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Letters
August 21, 1987

Toxic Shock Syndrome

Author Affiliations

National Institute of Child Health and Human Development Bethesda, Md

National Institute of Child Health and Human Development Bethesda, Md

JAMA. 1987;258(7):908. doi:10.1001/jama.1987.03400070046018
Abstract

To the Editor.—  In relating influenza to toxic shock syndrome (TSS), Sperber and Francis1 further diminish the prospect that barrier contraception will be a major determinant of TSS in this country. Even as multiple causes of TSS are identified, the number of recorded TSS hospital admissions is currently estimated to be less than 1500 nationally.2Already, prior surveillance efforts have shown that 60% to 80% of all cases of TSS are associated with menstruation and the use of tampons. The remaining cases of nonmenstrual toxic shock syndrome (NMTSS) occur post partum, in women with surgical wounds, or in women who use barrier contraceptives.3-6 It now appears that a portion of these cases may be due to postinfluenzal staphylococcal super-infection.A recent National Institutes of Health Center for Population Research workshop on TSS and contraception reviewed the National Institutes of Health—supported national case-finding effort by the Centers for

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