Update through 1985 on the incidence of toxic shock syndrome among members of a prepaid health plan.

Through hospital records of men and women aged 15-34 years who were members of the Northern California Kaiser-Permanente Medical Care Program, trends in the incidence of toxic shock syndrome (TSS) requiring hospitalization in 1984-1985 were examined, and the results were compared with those for the period 1972-1983. No definite or probable cases of TSS were found in men during either 1984 or 1985. A total of 16 cases of TSS (10 definite and six probable) were found in women in 1984-1985. Ten (71%) of 14 cases for which the menstrual status of the patient could be determined unambiguously from the medical record occurred during menstruation, and two of the four nonmenstrual cases occurred in postpartum women using barrier contraception. Of the 16 cases, 14 (88%) were diagnosed as TSS or probable TSS by the attending physician, although only nine (64%) of the 14 diagnosed cases were given the correct discharge code. While trends in the incidence of TSS requiring hospitalization in women 15-34 years of age generally paralleled changes in the absorbency of available tampons, the contribution of other factors (e.g., changes in the chemical composition of tampons, changes in patterns of tampon use) to these trends could not be assessed.