Who is affected by toxic shock syndrome?

Toxic shock syndrome (TSS) can affect men, women, and children. Most people who get TSS are in good health before they become ill. The illness usually develops rapidly, and most people become much sicker than would be expected if they simply had the flu or another minor infection. This can be a life-threatening illness, so immediate medical treatment in a hospital is always necessary.

Most cases of TSS that people have heard about have been related to women using tampons, which is called menstrual TSS. Young women aged 13 to 19 are affected most often, representing about 40% of menstrual TSS cases.1

Nonmenstrual TSS can follow outbreaks of the flu or be a rare complication of chickenpox. About 55% of people who develop TSS have nonmenstrual TSS. Nonmenstrual TSS may be related to a history of antibiotic use. It is most likely to develop in women who are in the hospital after childbirth or a surgical procedure.1

Menstrual TSS has declined since women have become more aware of the direct relation of TSS with tampon use. Also, certain extremely absorbent tampons are no longer available, which means that a woman must change a tampon more often. This reduces the risk for TSS.

While menstrual TSS cases have decreased, nonmenstrual TSS continues to occur at a steady rate.


  1. Andrews MM, et al. (2001). Recurrent nonmenstrual toxic shock syndrome: Clinical manifestations, diagnosis, and treatment. Clinical Infectious Diseases, 32(10): 1470–1479.

Last Updated: March 3, 2008

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