as TSS.

Here comes the unlikely culprit: The authors of the study failed to consider that the women with TSS were, at the time, menstruating.

Later that year, P&G, a company based in Cincinnati, introduced superabsorbent Rely tampons to the United States market. The introduction of the product was in response to women’s demands for tampons that could contain an entire menstrual flow without leaking, or needing to be replaced.

For those of you women reading this, I am sure you are thinking, as I am, “If only!” right?

Rely tampons used carboxymethylcellulose and compressed polyester for absorption; a design which allowed for nearly 20 times its own weight in fluid to be absorbed as it blossomed inside that vagina.

In the late 1970s and early 1980s, TSS began to make headlines after the deaths of several young women.

In January of 1980, the CDC received numerous reports of TSS, mostly in menstruating women, who’d used the Rely tampons and left them in over the course of their menstrual cycle. In September of that year, the CDC reported that users of Rely were at risk for developing TSS, and P&G recalled Rely.

However, it soon became clear that Rely was not the only culprit.

Regardless of the chemical composition or the brand of tampon, there seemed to be a correlation between higher absorbency of tampons and TSS.

Rely was the exception; the risk for TSS was still higher when corrected for its absorbency, due to the strange ability of carboxymethylcellulose to filter the bacterial toxin.

Today, the CDC has stopped tracking TSS, though there was again a rise in cases reported in the early 2000s; eight deaths in California in 2002, and four deaths per year in three consecutive years following that. The authors of one study attribute the rise to the removal of warnings by manufacturers not to leave tampons in overnight.


A tampon saturated with blood is an ideal place for the rapid growth of bacteria; an ideal place to release their poisons into the blood stream. The progression of the disease stems from a superantigen – allow me to explain.

Superantigens are peptide or protein molecules released in this case, by bacteria, and can react with the cells of the immune system in unprocessed form, in contrast to conventional peptides that require uptake and processing by the immune cell prior to presentation on the cell surface to the rest of the immune system.

There is a nonconventional, and nonspecific, recognition by the other cells of the immune system that takes place; this nonconventional binding can activate up to 30% of peripheral immune cells, and elicit a massive immediate response.

The rapid activation of immune cells leads to inflammation and severe perturbations in organ function that are manifested as severe clinical diseases – TSS, in this case.

So what have we learned today? Ladies, don’t leave your tampon in for more than four hours, just to be safe!

Also note the description of absorbency on the package; the terms “junior”, “regular”, “super”, and “super plus” are FDA standardized. Judging by their history, the more absorbent tampons seem to pose higher risk to women who have heavy menstrual cycles – take them out sooner, rather than later.


    0 of 8192 characters used
    Post Comment

    • profile image

      Shahwez 3 years ago

      Not bad, but most of the tracks are serolusiy lacking. The classical/orchestral ones are nice and somber, but lack the background instruments to really keep the whole thing flowing. The rock and techno songs tend to have more problems; The rock tracks do a good job of intensity, but there's no background melody, which leaves the main melody and riffs sounding slow and a bit dull. Most of the techno tracks lack any intensity that they should have. There're no crescendos or decrescendos, very few background melodies, and even fewer synths used. Overall, for almost every song on here there's just no backbone to them; No extra instruments or backups or variation in intensity.I do give props for being to put out so many tracks, but I'd rather get a few great tracks than many lackluster ones. Overall I'd give it 5.5/10. Not bad, keep trying, don't stop.

    • profile image

      Estiben 3 years ago

      And thus my pre-order was lost. Seriously, i was planing on genttig this first day, but because those who dont pre-order for whatever reason( lack of funds, on the fence, game may end up sucking so wait for reveiws) get jipped of content that could easily implemented ( im willing to bet it already has but was then removed) and sounds like it was made during the games development, I have lost all interest in this.Sadly people still support this dlc train by buying the stuff. Not cool SEGA

    • AliciaC profile image

      Linda Crampton 5 years ago from British Columbia, Canada

      Thanks for sharing the information, osaeoppongde. Toxic shock syndrome is a horrible disorder, but it is interesting to learn about its cause.


    This website uses cookies

    As a user in the EEA, your approval is needed on a few things. To provide a better website experience, uses cookies (and other similar technologies) and may collect, process, and share personal data. Please choose which areas of our service you consent to our doing so.

    For more information on managing or withdrawing consents and how we handle data, visit our Privacy Policy at: ""

    Show Details
    HubPages Device IDThis is used to identify particular browsers or devices when the access the service, and is used for security reasons.
    LoginThis is necessary to sign in to the HubPages Service.
    Google RecaptchaThis is used to prevent bots and spam. (Privacy Policy)
    AkismetThis is used to detect comment spam. (Privacy Policy)
    HubPages Google AnalyticsThis is used to provide data on traffic to our website, all personally identifyable data is anonymized. (Privacy Policy)
    HubPages Traffic PixelThis is used to collect data on traffic to articles and other pages on our site. Unless you are signed in to a HubPages account, all personally identifiable information is anonymized.
    Amazon Web ServicesThis is a cloud services platform that we used to host our service. (Privacy Policy)
    CloudflareThis is a cloud CDN service that we use to efficiently deliver files required for our service to operate such as javascript, cascading style sheets, images, and videos. (Privacy Policy)
    Google Hosted LibrariesJavascript software libraries such as jQuery are loaded at endpoints on the or domains, for performance and efficiency reasons. (Privacy Policy)
    Google Custom SearchThis is feature allows you to search the site. (Privacy Policy)
    Google MapsSome articles have Google Maps embedded in them. (Privacy Policy)
    Google ChartsThis is used to display charts and graphs on articles and the author center. (Privacy Policy)
    Google AdSense Host APIThis service allows you to sign up for or associate a Google AdSense account with HubPages, so that you can earn money from ads on your articles. No data is shared unless you engage with this feature. (Privacy Policy)
    Google YouTubeSome articles have YouTube videos embedded in them. (Privacy Policy)
    VimeoSome articles have Vimeo videos embedded in them. (Privacy Policy)
    PaypalThis is used for a registered author who enrolls in the HubPages Earnings program and requests to be paid via PayPal. No data is shared with Paypal unless you engage with this feature. (Privacy Policy)
    Facebook LoginYou can use this to streamline signing up for, or signing in to your Hubpages account. No data is shared with Facebook unless you engage with this feature. (Privacy Policy)
    MavenThis supports the Maven widget and search functionality. (Privacy Policy)
    Google AdSenseThis is an ad network. (Privacy Policy)
    Google DoubleClickGoogle provides ad serving technology and runs an ad network. (Privacy Policy)
    Index ExchangeThis is an ad network. (Privacy Policy)
    SovrnThis is an ad network. (Privacy Policy)
    Facebook AdsThis is an ad network. (Privacy Policy)
    Amazon Unified Ad MarketplaceThis is an ad network. (Privacy Policy)
    AppNexusThis is an ad network. (Privacy Policy)
    OpenxThis is an ad network. (Privacy Policy)
    Rubicon ProjectThis is an ad network. (Privacy Policy)
    TripleLiftThis is an ad network. (Privacy Policy)
    Say MediaWe partner with Say Media to deliver ad campaigns on our sites. (Privacy Policy)
    Remarketing PixelsWe may use remarketing pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to advertise the HubPages Service to people that have visited our sites.
    Conversion Tracking PixelsWe may use conversion tracking pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to identify when an advertisement has successfully resulted in the desired action, such as signing up for the HubPages Service or publishing an article on the HubPages Service.
    Author Google AnalyticsThis is used to provide traffic data and reports to the authors of articles on the HubPages Service. (Privacy Policy)
    ComscoreComScore is a media measurement and analytics company providing marketing data and analytics to enterprises, media and advertising agencies, and publishers. Non-consent will result in ComScore only processing obfuscated personal data. (Privacy Policy)
    Amazon Tracking PixelSome articles display amazon products as part of the Amazon Affiliate program, this pixel provides traffic statistics for those products (Privacy Policy)