Device-Associated Menstrual Toxic Shock Syndrome

Area of Science:

• Microbiology
• Epidemiology
• Public Health

Background:

• Menstrual toxic shock syndrome (mTSS) gained public and scientific attention in the 1980s.
• Early research elucidated the causative agent, *Staphylococcus aureus*, and its toxin TSST-1.
• Key risk factors, such as tampon use, were identified, leading to public health interventions.

Purpose of the Study:

• To review the historical understanding and conclusions regarding mTSS development and risk factors.
• To highlight the ongoing occurrence of mTSS despite reduced public awareness.
• To emphasize the potential reemergence of TSST-1 producing *S. aureus*.

Main Methods:

• Review of historical research and epidemiological data on mTSS.
• Analysis of the role of *Staphylococcus aureus* and TSST-1 in disease pathogenesis.
• Examination of risk factors and public health interventions.

Main Results:

• Identification of *Staphylococcus aureus* and TSST-1 as the primary cause of mTSS.
• Establishment of tampon use as a significant risk factor.
• Implementation of warning labels and standardized absorbency ratings for tampons.

Conclusions:

• mTSS cases continue to occur, underscoring the need for ongoing vigilance.
• *S. aureus* strains, including TSST-1 producers, exhibit cyclical population dynamics.
• Heightened physician awareness of mTSS and bacterial reemergence is crucial for timely diagnosis and management.