A 16-year-old girl in Canada died of toxic shock syndrome, according to a newly released coroner’s report that comes more than a year after the girl’s death.
This tragedy is renewing concerns about the rare, but serious, illness that’s caused by toxin-producing bacteria.
In March 2017, Sara Manitoski was found dead in a cabin near Vancouver Island during an overnight school trip.
The coroner’s report found that she died from toxic shock syndrome (or TSS) related to tampon use. While Manitoski’s death is worrisome, experts say TSS is fairly rare.
According to the National Organization for Rare Disorders, the TSS incidence rate is one per 100,000 women aged 19 to 44. However, TSS can be deadly in 50 percent of cases.
However, some who have been affected by TSS, including model Lauren Wasser, say more research is needed on the condition and that tampon makers don’t do enough to warn women about the serious risks. Sara’s older sister, Carli Manitoski, who said it was confirmed to her family in Dec. 2017 that her sister died from TSS, posted on Facebook that women need to be more educated about the illness.
Also, a point that is often glossed over: TSS doesn’t occur by using tampons alone. A woman must have a specific strain of staph bacteria known as “staphylococcus aureus” in her vagina, which then grows within the tampon material to produce harmful toxins.
The coroner’s report from Manitoski’s death shows that a strain of staphylococcus aureus was found on the girl’s tampon and notes that tampon use is not the sole cause of toxic shock.
“We know there is an association, and again, it’s very rare,” Island Health Medical Health Officer Dee Hoyano told CTV Vancouver Island. “Certainly we know a person needs to have this particular bacteria to get sick, and then there may be something with tampon use, maybe prolonged tampon use, that puts that risk higher for developing a more widespread infection.”
What Exactly Is Toxic Shock Syndrome?
While rare, TSS is a potentially life-threatening condition caused by certain strains of bacteria that produce toxins. Those toxins can cause blood pressure to plummet and vital organs like the liver, lungs or heart to fail, according to the Cleveland Clinic.
There are three types of bacteria that have the potential to cause TSS: staphylococcus aureus, clostridium sordelli and streptococcus pyogenes. These bacteria often live on the skin or in mucus membranes, without causing any illnesses. But, under certain conditions, some strains of these bacteria types can grow rapidly, producing toxins.
What Do Tampons Have To Do With It?
If you were a teen or pre-teen girl in the ’80s or ’90s, you probably read your fair share of scary stories about TSS in teen magazines and became wary of tampons.
But what’s the link?
Staph aureus bacteria may become trapped in the vagina when highly absorbent tampons are used, explains the Cleveland Clinic. Then, that bacteria can enter the uterus via the cervix. Also, bacteria may grow on tampons, especially if they are not changed often enough.
Super-absorbent tampons may harbor more bacteria growth, especially if a woman’s menstrual flow is light. The Cleveland Clinic also points out that tampons can cause tiny cuts in the vagina that can then allow the bacteria to enter the bloodstream.
In the early 1980s, a higher rate of TSS cases were reported among women who reported using super-absorbent tampons during their menstrual cycles. Tampon makers have since changed the materials they use to make those tampons; but health experts still warn to change your tampons frequently (don’t leave them in more than 8 hours) and use lower-absorbency tampons, especially when your flow is light.
In 2012, model Lauren Wasser became ill with TSS and doctors had to amputate one of her legs. She had to have her second leg amputated in January 2018.
Wasser is now on a mission to warn women about the potential risks associated with using tampons and advocate for more research into TSS.
TSS doesn’t only affect women who are menstruating. Men and children can also contract it. In fact, 50 percent of TSS cases are non-menstrual. Skin wounds, surgical incisions, burns, nasal packing and gynecological procedures can also increase the risk of TSS, according to the Cleveland Clinic.
What Are The Symptoms?
The onset of symptoms of TSS can be sudden, and they can vary depending on the type of bacteria that are producing the symptoms.
According to the Cleveland Clinic, the symptoms may include:
- Nausea or vomiting
- Sudden high fever and chills
- Watery diarrhea
- Rash resembling a bad sunburn or red dots on the skin
- Dizziness, light-headedness or fainting
- Low blood pressure
- Redness in the eyes
- Peeling of the skin on the soles of the feet or palms of the hands
Hopefully Sara Manitoski’s tragic death will help educate people about the dangers of TSS and prevent another person from losing their life to it.