Materiały źródłowe

• #1

  https://www.prevention.com/health/health-conditions/a21990135/how-to-avoid-toxic-shock-syndrome/

  Toxic shock syndrome only occurs in about one to three out of every 100,000 menstruating women. […] Toxic shock syndrome is very rare. So although Manitoski’s story is tragic, you shouldn’t throw out your tampons just yet. […] Women are encouraged to change their tampons frequently. The blood that accumulates in the tampon can serve as a breeding ground for bacteria. […] I usually tell patients, if you’re not filling your tampon at least halfway or so in six to eight hours, you need a smaller tampon, or you shouldn’t use one. […] Toxic shock syndrome is very rare. According to the National Organization for Rare Disorders, ever since manufacturers phased out the materials linked to toxic shock syndrome, it only occurs in about one to three out of every 100,000 menstruating women. […] If you’re showing symptoms of toxic shock syndrome, you should see a doctor right away; nearly half of cases are fatal, and subsequent complications can include organ damage like kidney, liver, and heart failure.

• #2 Toxic Shock Syndrome: A Literature Review

  https://www.mdpi.com/2079-6382/13/1/96

  Toxic shock syndrome (TSS) is a rare, life-threatening, toxin-mediated infectious process linked, in the vast majority of cases, to toxin-producing strains of Staphylococcus aureus or Streptococcus pyogenes. […] Management of TSS is a medical emergency and relies on early detection, immediate resuscitation, source control and eradication of toxin production, bactericidal antibiotic treatment, and protein synthesis inhibiting antibiotic administration. […] It is crucial to eradicate the source of toxin production. In the case of m-TSS, the foreign bodies (tampon, intrauterine device, menstrual cup, etc.) must be removed as soon as possible. […] Intravenous bactericidal antibiotics must be administered as soon as possible and within the first hour following suspicion according to the Surviving Sepsis Campaign Guidelines. […] The optimal duration of antitoxic antibiotics is unknown. […] The interest in polyclonal IVIG administration as an adjunctive treatment for TSS requires further evaluation.

• #3 How Can You Treat and Prevent Toxic Shock Syndrome?

  https://www.webmd.com/women/toxic-shock-syndrome-treatment-prevention

  TSS is rare. Youre unlikely to get it if youve never had it. But once you get it, youre at a higher risk of getting it again. You can take these steps to keep your chances as low as possible: […] Be careful when you use tampons, diaphragms, or contraceptive sponges. All three carry some risk of TSS. If youve had TSS before, or if youve had a serious bacterial infection, youre at a greater risk of getting TSS, and shouldnt use them at all. […] To use tampons safely and reduce your risk of TSS, you should: Use the lowest absorbency tampon you can, Change your tampon frequently — every 4 to 6 hours, or more often, depending on your flow, Use pads on light flow days, Dont use tampons when you dont have your period, Keep your tampon box in a cool, dry place to keep bacteria from growing, Always wash your hands before putting a tampon in, or taking one out.

• #4 Toxic Shock Syndrome Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/169177-treatment

  Patients who recover from TSS are at risk of recurrent episodes of STSS. Consider or recommend preventive therapy (eg, discontinuation of tampon usage, administration of antistaphylococcal antibiotics) before and during each menstrual period for several months. […] Chemoprophylaxis of household contacts of STSS patients: Household contacts of people with STSS have a higher risk of invasive GAS infection compared to the general population. The Centers for Disease Control and Prevention have not made definite recommendations; some authors have recommended a 10-day course of cephalosporin. […] Patient education about early signs and symptoms, risk factors, and avoidance of tampon use may help prevent relapses.

• #5 Toxic Shock Syndrome (TSS): Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/15437-toxic-shock-syndrome

  You can take steps to lower your risk for toxic shock syndrome. Some of these include: […] Use sanitary pads instead of tampons during menstrual periods or use pads at night. Switching from tampons to pads every other day or when the menstrual flow is heaviest may also help reduce your risk. […] Change tampons every four to eight hours. If the flow is heavy, tampons may have to be changed more frequently. […] Use a tampon with the lowest absorbency required for your flow. […] Don’t use tampons when you aren’t menstruating. […] Keep surgical incisions clean to avoid infection. See your healthcare provider if you notice unusual swelling, redness or heat near the wound. […] Follow directions when using vaginal contraceptives such as sponges, caps or diaphragms. […] Toxic shock syndrome is more likely to recur in people who’ve already had it. You should avoid using tampons during your period if you’ve recovered from a case of TSS.

• #6 Toxic Shock Syndrome: Symptoms, Treatment, and Prevention

  https://www.webmd.com/women/what-are-toxic-shock-syndrome-symptoms

  How Do You Prevent TSS? […] You can take these steps to keep your chances as low as possible: […] If you get a wound, keep it clean, dry, and bandaged. Make sure to change your bandages regularly. […] Any time you see signs of infection in a wound — redness, swelling, pain, fever — tell your doctor as soon as possible so it can be treated. […] Be careful when you use tampons, diaphragms, or contraceptive sponges. All three carry some risk of TSS. If youve had TSS before, or if youve had a serious bacterial infection, youre at a greater risk of getting TSS, and shouldnt use them at all. […] To use tampons safely and reduce your risk of TSS: […] Use the lowest absorbency tampon you can. […] Change your tampon frequently — every 4 to 6 hours or more, depending on your flow. […] Use pads on light flow days. […] Dont use tampons when you dont have your period. […] Keep your tampon box in a cool, dry place to keep bacteria from growing. […] Always wash your hands before putting a tampon in or taking one out.

• #7 Toxic shock syndrome | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/toxic-shock-syndrome?content_id=CON-20245743

  Manufacturers of tampons sold in the United States no longer use the materials or designs that were associated with toxic shock syndrome. Also, the U.S. Food and Drug Administration requires manufacturers to use standard measurement and labeling for absorbency and to print guidelines on the boxes. […] If you use tampons, read the labels and use the lowest absorbency tampon you can. Change tampons frequently, at least every four to eight hours. Alternate using tampons and sanitary napkins, and use minipads when your flow is light. […] Toxic shock syndrome can recur. People who’ve had it once can get it again. If you’ve had toxic shock syndrome or a prior serious staph or strep infection, don’t use tampons.

• #8 Toxic shock syndrome (TSS) – including symptoms, treatment and prevention | SA Health

  https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/conditions/infectious+diseases/toxic+shock+syndrome/toxic+shock+syndrome+tss+-+including+symptoms+treatment+and+prevention

  If high fever, vomiting or diarrhoea develops during menstruation, stop using tampons and seek medical advice immediately. It may not be TSS but this must be verified because TSS can be dangerous if not treated in its early stages […] the risk of TSS may be reduced by using tampons intermittently during menstruation. Overnight, it is advisable to use a pad […] take special care with personal hygiene during menstruation. Bathe or shower daily […] wash your hands before as well as after inserting a tampon. Unwrap a fresh, clean tampon just before insertion and do not handle it more than is necessary. Discard any tampons you may have unwrapped and not used immediately. Insert the tampon gently and carefully […] use the lowest absorbency tampon necessary […] do not leave the tampon in for a prolonged duration. Change the tampon as directed by the manufacturers instructions […] never insert more than one tampon at a time […] remove tampons at the end of a period.

• #9 Toxic Shock Syndrome: Why It Happens and How To Treat It

  https://www.verywellhealth.com/toxic-shock-syndrome-4175808

  Once you’ve had toxic shock syndrome, you are at risk of developing it again. Therefore, if you menstruate, your healthcare provider will likely advise you to avoid using tampons and menstrual cups. […] There is no vaccine or specific treatment that will prevent toxic shock syndrome. The best prevention course is to avoid known risks of developing the condition. Helpful tips to prevent TSS include: […] Frequently change tampons and avoid super-absorbent varieties. […] Keep devices inserted into the vagina clean (such as cervical caps, diaphragms, and birth control rings). […] Practice proper hygiene and wound care after surgery or medical procedures. […] Be aware of the potential signs and symptoms of TSS when recovering from childbirth, miscarriage, or abortion procedures. […] Receive timely treatment for complications that occur after illnesses like chickenpox.

• #10 Understanding Toxic Shock Syndrome: Causes, Prevention, and Treatment – Tulipon

  https://tulipon.com/understanding-toxic-shock-syndrome-causes-prevention-and-treatment/

  To prevent Toxic Shock Syndrome, it is essential to follow proper hygiene practices during menstruation. Here are some guidelines to minimize the risk: […] Use the lowest absorbency tampon suitable for your flow and change it regularly, at least every 4 to 8 hours. […] Consider using sanitary pads or menstrual cups as an alternative to tampons. Menstrual cups, in particular, have been shown to have lower levels of S. aureus growth compared to tampons. […] Wash your hands before and after inserting or removing tampons or menstrual cups. […] Avoid using tampons overnight if possible. Opt for pads or menstrual cups instead. […] Familiarize yourself with the symptoms of TSS, such as sudden high fever, rash, muscle aches, dizziness, and abdominal pain. If you experience these symptoms while using tampons, remove the tampon immediately and seek medical attention.

• #11 What Is Toxic Shock Syndrome (TSS)? | Franciscan Health

  https://www.franciscanhealth.org/community/blog/toxic-shock-syndrome

  The Centers for Disease Control and Prevention worked with tampon manufacturers to remove the high-absorbency tampons from the market and to add warning labels encouraging consumers to use the lowest absorbency product necessary, Dr. Monk said. As a result, cases were significantly reduced. […] Women who use menstrual cups should follow safe handling practices, including proper sterilization before each use. Whether using tampons or menstrual cups, understanding how to reduce TSS risk through safe hygiene practices is key, Dr. Monk said. […] To minimize the already low risk of TSS from tampon use, Dr. Monk recommended the following safety precautions: Avoid wearing tampons overnight or when not menstruating. Change tampons every 4 to 8 hours. Monitor for any unusual symptoms, such as fever, rash or flu-like symptoms, and seek medical attention immediately if they occur. Practice proper hygiene when inserting and removing tampons. Use the lowest absorbency tampon necessary for your flow.

• #12 Toxic Shock Syndrome (TSS) – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/gram-positive-cocci/toxic-shock-syndrome-tss

  People at highest risk of staphylococcal TSS are women who have preexisting staphylococcal colonization of the vagina and who leave tampons or other devices (eg, menstrual cups, cervical caps, intrauterine devices, contraceptive sponges, diaphragms, pessaries) in the vagina. […] Recurrences are common among women who continue to use tampons and other devices during the first 4 months after an episode. […] Patients suspected of having TSS should be hospitalized immediately and treated intensively. Tampons, diaphragms, and other foreign bodies should be removed at once. […] Advising all women, regardless of TSST-1 antibody status, to change tampons frequently or use napkins instead and to avoid hyperabsorbent tampons seems prudent.

• #13 Women’s Health and Education Center (WHEC) – Toxic Shock Syndrome

  http://www.womenshealthsection.com/content/print.php3?title=gyn015&cat=3&lng=english

  The use of low-absorbency tampon appears to reduce the risk of TSS in tampon use. […] The sponge should not be used during menstruation and should not be left in place for more than 30 hours. […] The prolonged use of diaphragm should be avoided, particularly in women who have previously manifested TSS. […] The incidence is reduced to less than 5% if antistaphylococcal antibiotic therapy is given during therapy of the initial occurrence. […] Early detection and early treatment is the key to the success. Instructions and information about the recurrence TSS should be given to the patient upon discharge.

• #14 Toxic shock syndrome

  https://dermnetnz.org/topics/toxic-shock-syndrome-and-toxic-shock-like-syndrome

  Women who have had toxic shock syndrome should avoid using tampons during menstruation as reinfection can occur. If worn, they should be changed every 48 hours. The use of diaphragms and vaginal sponges may also increase the risk of toxic shock syndrome. […] Prompt and thorough wound care will help to avoid toxic shock syndrome and STSS.

• #15 Toxic Shock Syndrome | Sepsis Alliance

  https://www.sepsis.org/sepsisand/toxic-shock/

  Toxic shock syndrome is not always preventable, but you can take some steps to reduce your risk of developing it. […] Keep cuts, wounds, and incisions as clean as possible, perhaps using antibacterial ointments, as directed by your doctor. […] Watch all cuts, wounds, and incisions for signs of infection (increasing pain, redness around the wound, pus or other discharge from the wound). […] Change tampons frequently and use the lowest absorbency possible. […] Use menstrual pads instead of tampons for light flow days. […] Remove diaphragms and contraceptive sponges as quickly as possible.

• #16 Toxic shock syndrome

  https://www.nhs.uk/conditions/toxic-shock-syndrome/

  Toxic shock syndrome (TSS) is rare, but there are things you can do to reduce your chance of catching or spreading a bacterial infection. […] wash your hands and follow the instructions when using tampons, menstrual cups, contraceptive caps and diaphragms, and do not leave them in longer than needed or recommended […] keep cuts and burns clean, and look out for signs of infection, such as a rash, swelling or pain. […] If you’ve had TSS before, your doctor may advise you not to use tampons, contraceptive caps or diaphragms.

• #17 Toxic Shock Syndrome Symptoms & Treatment | Baptist Health

  https://www.baptisthealth.com/care-services/conditions-treatments/toxic-shock-syndrome

  The risk of developing TSS can be minimized by taking appropriate precautions. The tampon industry no longer uses materials that were associated with higher rates of TSS. The Food and Drug Administration also requires manufacturers to label tampon boxes with specific instructions and guidelines that help prevent TSS. […] Additional preventative measures include not keeping tampons in for more than 4-8 hours and trying to match the tampons absorbency measurement with how light or heavy your flow is. It is also helpful to alternate tampon use with sanitary napkins when your period flow is light. It is recommended to use the lowest absorbency tampon that is possible with your flow. If you are a woman and have had TSS before, avoid using tampons during your menstrual periods. TSS is more likely to recur in women who have had it before. […] Other preventative measures include: Being diligent about keeping surgical incision areas clean to avoid infection. If you notice any redness, swelling, or heat around an incision site, call your doctor immediately. Follow instructions when using vaginal contraceptives.

• #18 Toxic shock syndrome secondary prevention – wikidoc

  https://www.wikidoc.org/index.php/Toxic_shock_syndrome_secondary_prevention

  Secondary prevention strategies following toxic shock syndrome (TSS) include chemoprophylaxis for invasive group A streptococcus or staphylococcus carriers. Although it is still not certain to be helpful. […] One of the major complications of toxic shock syndrome is that it increase the risk of disease re-currence. This condition can be controlled by chemoprophylaxis of patients with a past medical history of TSS. However, there is limited data concerning chemoprophylaxis for severe invasive group A streptococcal or staphylococcal infections. […] Also researchers advice not to continue tampon usage after a TSS, to prevent the recurrence of the disease. […] Several antibiotic regimens have been successful in eradicating group A streptococcus from the pharynx of chronic carriers i.e., Rifampin plus intramuscular benzathine penicillin or A 10-day course of a second-generation cephalosporin or Clindamycin.

• #19 Toxic Shock Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459345/

  Currently it is not recommended to provide prophylaxis for GAS to household contacts despite the increased risk of developing GAS. However, it is important to educate close contacts regarding the symptoms of GAS, and to recommend they seek care immediately should they develop. […] The CDC does not recommend routine screening and chemoprophylaxis of household contacts of patients with invasive Group A Strep (GAS) infections. […] Based on risk factors for death from invasive GAS, the CDC states health care providers may choose to offer chemoprophylaxis to household members aged 65 years or those at increased risk of sporadic invasive GAS infection.

• #20 Clinical Guidance for Streptococcal Toxic Shock Syndrome | Group A Strep | CDC

  https://www.cdc.gov/group-a-strep/hcp/clinical-guidance/streptococcal-toxic-shock-syndrome.html

  Reduce the spread of group A strep bacteria with standard infection control practices, including good hand hygiene and respiratory etiquette. […] For household contacts of people with a confirmed invasive group A streptococcal infection, CDC doesn’t routinely recommend: […] Healthcare providers may choose to offer prophylaxis to all household members of a confirmed case if the household includes someone […] The risk of a secondary case of invasive disease within 30 days of exposure is highest among household contacts aged 65 years or older. The risk of infection is low among younger household members.

• #21 :: JKMS :: Journal of Korean Medical Science

  https://jkms.org/DOIx.php?id=10.3346/jkms.2024.39.e154

  Due to the potential transmission to household contacts, there has been concern regarding post-exposure antibiotic prophylaxis. However, given the infrequency of family outbreaks and the lack of evidence supporting the efficacy of eradicating the infection among contacts, the Working Group on Prevention of Invasive Group A Streptococcal Infections initially refrained from making any recommendations regarding chemoprophylaxis for household contacts of invasive GAS infection in 1998. […] Although routine screening for and chemoprophylaxis are not encouraged, the group recommended surveillance for healthcare-associated postpartum or postsurgical invasive GAS infection in 2002. […] Due to the higher risk of infection indicated by population-based surveillance data from 2013 to 2016, consideration should also be given to providing chemoprophylaxis to household contacts aged 65 and older.

• #22 Toxic Shock Syndrome – MD Searchlight

  https://mdsearchlight.com/infectious-disease/toxic-shock-syndrome/

  At the moment, doctors typically do not give preventative treatment for GAS (Group A Streptococcus, a type of bacteria that can cause infections) to people living in the same household, even though these individuals are at a higher risk of getting GAS. However, it is crucial to let these close contacts know about the symptoms of a GAS infection and emphasize they should get medical help straight away if they start to see signs of the infection. […] People over 65 years of age have a higher chance of dying from a GAS infection, so giving these individuals or those at a higher risk for GAS preventative treatment could make sense. […] At the very least, hospitals should follow basic safety guidelines to prevent spread of the infection to other patients and hospital staff. The Centers for Disease Control and Prevention (CDC) suggests that for the first 24 hours of effective antibiotic treatment, the patient should be isolated to prevent any contact and droplet spread of the infection.

• #23 On the use of prophylactic antibiotics in prevention of toxic shock syndrome – PubMed

  https://pubmed.ncbi.nlm.nih.gov/16288963/

  No consensus exists among burn surgeons on the role of prophylactic antibiotics in prevention of toxic shock syndrome (TSS). […] The aim of this study was to assess whether prophylaxis with a one off single dose of systemic antibiotics prevented the occurrence of TSS. […] In conclusion, this study suggests that prophylaxis may prevent TSS in children.

• #24 Do All Packed Noses Get Antibiotics? — Taming the SRU

  https://www.tamingthesru.com/blog/consultant-corner/do-all-packed-noses-get-antibiotics

  Due to the fear of toxic shock syndrome (TSS), it has long been considered the standard of care to prescribe antibiotics as prophylaxis for patients who receive packing to treat anterior epistaxis. […] Antibiotics are given to patients with packing for anterior epistaxis to minimize the incidence of toxic shock syndrome, sinusitis, and otitis media. […] The amount of data supporting or refuting this practice is small, though is enough for the EM literature (and UpToDate) to recommend not administering antibiotic prophylaxis to all of these patients, and only using prophylaxis on the immunocompromised or those with valvular heart disease. […] Strict guidelines do not exist in the otolaryngology literature, but given the potential complications, most otolaryngologists, including our own, do recommend prophylaxis with either Keflex or Augmentin for the duration of the packing, which should be removed in 24-72 hours. […] Antibiotics should always be given when posterior packs are placed.

• #25 Toxic Shock Syndrome: What women need to know | Texas Children’s

  https://www.texaschildrens.org/content/wellness/toxic-shock-syndrome-what-women-need-know

  What are the signs and symptoms? The earliest signs of TSS begin abruptly and can present with flu-like symptoms including fever, headache, vomiting, diarrhea and sore muscles. […] How can it be prevented? The current FDA guidelines for decreasing the risk of contracting TSS include: […] – Selecting the appropriate tampon absorbency for menstrual flow […] – Follow package directions for proper tampon insertion […] – Limit wear-time to no more than 8 hours per tampon […] – Avoid wearing tampons overnight […] – Consider alternating tampons with pads […] Safe or not? The bottom line is, yes, tampons are safe to use as long as they are used properly. All teens should be familiar with the basics about TSS prevention before choosing to use tampons and should be properly educated on insertion techniques.

• #26 About Streptococcal Toxic Shock Syndrome | Group A Strep | CDC

  https://www.cdc.gov/group-a-strep/about/streptococcal-toxic-shock-syndrome.html

  There are things people can do to protect themselves and others from group A strep infections. […] Healthcare providers treat STSS with antibiotics. […] People with STSS need care in a hospital.

• #27 Toxic Shock Syndrome (for Teens) | Nemours KidsHealth

  https://kidshealth.org/en/teens/tss.html

  Toxic shock syndrome can be prevented by washing hands well and often. […] During their periods, girls can reduce their risk of TSS by washing their hands well before and after inserting a tampon, not using tampons or alternating them with sanitary napkins, if using tampons, choosing ones with the lowest absorbency that will handle menstrual flow, and changing the tampons often, and on low-flow days, using pads instead of tampons. […] Between menstrual periods, store tampons away from heat and moisture, where bacteria can grow (for example, in a bedroom rather than in a bathroom closet). […] Any female who has had TSS should not use tampons. […] Clean and bandage all skin wounds as quickly as possible. Call your doctor if a wound gets red, swollen, or tender, or if a fever begins.

• #28 Volume 1, Chapter 43. Toxic Shock Syndrome

  http://www.glowm.com/resources/glowm/cd/pages/v1/v1c043.html

  Recommendations for prevention of menstrual-associated TSS remain speculative until the pathogenesis of the disease is better understood. However, presumptive recommendations may be made on the basis of current knowledge. Continual use of tampons through menses and use of highly absorbent tampons should be avoided. Tampons with the greatest amount of absorbency have been removed from the market by manufacturers. Limiting tampon use to the days of heaviest menstrual flow and switching to napkins or pads while sleeping appears appropriate. Tampons for midcycle bleeding, symptomatic discharge, or leukorrhea can be avoided with the alternative use of minipads and appropriate medical care. The fingers and vulva are colonized by S. aureus and careful handwashing before handling a fresh tampon and the separation of the vulva during gentle tampon insertion can be recommended. Vulvar skin and hand cleansing before the insertion of any tampon or contraceptive device can decrease the inoculation of microorganisms into the vagina. Tampons and vaginal contraceptives probably should be avoided in the presence of S. aureus infection elsewhere in the body, including boils, paronychia, or other pyodermas. Handwashing should become customary after handling used tampons.

• #29 Toxic shock syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Toxic_shock_syndrome

  During menstruation: […] Use pads at night instead of tampons […] Try to keep up with changing a tampon every 4 to 8 hours […] Use low absorbent tampons […] Follow directions when using vaginal contraceptives (sponges or diaphragms) […] Make sure to maintain good hygiene during a menstrual cycle. […] For anyone: […] Keep open wounds clean […] Watch wounds and cuts for signs of infection (e.g. pus, redness, and warm to touch) […] Keep personal items personal (e.g.towels, sheets, razors) […] Wash clothing and bedding in hot water.

• #30 Toxic Shock Syndrome (TSS)

  https://healthlibrary.vidanthealth.com/wellness/Stress/Tools/85,P00653

  Because reinfection is common, don’t use tampons if you have had tampon-related TSS. […] You can also prevent TSS with correct and thorough wound care.

• #31 Toxic Shock Syndrome (TSS): Basics & Causes – Consensus: AI Search Engine for Research

  https://consensus.app/home/blog/toxic-shock-syndrome-tss-basics-causes/

  Currently, there are no specific treatments or preventive measures for TSS. […] However, recent research has focused on developing vaccines to combat this condition. […] The study found that the rTSST-1v vaccine was safe, well-tolerated, and immunogenic, representing a significant step forward in the development of preventive measures for TSS. […] Understanding its causes and the recent advancements in vaccine development can help in mitigating the risks associated with this condition. […] Continued research and development are essential to provide effective preventive measures and treatments for TSS.

• #32 :: JKMS :: Journal of Korean Medical Science

  https://jkms.org/DOIx.php?id=10.3346/jkms.2024.39.e154

  According to findings from a longitudinal cohort study, previous detection of certain GAS emm types was associated with protection against typical symptoms upon re-infection with the homologous type. This suggests a potential for the development of an emm type-based vaccine in the future, although there is still a gap in knowledge regarding emm type-based rheumatogenicity. Given the related economic burden, the development of a GAS vaccine could be a global priority.

• #33 Reporting Toxic Shock Syndrome – MN Dept. of Health

  https://www.health.state.mn.us/diseases/tss/report.html

  Toxic shock syndrome must be reported to MDH within one working day. […] For toxic shock syndrome, submission of clinical materials (isolate, if available) to MDH is required by rule. […] Health care practitioners (health care facilities, medical laboratories, and in certain circumstances veterinarians and veterinary medical laboratories) are required to report disease to the Minnesota Department of Health (MDH) under Minnesota state law. […] Any person in charge of any institution, school, child care facility, or camp is also required to report disease to MDH.

• #34 Toxic Shock Syndrome: Symptoms, Causes, Tampons, and More

  https://www.healthline.com/health/toxic-shock-syndrome

  Certain precautions can reduce your risk of developing toxic shock syndrome. These precautions include: […] changing your tampon every 4 to 8 hours […] wearing a low-absorbency tampon or sanitary napkin during menstruation […] using a reusable silicone menstrual cup and cleaning your hands thoroughly when changing it […] wearing a sanitary napkin on light-flow days […] washing your hands frequently to remove any bacteria […] keeping cuts and surgical incisions clean and changing dressings often. […] Don’t wear tampons if you have a personal history of TSS. This condition can recur.

• #35 Toxic shock syndrome

  https://www.nj.gov/health/womenshealth/reproductive-health/periods-menstruation/toxic-shock-syndrome/

  Toxic shock syndrome (TSS) could be a potentially life-threatening condition caused by certain strains of bacteria, most commonly Staphylococcus aureus (Staph) or Streptococcus pyogenes (Strep). Affecting both men and women, it is often associated with women who use tampons. […] To reduce the risk of TSS: […] Use the lowest absorbency tampon necessary and change it frequently (at least every 4-6 hours). […] Alternate between tampons and sanitary pads during your period. […] Consider using menstrual cups or other menstrual products with lower risk. […] Wash your hands before and after inserting or removing tampons. […] Follow proper wound care techniques to prevent infections. […] TSS is rare, especially if you use tampons safely. Change them every 4-6 hours. […] Seek medical help immediately if you experience symptoms associated with TSS.

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