MYTH: Toxic shock syndrome only affects women who use tampons.

FACT: Toxic shock syndrome can affect men, children and women of all ages.

Toxic shock syndrome is rare condition that affects a very small percentage of the population each year. But when it strikes, it can be deadly. And it is for this reason that it puts such fear into the hearts of women. But the condition does not just affect women. And it is not just caused by tampons. In fact, tampon use is a factor in less than half of all diagnosed cases, according to the National Institutes for Health.

What causes toxic shock?

The condition is caused by the body's reaction to bacteria, most commonly certain types of the Staphylococcus bacteria, reports the Mayo Clinic. The syndrome was first identified by Dr. James K. Todd, a Denver pediatrician who noticed the condition in several of his young patients. In the 1980s, incidence of toxic shock syndrome rose significantly and was linked to the use of super-absorbent tampons.

Although no one was ever able to understand why tampons might cause such a deadly infection, public health campaigns were launched advising women and young girls to change their tampons more regularly and steer clear of high-absorbency products. In addition, manufacturers took some higher-absorbency products off the market. The incidence of disease declined and with the public health scare diminished, the disease all but disappeared from the news.

But toxic shock syndrome has not disappeared. And though it is rare, it still has an incidence rate of around 0.52 per 100,000 people for all men, women and children. The incidence is higher, around 1.41 per 100,000 people for women between the ages of 13 and 25 and higher still — around 17 per 100,000 — for menstruating women who use tampons.

Clearly, the link between tampon use and toxic shock syndrome is strong, but using tampons is not the only way to contract the disease. It can also be caused by skin infections, burns and as a complication from surgery. Any time a wound is opened in the body, it can become infected with the bacteria that lead to toxic shock syndrome.

Avoiding toxic shock

The numbers certainly seem to indicate that using tampons cautiously — changing them frequently and avoiding higher-absorbency products — can help reduce your risk. So one might also conclude that avoiding tampons or even switching to reusable feminine hygiene products might reduce your risk even further.

But researchers don't really know why tampon use increases a woman's risk for toxic shock. It could simply be that inserting anything into the vagina causes tiny scratches that open up the area to infection. If that's the case, reusable products would be as likely to cause toxic shock syndrome as tampons.

One of the reasons that toxic shock syndrome is so deadly is that it strikes fast, but its initial symptoms mimic the flu: fever, nausea, vomiting, chills, aches and headache. These symptoms quickly progress to confusion, low blood pressure, seizures and organ failure.

One symptom that may develop — and may help differentiate toxic shock syndrome from the flu — is a sunburn-like rash that may appear on the palms of the hands and the soles of the feet.

But the best way to protect yourself and your family members from toxic shock syndrome is getting medical help right away. So even if the rash is not present, if you are menstruating, or if you have a burn or skin infection, and you develop flu-like symptoms, you should get to the doctor immediately.