Toxic shock syndrome in Canada.

Fifty-three cases of toxic shock syndrome were reported in Canada from 1976 to 31 October 1981. Three of the 50 women with this syndrome died. Thirty-seven cases were associated with menstruation and all but one of these cases were in tampon users. Staphylococcus aureus has been isolated from eight patients, and enterotoxin was found in seven. The Canadian government has asked tampon manufacturers to print a warning statement on tampon boxes and to include a package insert informing users about toxic shock syndrome. Generally, the incidence of communicable disease in Canada is one tenth that of the United States, reflecting the population differential of 1:10 between the two countries. This ratio has not been found with respect to toxic shock syndrome.