Surveillance of toxic shock syndrome in Minnesota. Comments on national surveillance

In January 1980, the Minnesota Department of Health began the surveillance of toxic shock syndrome with epidemiologically defined active and passive components. The intensity of surveillance has been constant since its inception. As of 30 June 1981, 197 confirmed cases of toxic shock syndrome, 15% of all cases nationwide, have been identified in Minnesota. During the 18 months of active surveillance, the total cases reported per calendar quarter ranged from 20 to 24 cases, and the number of tampon-associated cases ranged from 15 to 21. There was no difference in the quarterly distribution of total (p > 0.2) or tampon-associated (p > 0.2) cases of toxic shock syndrome during the six quarters. Fifty-five tampon-associated cases had onset of illness during the 9 months of surveillance in which Rely tampons (Procter & Gamble) were on the market; 59 tampon-associated cases had onset of illness during the 9 months after Rely tampons were removed from the market.