LANSING, Mich. - The Michigan Department of Health and Human Services (MDHHS) reported that a cluster of tampon-associated Toxic Shock Syndrome (TSS) cases have been reported in the state. FOX 17 first brought you this story in January , and we've been following the state's investigation ever since.
Since December 2015, there have been five reported cases of TSS across Michigan. The cases were reported in four different local jurisdictions, including Kent County.
"We have an elevation in the number of cases of Toxic Shock Syndrome in the state of Michigan, so that kind of pushes us to do this additional investigation on a state wide level," said Kent County Epidemiologist Brian Hartl Wednesday afternoon. "Over the past ten years, we’ve seen fewer than four [cases] each year and so we’re already into the second month of the year and we’ve had five cases already."
Rylie Whitten, a teenager from Greenville, Michigan, was placed on life support at Helen DeVos Children's Hospital in January when she was found to be suffering from TSS. According to her dad, Nate Whitten, she is recovering and doing better. Her toxic shock is believed to have been caused from the tampons she was using, of which her father says she used properly.
The MDHHS says that TSS is a rare, but serious, clinical syndrome typically caused by bacterial infection due to Staphylococcus aureus or Streptococcus pyogenes. Toxic shock progresses quickly. Its symptoms include: sudden fever, vomiting, diarrhea, dizziness, muscle aches, low blood pressure, rash, and shock with multi-organ dysfunction. The national fatality rate is about four percent.
“Although Toxic Shock Syndrome cases are rare, this recent cluster is an important reminder to always review product safety information,” said Dr. Eden Wells, chief medical executive in a press released with the MDHHS.
Historically, tampon-associated TSS has been attributed to improper use; for example, leaving a tampon in too long. The MDHHS says that women should never leave a tampon in longer than six to eight hours. Additionally, the risk of TSS increases with the use of higher-absorbency tampons.
The MDHHS says that the only common factor of the Michigan cases has been the products. Four of the five cases involved used the brand Playtex Sport; the fifth was using U by Kotex. Also, four of the five cases were using super absorbency tampons. The FDA has been notified, and issued this statement:
"[The] FDA is aware of the increase in TSS cases linked to tampon use and has been working with Michigan state health authorities to learn more about the recent cases. The agency recommends that women read and follow the instructions on tampon package labels to minimize their risk of TSS and to understand the warning signs."
But according to Hartl, the FDA isn't doing enough.
"So far, I don’t think there’s been a great response, you know, from the FDA on this situation," Hartl said. "This may change things now that we’ve got some of these other linkages with the four cases with the one brand and the bar codes that match, but that’s all done through the FDA."
Although most of the TSS patients used the same brand of tampon, Jennifer Eisner of the MDHHS tells FOX 17 there's still no proof this brand is to blame for the recent uptick in TSS cases across the state.
"To date, we do not have scientific links," Eisner said. "We just know four of the five cases were linked to one brand and one to another, so out of an abundance of caution we’re putting this information out there but we absolutely don’t have a scientific link at this point."
Right now, the MDHHS is working closely with local health departments on behalf of these cases. A Michigan Health Alert Network notification was sent to health care providers to encourage enhanced surveillance and collection of clinical specimens and product history during evaluation.
"We want to make sure we’re aware in monitoring any new potential cases, that doctors are looking out for it so we can respond quickly and efficiently and work with our local partners to identify any potential links there may be," Eisner said.
FOX 17 reached out to Playtex for comment, but as of Wednesday evening have yet to receive a response. The website for their Playtex Sport line has a link that provides information to consumers about TSS. Kotex's web page has a section called 'tampon safety' that redirects visitors to a TSS warning page from the FDA.