From 2004 to 2014, the number of toxic shocks increased from 5 to 22. Young women are poorly informed about the risks during their period.
Tampons should be worn for a maximum of eight hours. The warning is present on all buffer packets. Beyond this period, the risk of toxic shock syndrome (TSS) increases sharply. A clear message, but largely ignored by the general public and health professionals. It must be said that the disease is particularly rare: 22 cases were diagnosed in 2014. TSS is no less serious since it often results in hospitalization and can cause severe complications. To raise awareness, the Hospices Civils de Lyon (Rhône) are sounding the alarm.
It is Gérard Lina who is at the origin of this alert. This specialist is the head of the bacteriology and mycobacteria laboratory at CH Lyon-Sud. Since 2004, he has observed a marked increase in cases of menstrual TSS. They went from 5 to 22 in 2014. All these young women presented the typical symptoms: fever, vomiting, sore throat, diarrhea, dizziness… A sudden and apparently unexplained increase. And above all: “Among these 20 cases, 16 to 18 concern young girls in good health who end up in intensive care”, deplores the researcher.
Source : Hospices Civils de Lyon
The secret of the manufacturers
Gérard Lina has been interested in toxic shock syndrome during menstruation for 20 years. The disease is caused by a Staphylococcus aureus naturally occurring in the vagina. It makes up 4% of its flora. Of these bacteria, a quarter releases a toxin that causes TSS.
“The toxin is not present in the tampon,” he emphasizes. An important detail that is often forgotten. And for good reason: the rules favor the occurrence of SCT when the flow is blocked by a protection – tampon or menstrual cup. “The fluids serve as a sort of culture medium,” illustrates Professor Lina. If periodic protection is worn for too long, the risk of developing staphylococcus increases. This explains the confusion.
Most people develop antibodies to this toxin. This explains the rarity of incidents, which mainly occur among young women. But certain factors favor the development of Staphylococcus aureus and its toxin.
Among them, the composition of the tampon. “The literature shows that polyacrylate promotes toxic shocks”, indicates Gérard Lina. The only problem: the periodic protection industry maintains the utmost secrecy about the components used despite repeated requests. The absorbency of tampons is also a problem, since it extends the time that the product is worn.
An American epidemic
Concrete solutions exist to prevent TBS. But the subject remains taboo. In the periodic protection department, learning is done on the job. “The rules are seen as something dirty,” summarizes Gérard Lina. Unfortunately, he is not the only one to make this observation.
A vague malaise thus hangs over the periodic protections, and the young girls are not educated in the precautionary measures. If they don’t take the time to decipher the records, mistakes are easy. “Two-thirds of the young women questioned looked at the instructions for use, the others did not,” laments Professor Lina.
Another major obstacle arises in the path of this seeker. The declaration of toxic shock syndrome is not obligatory. He must therefore rely on the goodwill of the doctors who report cases to the national referral center. They still have to know him. “It is impossible to know if our measure is exhaustive”, concludes Gérard Lina. If an epidemic is brewing, it will therefore be difficult to observe it.
The United States has faced this problem In the 1980’s. It took an epidemic for the authorities to put in place a surveillance system. From now on, all cases must be reported. A decline progressive and sustained new cases followed. In Lyon, Professor Lina wants to be inspired by this model. It calls for the participation of patients and their physicians. After a SCT, any sample can be sent to him.
This will improve knowledge. And tampons aren’t the only protections involved. The currently popular menstrual cups may also be involved.
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