Toxic Shock

A history of Toxic Shock Syndrome

In 1978, doctors in Denver, Colorado observed several healthy children who suddenly and mysteriously developed a serious, life-threatening illness with no visible source. Their condition, which doctors dubbed ‘toxic shock syndrome’ (TSS) was rare, but observed with increasing frequency over the next few years in young women, and was soon learned to be associated with a bacterium and the use of high-absorbency tampons that had only recently gone on the market. In 1980, the Centers for Disease Control identified Rely tampons, produced by Procter & Gamble, as having the greatest association with TSS over every other tampon, and the company withdrew them from the market. To this day, however, women are frequently warned about contracting TSS through tampon use, even though very few cases are diagnosed each year.

Historian Sharra Vostral’s Toxic Shock is the first and definitive history of TSS. Vostral shows how commercial interests negatively affected women’s health outcomes; the insufficient testing of the first super-absorbency tampon; how TSS became a ‘women’s disease,’ for which women must constantly monitor their own bodies. Further, Vostral discusses the awkward, veiled and vague ways public health officials and the media discussed the risks of contracting TSS through tampon use because of social taboos around discussing menstruation, and how this has hampered regulatory actions and health communication around TSS, tampon use, and product safety.

A study at the intersection of public health and social history, Toxic Shock brings to light the complexities behind a stigmatized and under-discussed issue in women’s reproductive health. Importantly, Vostral warns that as we move forward with more and more joint replacements, implants, and internal medical devices, we must understand the relationship of technology to bacteria and recognize that both can be active agents within the human body. In other words, unexpected consequences and risks of bacteria and technology interacting with each other remain.

Sharra L. Vostral is Associate Professor of History at Purdue University. She is the author of Under Wraps: A History of Menstrual Hygiene Technology.

Vostral has found a wealth of information: from medical reports and research, to legal papers and media coverage. Her assemblage of sources is never forced, but rather presents a Donna Harawayesque combination of biology, technology, culture and gender... Vostral effectively dismantles another myth: menstrual history is not just about women but has in fact been dominated by men in corporate positions for around 100 years. Knowing the complicated history of TSS strengthens both the history of technology and menstruation, but, equally important, it also empowers consumers more than the small insert warning of potential death in each tampon box purchased today.

Monica J. Casper,Co-editor of Critical Trauma Studies:
Vostrals excellent and accessible book is the first to address Toxic Shock Syndrome. She helpfully situates it within the history of the womens health movement, which challenged TSS through Our Bodies, Ourselves and other fora. Beautifully written, Toxic Shock melds feminist science and technology studies with careful attention to how 'health' works politically, culturally, and affectively. It is a superb addition to the womens health and biopolitics literature.

Rebecca Herzig,Author of Plucked: A History of Hair Removal:
This deft study of technology, disease, and consumer capitalism illuminates the centrality of shame in the history of U.S. women's health and health policy. The story of Toxic Shock Syndrome is as necessary as it is painfula harbinger, Vostral shows, of other medical injuries to come.

Women's Reproductive Health:
Lays bare the devastating consequences of the broad cultural, legal, and corporate misunderstanding of tampons as an inert technology that could not produce a reaction within the body. Vostral explains the pathology of tampon-related toxic shock syndrome (TSS) in accessible language with clarity and authority that has often been unfortunately missing from contemporary discussions of TSS. The publication of this book is timely and welcome, as it provides a rich and scholarly counterpoint to recently reported cases of TSS in mainstream media (e.g., Vonberg & Ritschel, 2018). Vostral’s is a voice of reason in contrast to irresponsible and poorly researched journalistic articles, which have the potential to reignite the confusion and panic experienced by many women and healthcare professionals in the late 1970s and early 1980s when TSS first made the news. This detailed account of the complex co-factors that contributed to—and the failure to adequately solve—the 1980s TSS health crisis brings a much-needed understanding of the disease into the women’s reproductive health research community’s and the public’s consciousness

Choice:
Vostral provides a history of the societal and medical contexts, events, and investigations that eventually revealed tampons and bacteria as co-producers of illness and thus a women’s health problem… Vostral uses the social history of toxic shock syndrome as a cautionary tale about the potential for other illnesses that could emerge from biocatalytic activity, and about the limits of health activism to provoke actions to ensure consumer safety.

Social History of Medicine:
Despite the corporate silence, Vostral has found a wealth of information: from medical reports and research, to legal papers and media coverage. Her assemblage of sources is never forced, but rather presents a Donna Haraway-esque combination of biology, technology, culture and gender... her book should be the standard text on TSS, rather than the corporate one-liner found in consumer goods.