The Effect of Publicity on the Reporting of Toxic-Shock Syndrome in Wisconsin

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Abstract
The Wisconsin and Centers for Disease Control (CDC) surveillances for toxic-shock syndrome (TSS)were compared; the distributions of CDC and Wisconsin cases in 1980 by calendar quarter of the initial onset werevirtually identical. Among 131 casesin Wisconsin, 33 of 40 self-reported vs. 16of 91 physician-reportedcaseswere reported during the four-week period (September 18–0ctober 15, 1980) following the CDC announcement of a higher relative risk of TSS among users of Rely® tampons (Procter and Gamble, Cincinnati, Ohio) (P < 0.(01). Of cases with onsets during October 1, 1979–June 30, 1980, eight of 31womenwith physician-reportedcasesvs. nine of 15 with self-reported cases used Rely tampons during their TSS-associated menstrual period (P P < 0.05). Multiple interviews of 22 patients with TSS suggested that patient recall of tampon brand may have been influenced by publicityabout TSS. Passive as compared with partially active surveillance for TSS significantlyfavored self-reporting. In Wisconsin, the volume and source of TSS reporting have been greatly influenced by publicity, and selective reporting of TSS has been influenced by the content of news media reports of TSS.

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