| Clinical Features |
Toxic shock syndrome (TSS) is characterized by sudden onset of fever, chills, vomiting, diarrhea, muscle aches and rash. It can rapidly progress to severe and intractable hypotension and multisystem dysfunction. Desquamation, particularly on the palms and soles can occur 1-2 weeks after onset of the illness. |
| Etiologic Agent |
Usually exotoxin producing strains of Staphylococcus aureus, a bacterium. |
| Incidence |
In the United States, annual incidence is 1-2/100,000 women 15-44 years of age (last active surveillance done in 1987). |
| Sequelae |
5% of all cases are fatal. |
| Transmission |
S. aureus commonly colonizes skin and mucous membranes in humans. TSS has been associated with use of tampons and intravaginal contraceptive devices in women and occurs as a complication of skin abscesses or surgery. |
| Risk Groups |
Menstruating women, women using barrier contraceptive devices, persons who have undergone nasal surgery, and persons with postoperative staphylococcal wound infections. |
| Surveillance |
National surveillance is conducted through the National Electronic Telecommunications System for Surveillance (NETSS). The last active surveillance was in 1987 in four states with a total population of 12 million. |
| Challenges |
To describe the current epidemiology of TSS in the United States by conducting active surveillance. To better define the risk factors of nonmenstrual TSS to design prevention strategies. |
