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Pamela H. Wolf, DrPH; Jeffrey Perlman, MD; Judith Fortney, PhD; Dennis Lezotte, PhD; Ronald Burkman, MD; Gerald Bernstein, MD, PhD
National Institute of Child Health and Human Development Bethesda, Md

JAMA. 1987;258(7):908.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

In relating influenza to toxic shock syndrome (TSS), Sperber and Francis¹ further diminish the prospect that barrier contraception will be a major determinant of TSS in this country. Even as multiple causes of TSS are identified, the number of recorded TSS hospital admissions is currently estimated to be less than 1500 nationally.²

Already, prior surveillance efforts have shown that 60% to 80% of all cases of TSS are associated with menstruation and the use of tampons. The remaining cases of nonmenstrual toxic shock syndrome (NMTSS) occur post partum, in women with surgical wounds, or in women who use barrier contraceptives.^3-6 It now appears that a portion of these cases may be due to postinfluenzal staphylococcal super-infection.

A recent National Institutes of Health Center for Population Research workshop on TSS and contraception reviewed the National Institutes of Health—supported national case-finding effort by the Centers for . . . [Full Text PDF of this Article]

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