Toxic Shock Syndrome almost killed 24-year-old Joanna Cartwright.

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When Joanna Cartwright awoke after eight days in an induced coma, she was surrounded by photos of her daughters Lacey, Nicole and Scarlett-Rose. Although the girls’ faces looked familiar, the then 24-year-old says she “couldn’t place them” in her memory.

“It’s very strange to wake up and not know who you are or where you are … I tried to speak but by the time I’d got to the end of a sentence I couldn’t remember why I’d started it,” the English mother told The Daily Mail.

The illness that caused Ms Cartwright to be put in the coma is one every woman is familiar with: Toxic Shock Syndrome. TSS is a rare, serious infection caused by the overgrowth of certain bacteria – in most cases, Staphylococcus aureus (staph), or group A streptococcus (strep). When this occurs, a toxin is released by the bacteria that can affect numerous regions of the body.

While anyone can develop TSS, and it can result from any situation where a bacterial infection is present (eg. surgery, or cuts and burns to the skin) it most commonly occurs in women during menstruation, and is thought to be linked to tampon use.

This is why tampon packages usually contain warnings about the risk of TSS.

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In Ms Cartwright’s case, the infection did come from a tampon. When she initially fell ill, she thought he had the flu – but three days later she was having difficulty breathing and was sliding in and out of consciousness. When her mother and partner Stephen rushed her to the hospital, they were informed she had just hours to live.

“My internal organs were shutting down so I was put on life support, and put into a medically induced coma … My hands had swollen, about eight layers of skin peeled off, I lost about 50 per cent of my hair, and all my nails fell off – I must have looked horrendous,” Ms Cartwright tells the Daily Mail.


According to Brisbane-based obstetrician Dr Gino Pecoraro, it’s not unusual for TSS to present in such dramatic ways.

“The classic presentation is that [the patient] looks bright red – they think they look sunburnt, but their blood vessels open up and the skin starts to peel off,” he explains.

Depending on where the infection goes in the body, high temperatures, muscular pain, light-headedness and headaches are also common side-effects. TSS can also infect the kidneys and cardiovascular system, causing symptoms like a drop in blood pressure.

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For Joanna Cartwright, toxic shock syndrome almost claimed her life. She was put into a coma on her 25th birthday, and woke up eight days later confused and disorientated, unsure of where she was and who was around her – even confusing her brother for her boyfriend. “All I really knew was that I was very poorly, and I thought I was going to die,” she recalls.

Two days after she left the hospital, doctors called Ms Cartwright to tell her she’d suffered from TSS, and subsequently, meningitis. She was particularly shocked to learn her TSS had resulted from a tampon. “I hadn’t done anything different from what I usually do every other month.”

Just reading her story is enough to send chills down any woman’s spine – the risk of TSS is something we’ve all been made aware of through sex education and learning to use tampons. Although it’s a very rare occurrence, there is a link between tampon use and TSS, mainly due to the environment surrounding a tampon after insertion.

“If you’ve got a skin infection with the bacteria, it can be transferred to the vagina when putting a tampon in. As it’s warm and moist it allows bugs to grow. It can also push where the infection is close up to the vaginal walls, making it easier for toxins to diffuse into the bloodstream,” he says.


However, he stresses there is no need for anyone to be scared of using tampons due to the TSS risk. First of all, he explains, the recorded incidences of TSS are very low – just 20 patients contract it annually in the UK, resulting in three deaths.

In the US, the figure is 1 woman in 100,000 between the ages of 15 and 45. Dr Pecoraro has only witnessed two cases of TSS in his more than 20 years as an OB/GYN.

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He says it’s also important to remember the tampon was a huge advance for women, providing them a discrete way to manage periods, and that thousands of women around the world will use countless tampons throughout their lives.

“Put it into perspective. Tampons have really really helped make the whole menstruation thing a lot less dramatic; they’ve changed women’s lives. Before the days of tampons, when you just had the surfboards [large sanitary pads], having a period was quite an invasive thing.”

Dr Pecoraro says Joanna Cartwright’s case is a “timely reminder” for women to simply follow the instructions provided by tampon manufacturers, and to see a doctor if they experience a high fever or rash.

“Wash your hands before you put a tampon in, make sure they’re individually wrapped and that you take the plastic off just before you put it in because they’re sterile when they’re wrapped. And don’t leave your tampon in for days – you do have situations where women forget they have it in,” he says.

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