The toxic shock syndrome revisited.

The association between toxic shock syndrome and the staphylococcal toxin TSST-1 is not entirely consistent. In vitro, the elaboration of the toxin occurs only under aerobic conditions, whereas the environment of the vagina is largely anaerobic. So far, moreover, the materials of which tampons are composed seem not especially to favour the growth of the causative micro-organisms. Further, the relationship between the disease and tampon absorbability is not entirely established. Nevertheless, the effect of particular fibres cannot be discounted.