What are the symptoms of menstrual toxic shock?

“Our 17-year-old Maëlle, a great sportswoman, full of life and projects, has just left us in less than 48 hours,” posts the mother of a Belgian teenager on her Facebook profile on Friday January 10. Cause of death: toxic shock syndrome (TSS). This rare disease is an infection due to Staphylococcus aureus, a bacteria naturally present on the body but which can produce a toxin, TSST-1, causing shock thereafter. To contract it, two criteria must be taken into account: having your period and keeping internal protection for too long (tampon, menstrual cup or sponge), until creating an ideal culture medium for bacteria to develop and intoxicate the blood. .

To date, there is no reliable epidemiological study to identify or improve its screening. “We have around twenty cases declared in the laboratory, but since it is not a reportable disease, this remains undervalued”, reports Professor Gérard Lina, hospital practitioner in bacteriology at the National Reference Center ( CNR) staphylococci, located in the Hospices Civils de Lyon. According to their estimates, we would rather approach 100 cases per year. However, while waiting to shed all the scientific light on this syndrome, there are a few early signs to alert and guard against danger.

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Nausea, body aches, rash

Look for no gynecological clue to detect toxic shock syndrome, warns the bacteriologist straight away. In reality, the infection triggers the same symptoms as more common illnesses such as gastroenteritis (nausea, vomiting, diarrhea) or flu-like illness (fever, headache, body aches). This can strongly mislead the medical diagnosis. “The symptoms vary from one woman to another but remain progressive, worsening over the hours,” adds Professor Lina.

The last symptom, and the most characteristic of the infection, remains the rash. When these large sunburn-like spots appear, they multiply all over the body. “The toxins activate the white blood cells which will take the inflammation to the level of the skin”, explains the hospital practitioner in bacteriology. If this sign is suggestive, it especially indicates that the organism is well poisoned and that the toxic shock will occur quickly. This results in a drop in blood pressure, organ failure and vital functions.

Risk factors difficult to detect

But we are not all equal when dealing with toxic shock syndrome. “4% of women are carriers of the staphylococcus aureus producing the bad toxin and 10% do not have the necessary antibodies to protect themselves from it,” said the hospital practitioner in bacteriology.

However, no need to rush to the doctor to perform a test. “The composition of the vaginal flora varies so much from one cycle to another that one can be a carrier one day and the other not. This is false protection, “warns Professor Lina. Age is also to be taken into account. “50% of cases occur before age 17, and the peak of the disease arrives around the age of 15,” says the specialist.

The right reflexes to implement

In practice, depending on the amount of toxins in the blood, the course of symptoms varies from a few hours to half a morning, according to Professor Gérard Lina. From the first signs observed and felt, we must act quickly. “The more they are taken in time, the more we avoid a stay in intensive care, necrosis and especially death,” says the hospital practitioner. And before going to consult, the first and the best reflex to have is to remove the internal protection and replace it with a towel. “Without this tampon or menstrual cup, the blood is no longer kept in the vagina,” said the microbiologist. Then observe if the symptoms go away. If this is not the case, an emergency medical consultation is necessary.

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Fortunately, the hospital bacteriology practitioner notes a growing awareness of pathologies linked to the rules on the part of patients who “arrive at the emergency room better informed and allow toxic shock to be diagnosed earlier”. Many of them, for example, know the story of supermodel Lauren Wasser, both legs amputated, and seek information about this infection. This Tuesday, February 11, two deputies have also submitted a parliamentary information report on menstruation, with the aim of providing women with public health prevention worthy of the name on the subject.

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In their text, they reminded manufacturers in particular of the need to explicitly state the conditions of use of internal protection which, when neglected, are likely to cause toxic shock syndrome. Namely, as Professor Gérard Lina reminds you: sterilize your cup each time you use it, wash your hands before introducing intimate protection, limit the wearing time to less than 6 hours, alternate swabs and towels for better drainage of the blood and avoid sleeping with internal protection.