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Causes of Toxic shock syndrome
Toxic shock syndrome caused by Streptococci is more common than that caused by Staphylococci. TSS develops when Streptococci spread from damaged tissue into the bloodstream. This can happen following accidents, surgery, insect bites (rarely), chickenpox, or some infections. It can be difficult to treat as it is often accompanied by dying tissue (called necrotising fasciitis).
Staphylococcal TSS does not require bacteria to get into the blood: they make their toxins at the body surface. Staphylococcal TSS can develop following minor burns, boils, surgery, ‘flu and in some cases menstruation (most commonly when a tampon has been used). Tampon-associated TSS rates are low – there are around 4-5 identified cases a year. Staphylococcal TSS has a lower death rate and is often more straightforward to treat.
It still isn’t clear why certain bacteria make the toxins in some situations and not others. It’s also unclear why many people don’t become ill after being exposed to such toxins. Children and young people are more likely to get TSS because the antibodies needed to protect against TSS may take several years to develop.
The number of TSS deaths have gone down over the last 20 years because people are becoming more aware of the risks: it is very important to detect shock early, and get emergency treatment as quickly as possible.
