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Toxic-shock syndrome (TSS) surveillance began in the spring of 1980 after it was recognized that an illness affecting previously healthy young women in Wisconsin and Minnesota was TSS. As of June 1981, 823 cases of TSS meeting the current CDC case definition and having onset in 1980 had been reported. TSS is overwhelmingly a disease of menstruating women (96% of cases) and has been associated with the use of tampons, but cases have also been recognized in males (1.5% of cases) and nonmenstruating females (2.5% of cases). Menstrually-associated cases have been strongly associated with the presence of Staphylococcus aureus in the vagina, while nonmenstrually-associated cases have been associated with focal staphylococcal infections at a variety of sites, including abscesses, surgical wounds, burns, etc. Postpartum cases associated with vaginal infections have also been reported.
Menstrually-associated TSS is predominantly a disease of young women, with over 33% of the cases being reported in the 15 to 19-year-old group. Over 98% of the reported cases have occurred among whites, but cases have been recognized among blacks, Asian-Americans, American Indians, and Hispanics.
A disproportionately large number of reported cases of TSS have come from a small number of states. It is not possible to determine to what extent this difference in reporting between states is a result of true geographic differences in the incidence of TSS and to what extent it reflects the interests of local health officials and researchers.
While a large percentage of the cases of TSS reported in 1980 had onset in the summer and early fall, it is too early to determine whether or not TSS demonstrates seasonality. The extensive publicity regarding TSS may have contributed to the large number of cases reported with onset in August and September 1980.
TOXIC-SHOCK SYNDROME – Reported cases by state and by age, United States, 1980
14, 32, 33
Foodborne 3, 4, 11-17, 25
A (infectious) 3, 6, 10-17, 39-41
Flea-borne (murine) 3, 9, 11-17, 93
Spotted) 3, 9, 11-17, 94, 95
animal 8, 12, 14-17, 67, 68
human 3, 8, 11, 12-17, 67
(see Typhus fever)
Yellow fever 12-17