The Deadly Toxic Shock Syndrome
Affecting Older Women

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February 5, 2018,
By Susan Callahan, Associate Editor and Featured Columnist

A woman woke up with a fever and a bladder infection. She
was not alarmed because she had had them many times
before. But when she couldn't remember her name, her
husband took her to the hospital. She had sepsis, the
deadly blood infection, from the recurrent bladder
infections. But who had given her the bladder infections?

There ought to be some compensations for getting older.
One of the compensations older women thought we got
was freedom from toxic shock syndrome. Remember toxic
shock syndrome? It's that bacterial infection caused when
younger women left tampons in their vaginas too long.
Over a period of hours, the tampons accumulate too much
bacteria, the bacteria escapes into the blood stream
through the vagina, causing sepsis, leading to shock and
organ failure.

Safely past menopause, with the days of tampon use a
faraway memory, most of us thought that toxic shock
syndrome was a danger in our rear view mirror, right?

Wrong. Toxic shock syndrome is still a very real threat to
post-menopausal women, only it masquerades under
different names. Let's take a look and connect the dots.

Sexual Intercourse Can Introduce the Same Bacteria as
Tampons and Cause Sepsis

The good news is that more women beyond the
reproductive years are still having sex. Sex helps to
improve our mood, our emotional connections with our
mates and even gives us a bit of exercise.

Unfortunately, there is one big downside to having an
active sexual life after menopause --- the risk of infection.
Penile intercourse can introduce bacteria that can lead to
bladder infections (called "cystitis" when it is bacterial in
origin)and other conditions. The now epidemic rise in
cystitis, once called "the honeymoon disease", is linked
directly to the extension of the years of erectile
performance in men enabled by Viagra. Older men are
having sex decades into retirement and women are
becoming more infected with cystitis and related risks.

Bladder infections, when they are left untreated for long
enough, can trigger the same bacterial cascade that leads
to sepsis.

The Cytokine Storm Is the Same Trigger That Causes Toxic
Shock Syndrome and Sepsis from Bladder Infections

The underlying biological processes underlie toxic shock
syndrome and sepsis from bladder infections.

By the way, this cytokine storm is also the underlying
process that led to 50 million deaths in the 1918 flu

The same toxic sepsis may have been responsible for
plague that ended the Golden Age of Athens, in ancient
Greece, according to Dr. Donald E. Low, writing in the 24th
Edition of  the medical reference text, Goldman's Cecil
Medicine (2012).

Toxic shock syndrome was first described following a series
of cases involving young women in 1978. These young
women, soon after they began menstruating, became
critically ill with fever, rash, and extremely low blood
pressure. Eventually, doctors were able to connect the
dots, and linked the syndrome to the use of highly
absorbent tampons which had become colonized with a
toxin producing strain of Staphylococcus aureus.

After the initial cases of toxic shock, other cases were
found in women who had just given birth or who had
undergone surgery.

The symptoms of toxic shock and sepsis following bladder
infections are the same --- fever, low blood pressure,
vomiting, confusion, multiple organ involvement.  

The complete list of symptoms, drawn from a study entitled
"Toxic Shock Syndromes" by Dr. Michael Klompas, are:

Temperature 38.9° C (102° F)
• Diffuse macular erythroderma

• D esquamation—1–2 weeks after onset of illness,
particularly palms and soles

• Systolic blood pressure 90 mm Hg

• Multisystem involvement—three or more of the following:

1. GI: vomiting or diarrhea at onset of illness
2. Muscular: severe myalgia or creatine phosphokinase level
at least twice the upper limit of normal for laboratory

3. Mucous membrane: vaginal, oropharyngeal, or
conjunctival hyperemia

4. Renal: BUN or creatinine at least twice the upper limit of
normal for laboratory or urinary sediment with pyuria (5
leukocytes per high-power field) in the absence of urinary
tract infection

5. Hepatic: total bilirubin, ALT, AST at least twice the upper
limit of normal

6. Hematologic: platelets over 100,000/mm3

7. CNS: disorientation or alterations in consciousness
without focal neurologic signs when fever and hypotension
are absent.

Sepsis and toxic shock syndrome both result from the
body's overreaction to an infection. An infection triggers in
your body triggers a response from the immune system.

With severe infections, the body releases multiple defensive
weapons, all of which must be coordinated by signalling
compounds called "cytokines".  An overwhelming flood of
pro-inflammatory cytokines of many different types are
released --- called a "cytokine storm" --- which leads to the
immune system going rogue.  Rather than protecting the
body from invading infection, the immune system begins
attacking the organs of the body, leading to organ failure
and, in many cases, death.

"Cytokine storm" is a term you'll want to keep handy in
your memory. These storms, once triggered mostly during
childbirth in the days before antibiotics, are now being
triggered more and more by bacteria and in simple,
everyday settings.  Doctors have seen cases of toxic sepsis
that started with simple cuts, nosebleeds and, yes, sex.

All that needs to happen is the introduction of bacteria into
your blood, coupled with an over-reactive immune system,
and you're there.

So, How Can You Avoid Developing Toxic Shock

Practice Clean Sex. Sex is about sharing of bodily fluids.
But it needn't become toxic. Men need to be especially
vigilant with their hygiene, cleaning their penis before sex,
to protect their partners from the introduction of bacteria.

Go to the Toilet the Correct Way. You have to be
especially careful not to introduce bacteria from feces into
your bladder or vagina. Wipe from front o back. Use wet

3. Change Underwear Often to Stay Dry and Clean. Many
women use panty shields to protect the panties from bodily
fluid. But they should be protecting their vagina and
bladders from the shields,once they become soiled.

The solution is to stay dry and clean. Change underwear
often. Check your underwear and if there is soiling, clean
your body carefully and also change your underwear.
Always carry extra underwear.

4. Drink Plenty of Fluids. Bladder infections increase when
you are dehydrated. Drink up! It's rather easy to become
dehydrated as you age.  Your body's ability to detect when
you are actually dehydrated

5. Take Care of Infections Immediately. Pay attention to
any infection, both acute and chronic. Chronic bladder
infections, boils, nosebleeds, vaginitis, periodontal disease
-- any and all infections, low grade or urgent, need to be
addressed. Otherwise, your body's protective immune
system may become alarmed and overreact.

Antibiotics Are a Help and a Problem

The first line of defense in treating sepsis are antibiotics.
Unfortunately, doctors are finding that, owing to the
overuse of antibiotics, many strains of bacteria now are
resistant to them.

New drug therapies are being developed to dampen the
cytokine storm while at the same time protecting the
organs from failure.

Oregano oil and thyme also may help in fighting drug
resistant infections, new studies have found. One 2003
study led by the Universita di Messina in Italy, entitled
"Susceptibility of methicillin-resistant staphylococci to
oregano essential oil, carvacrol and thymol" found that
topical application of oregano oil reduces MRSA skin
infections. Other studies are needed to confirm that
ingestion of orgeano as a tea also remediates MRSA.

We have seen that thymol, the active ingredient in thyme
spice, inhibits
boils and MRSA skin infections. For  this
reason, we advocate a
weekly body rinse with these herbs
to help prevent skin infections


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Oregano oil inhibits MRSA