The Wisconsin Department of Health Services reported an increase in the number of adolescents with cases of toxic shock syndrome
At Every Turn > Primary Care > Toxic shock syndrome: What to watch for and how your teen can stay safe
Tips Feb 13, 2023

Toxic shock syndrome: What to watch for and how your teen can stay safe

Melissa Vukovich, APNP, Family Nurse Practitioner

Families should know that the Wisconsin Department of Health Services reported an increase in the number toxic shock syndrome (TSS) among teens. Although it is rare, TSS can get very serious, very quickly. 

What is toxic shock syndrome? 

TamponsTSS is caused by bacteria, including certain strains of staph or strep. Strep infections likely cause TSS when there has been an infection due to an open wound. However, staph infections are the most common infection associated with TSS, and are commonly found in teens using tampons. 

Rare, but dangerous 

Over the course of my practice, educating patients and families about the reality of TSS is something that is very important to me. TSS is very rare and thankfully I have never had a patient with TSS. But it is necessary to have conversations with teens about their menstrual cycle, and the proper hygiene they need to follow. 

How to keep your teen safe

There are some clear and easy things all teens should do for proper hygiene during their menstrual cycle. It is important to share and reinforce these steps with others. When done, the following steps reduce the risk for TSS. 

Remind your teen: 

To wash their hands well before inserting a tampon. 

Don’t use unwrapped tampon if it falls on floor before inserting.

Use tampons with lowest absorbency that can still manage their flow.

Alternate between pads and tampons when possible.

Change tampons every four to six hours. 

Don’t use a super absorbency tampon to avoid need to change during the school day. Share with a teacher or office person the need to visit the bathroom.

Don’t use tampons overnight. 

If menstrual flow is light, use a maxi-pad instead.

Never use a tampon for “vaginal discharge.” Tampons are for bleeding only

Tips to using the right tampon for the right flow

1. First and last days of period are often lightest. Use a light maxi-pad or light tampon if needed.

2. Start with a regular tampon and change it every 4-6 hours. If it is full sooner than 4 hours, increase to a super tampon. Increase to the next size as needed only if the current size fills sooner than 4 hours.

3. If your tampon is mostly white at 4-6 hours or feels dry and uncomfortable when removed, it’s too absorbent. Go down a size or change to a pad.

If you have questions about how to talk with your teen about their menstrual cycle, or would like to seek care for any menstrual-related concerns, please reach out to our Teen Health Clinic.  

What are the symptoms? 

TSS symptoms include: 

A sudden high fever

Low blood pressure, which may cause dizziness or feeling faint

Vomiting or diarrhea

A rash resembling a sunburn, particularly on the palms of hands or soles of feet 

Confusion

Muscle aches

Redness of your eyes, mouth and throat

Seizures

Headaches

If you or your child are experiencing these symptoms, remove tampon if present and seek medical attention immediately. TSS can progress very quickly, and can lead to shock, kidney and liver failure or death. 

TSS requires hospitalization and antibiotics. The Children’s Wisconsin critical care team is experienced in treating TSS and are able to provide the immediate help your teen needs with care and compassion. But our real goal is to keep kids healthy and out of the hospital.  

Here to help

Children’s Wisconsin is here to help you — whether you’re anticipating a visit with us or not. Remember, educating ourselves and others is the best thing we can do to prepare for the unexpected. It’s why I love my practice — planting a seed of knowledge helps to grow healthy children and families, which is what we’re all about at Children’s Wisconsin.

Children's Wisconsin Resources

Children’s Wisconsin has more than 20 primary care offices conveniently located throughout the Milwaukee area and southeast Wisconsin. Find a pediatrician near you. View more articles from Melissa Vukovich, APNP

Related stories

Beige parenting Children's Wisconsin
Tips Apr 02, 2025

The Rainbow Connection: How the Beige Parenting Trend Can Affect Children

Elizabeth Frantal, PA-C Physician Assistant

Beige parenting deviates from the bright colors and bold patterns that have dominated baby items for decades.

Children's Wisconsin Eating Disorder Program Adolescent Health and Medicine
Tips Mar 26, 2025

What Parents Need To Know About the Rise in Eating Disorders

Margaret Thew, DNP, FNP-BC Family Nurse Practitioner

Eating disorders can affect many parts of a child’s life, including how they feel physically and emotionally, as well as their friendships.

How to treat seasonal allergies in kids Children's Wisconsin
Tips Mar 21, 2025

Kids and Seasonal Allergies: Navigating Symptoms and Solutions

Andrew MacGinnitie, MD Allergy Immunology Specialist

Knowing what’s causing your child’s seasonal allergies can be helpful in minimizing exposure to common triggers.

Is your kid ready for overnight summer camp Children's Wisconsin
Tips Mar 18, 2025

Happy Campers: How To Tell if Your Child Is Ready for Overnight Camp

Maggie Moegenburg, LCSW Behavioral Health Consultant

If you’re thinking about sending your child to an overnight camp, it’s essential to assess whether they’re ready.

Measles outbreak United States 2025 Children's Wisconsin
Tips Mar 10, 2025

Measles outbreak shows importance of getting your kids vaccinated

Frank Zhu, MD Medical Director

The recent measles outbreak is a regrettable reminder to all of us of just how preventable this disease truly is when your child is vaccinated.

Teaching kids about finances and money management Children's Wisconsin
Tips Mar 04, 2025

Dollars and Sense: Teaching Kids About Money

Sadia Hussain, DO Pediatrician

How to build healthy attitudes and practices about money.

How to identify and treat dry winter skin Children's Wisconsin
Tips Feb 26, 2025

Dry Days: How To Treat Itchy Skin in the Winter

Leah Lalor, MD Dermatologist

How to treat identify, treat and prevent dry skin in the winter.