As part of the voluntary recall, Procter and Gamble entered into a consent agreement with the FDA "providing for a program for notification to consumers and retrieval of the product from the market". However, it was clear to other investigators that Rely was not the only culprit. Other regions of the United States saw increases in menstrual TSS before Rely was introduced.It was shown later that higher absorbency of tampons was associated with an increased risk for TSS, regardless of the chemical composition or the brand of the tampon. The sole exception was Rely, for which the risk for TSS was still higher when corrected for its absorbency. The ability of carboxymethylcellulose to filter the S. aureus toxin that causes TSS may account for the increased risk associated with Rely. Notable cases
Clive Barker, fully recovered, contracted the syndrome after visiting the dentist. Lana Coc-Kroft, fully recovered, contracted the syndrome due to group A streptococcal infection. Jim Henson, d. 1990, contracted the syndrome due to group A streptococcal infection and subsequently died from it. Nan C. Robertson, d. 2009, the 1983 winner of the Pulitzer Prize for Feature Writing for her medically detailed account of her struggle with toxic shock syndrome, a cover story for The New York Times Magazine which at that time became the most widely syndicated article in Times history. Barbara Robison, lead vocalist for the psychedelic rock band the Peanut Butter Conspiracy, was performing in Butte, Montana on April 6, 1988; during the concert, she fell ill and was transported to a hospital.
In typical T-cell recognition, an antigen is taken up by an antigen-presenting cell, processed, expressed on the cell surface in complex with class II major histocompatibility complex (MHC) in a groove formed by the alpha and beta chains of class II MHC, and recognized by an antigen-specific T-cell receptor. This results in polyclonal T-cell activation. Superantigens do not require processing by antigen-presenting cells but instead, interact directly with the invariant region of the class II MHC molecule. In patients with TSS, up to 20% of the bodys T-cells can be activated at one time. This polyclonal T-cell population causes a cytokine storm, followed by a multisystem disease. Risk factors
A few possible causes of toxic shock syndrome are:
Cuts or open wounds on the skin
Surgical wounds
Viral infections (e.g.