toxic shock

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Toxic Shock Expert On O.B. Tampon Shortage

A photo from 2008, when o.b.s were still plentiful

I checked back in with Johnson & Johnson spokeswoman Bonnie Jacobs this week to ask if she had any news on the o.b. tampon shortage. No, she messaged: “I don’t have any updates to the information I provided.” (See her previous statement here; she cites a “supply interruption” and says that the decision to discontinue the Ultra size was not based on any adverse events.)

All well and good, but frustrated reports of empty o.b. shelves continue to roll in to CommonHealth from as far away as Iceland, and to be honest, I’m now just ragingly curious. Why can Johnson & Johnson not just tell their clamoring would-be customers exactly what went wrong with o.b. production? And why not disclose their reasons for doing away with the Ultra, which has long been a mainstay for women with heavy periods?

One theory bandied about in our comments is that perhaps the Ultras, or o.b.s in general, have been linked to recent cases of toxic shock, a rare but potentially deadly syndrome that can be triggered by tampon use. To check on that, I spoke today with the microbiologist known for helping to crack the mystery of toxic shock syndrome back in the 1980s.

Dr. Philip M. Tierno Jr. is director of clinical microbiology and immunology at New York University Langone Medical Center, and author of the “The Secret Life of Germs.” He has been involved in work on toxic shock syndrome for thirty years, and speaking with him for just a few minutes is enough to convert any tampon-user to the all-cotton products sold in health food stores. Or pads. Or cups. The point is, toxic shock, though rare, still happens. Young women still die, or need limbs amputated, he said.

But first, the o.b. question. I laid out the picture of the shortage, including J&J’s report of supply interruptions, and asked what light he could shed.

“I have no idea what their production problem is,” Dr. Tierno said. “Certainly there is some sort of production problem, that’s clear. I know that tampons are made primarily of viscose rayon; sometimes they may have mixes of cotton. And what I know is that the Chinese and other producers of cotton have had difficulty with crops. So this may play some role, if they’re mixing with a specific amount. And the only other thing I can tell you is that all of the extant tampons on the [mainstream] market are made with the synthetic ingredient viscose rayon, in mixes with or without cotton, and all of these extant tampons are able to produce TSST1 toxin [which has been implicated in toxic shock syndrome]. In my studies I have clearly shown that, albeit viscose rayon is the best of the bad four ingredients in tampons and the other three have been removed, this still remains, and toxic shock still occurs in this country, and deaths also occur in this country.”

[See this story on a 20-year-old Indiana woman who died of toxic shock syndrome this summer.]

How many people are dying? I asked. A handful a year? Continue reading