How common is TSS?

TSS is a very rare illness - much rarer than one would predict based only on the considerations discussed in the previous section ’How does TSS occur?’ Health Department figures likely understate the true incidence, both because of incomplete reporting and misdiagnosis. Nevertheless, only about 18 "probable" or "confirmed" cases (see Table 1 for definitions) are reported in the UK each year, from a total population of some 58 million [Source: UK Public Health Laboratory Service 1985-1995]. A similar number of cases meeting 4 or fewer criteria are also reported. The mortality rate for confirmed or probable menstrual cases has historically been about 2.5 percent. It is two- to three-fold higher for nonmenstrual cases.

In what settings does TSS occur?

TSS can occur whenever a nonimmune person is exposed to a TSS toxin. Illness is said to be "menstrual" if it occurs during the menstrual period and "nonmenstrual" if at other times. Each category accounts for about half of cases ( Table 2). It is thought that the risk of TSS may be greater in children and young people, and that the acquisition of protective antibodies being a function of age.