The inquest on Monday determined that a tampon may have possibly been the source of an infection that resulted in blood poisoning, leading to the death of a 36-year-old healthy Dublin woman named Samantha Comiskey. The phenomenon of toxic shock syndrome (TSS) being triggered by a tampon that has been in place for too long is considered to be more uncommon than common, as pointed out by Coroner Dr Clare Keane.
TSS is a group of symptoms impacting various parts of the body caused by specific bacterial infections. These infections release toxins into the bloodstream, which then disperse these toxins to the body’s organs. This can result in extreme damage and potentially deadly illness. It tends to manifest abruptly and is defined by symptoms such as fever, low blood pressure, a rash akin to sunburn and extensive damage to organs across the body.
Staphylococcus aureus and Streptococcus pyogenes are the two strains of bacteria which are known to trigger TSS frequently. Staphylococcus-related TSS was recognised in the late 1970s and early ’80s when highly absorbent tampons became popular amongst women on their periods. Advances in tampon production have led to a reduction in instances of TSS as a result of tampon use. That being said, streptococcus-induced TSS is most often identified in older adults and children. Those with a compromised immune system or diabetes are also at risk.
In addition to menstruation, there are other conditions that can trigger TSS. These include soft-tissue infections, post-surgery infections, burns, foreign bodies left in the body such as nasal packing, and dialysis catheters. TSS caused by Staphylococcus is typically the outcome of a localised infection like an abscess, while TSS from Streptococcus can occur due to septicaemia or a skin infection referred to as cellulitis.
This infrequent ailment, often identified as TSS, is prevalent in developing regions, with rates ranging from 0.8 to 3.4 in every 100,000 inhabitants and is deemed non-transmittable.
What should one look for when identifying TSS?
Many of the TSS symptoms could be mistaken for other infections as they affect various body systems. Common symptoms include an abrupt rise in temperature exceeding 38.9 degrees, a reddish, flat rash engulfing much of the body’s surface, and significantly decreased blood pressure. Early signs could include feverish chills accompanied by retching and a sensation of unwellness, generalised aches, and headache. If the toxins persist in damaging the body’s organs, liver and kidney failure is likely to follow.
What’s the recommended treatment for TSS?
The immediate course of treatment for TSS involves the application of intravenous antibiotics that attack a range of bacteria, coupled with the administration of IV fluids. It’s imperative that any likely origin of the inflection, like a tampon or nasal packing, be promptly eradicated. Given the severity of the condition, the patient may require admission to an ICU for extensive care.
Is there a risk in women using tampons, given the potential of contracting TSS?
Not exactly. Contemporary tampons, which do not have high absorbance, are deemed safe for usage. However, it should be noted, for safety, that tampons should not be left inside the body for extended durations, with a recommended change time being every four to eight hours during the menstrual cycle.