Toxic-shock syndrome in Minnesota: results of an active-passive surveillance system.

In January 1980, the Minnesota Department of Health began a surveillance system for toxic-shock syndrome (TSS) with both epidemiologically defined active and passive components. As of June 30, 1981, 197 confirmed cases of TSS, 15% of all nationally reported cases, have been in Minnesota residents. The onset in 61 of the cases was before 1980; these cases were retrospectively recognized and reported. Of the 136 cases reported between January 1980 and June 1981, 114 (83.8%) cases were tampon-associated. During the 18 months of active surveillance, there was no difference (P greater than 0.2) in the quarterly distribution of total or tampon-associated TSS cases. The onset of illness in 55 tampon-associated cases was during the nine months of surveillance in which Rely tampons (Procter and Gamble, Cincinnati, Ohio) were on the market, whereas the onset in 59 tampon-associated cases was during the nine months following their removal from the market.