Action Urged on Toxic Shock : Health Groups Seek Detailed Warnings of Link to Tampons

Consumer groups, reacting to the death of a Riverside woman from toxic shock syndrome, are calling for immediate federal action to require more detailed warnings about the link between highly absorbent tampons and the sometimes deadly disease.

Sybil Shainwald, board chairman of the National Women’s Health Network, complained recently that warnings about toxic shock syndrome that appear on tampon packages are not detailed enough and that “manufacturers have refused to come to any agreement” on the matter.

“To hear about a young woman dying from something like this is terrible when it could be prevented,” she said.

In recent weeks, two manufacturers have voluntarily offered to exchange tampons that contain high-absorbency material. One of them, Playtex Inc., made the tampons used by Tammy Bader McNabb, 21, a Riverside woman who died this month in one of the year’s first cases of toxic shock syndrome. The other company that has begun an exchange program is Tambrands Inc., which manufactures Tampax tampons.

Absorbency Rating Due

The Food and Drug Administration now requires manufacturers to warn women that tampons are only “associated with” toxic shock syndrome. But, in September, the agency will announce regulations requiring the companies to numerically rate the absorbency of their products.

Until the rules are announced, Shainwald said, a chart rating tampon absorbency will be available through her organization.

However, in spite of the renewed warnings about high-absorbency tampons, federal health officials said they have seen no surge in cases of toxic shock syndrome. Instead, they said, only 186 cases of toxic shock syndrome were reported in 1984, compared with 867 reported in 1980, when the highest annual number of cases raised nationwide concern about the disease.

By the end of last year, 2,683 cases of the disease had been reported since it was discovered in 1978, and 114 of them were fatal, said Dr. Seth Berkley, an epidemiologist for the Centers for Disease Control in Atlanta. He added that, because reporting is not required, the number of cases could be even higher.

He said that most of the cases involve young menstruating women but that some men also have contracted the disease, which can be transmitted through surgical gauze that contains the absorbent materials linked to the syndrome. The disease also has been linked to the use of diaphragms.

Although publicity about the disease had waned in the last few years, the illness “never went away,” Berkley said.

Dr. Bruce Dan, senior editor of the Journal of the American Medical Assn., said that one reason why the disease persists is that many of the women most susceptible to it were too young in 1980 to have learned about it. Dan, a former CDC official, said that those most likely to contract the disease are aged 14 to 19 and that many of them “know nothing about it.”

The disease strikes suddenly, causing high fever, skin rash, vomiting, diarrhea and sinking blood pressure. If such symptoms occur during menstruation, a woman should immediately remove her tampon and call her doctor, Dan said.

Even before the absorbency issue had been raised, many health officials and consumer groups had said that more prominent warnings on the outside of tampon boxes would help prevent the increase of the disease.

Hercules Sotos, president of Playtex Inc., said in an interview that he was “sorry to hear about the death” of the Riverside woman, but stressed that his company’s product contained the warning now required by the FDA. He added that the company has not decided whether to support the FDA’s planned numerical ratings on absorbency.

Paul E. Konney, a vice president of Tambrands Inc., opposes the numerical approach. “We have been advocates of the word system,” he said, referring to designations such as “regular” or “super.”

Konney said marketing research shows that “over 90% (of the women who use tampons) are aware of toxic shock syndrome and its symptoms, so we believe we are doing a good job of letting women know what it is.”