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Sara complained of period pain at her school camp. The next morning, she was dead.

On the night of March 14, 2017, 16-year-old Sara Manitoski complained to her school camp mates that she was feeling unwell and suffering from menstrual cramps.

She was away on a school-run overnight trip.

The next day, after coming back from breakfast, her friends found Sara still in bed, her body unresponsive as her alarm continued to ring.

The students then alerted their teachers who called the paramedics and attempted CPR, but the student from British Columbia, Canada, was not able to be resuscitated.

Now, the British Columbian Coroners Service has confirmed that the teenager died from toxic shock syndrome (TSS) – a potentially fatal, but rare bacteria infection commonly associated with tampon usage.

Documenting the teenager’s last moments, the Vancouver Sun reported that despite not feeling well the day before her death, Sara continued to participate in the activities at the Outdoor Education Centre and was present at a bonfire activity before going to sleep at 9:50 pm.

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During the coroner’s investigation, it was reported that Sara was heard “breathing rapidly and shallowly in the middle of the night for a short period of time” and the autopsy documented increased redness on the teenager’s neck, upper arms, upper chest, lower abdomen and thighs – symptoms consistent with the infection.

Microbiology cultures on a tampon found “in place” also contained the bacteria ‘staphylococcus aureus’ which is often the cause of TSS. Despite this, the coroner’s report specified that “the risk for toxic shock syndrome is increased with tampon use, however, tampon use is not the sole cause.”

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According to Health Direct, there is no evidence that tampons cause TSS – it is instead caused by bacteria.

While medical treatment through antibiotics is normally successful if caught early, early identification is paramount and Health Direct lists the symptoms as diarrhoea, dizziness, tiredness, vomiting, aching muscles, headaches, red eyes, mouth and throat and a peeling red rash found on the hands and feet.