The Doctor Who Discovered and Named T.S.S. Stresses That Women Are Not Its Only Victims

In May 1975 a 15-year-old boy was rushed into emergency at Children’s Hospital in Denver suffering from high fever, diarrhea, delirium, shock and a red rash which covered his body. Further examination revealed a fingertip-size abscess on his buttock. After treatment that included antibiotics, the boy recovered and his illness was formally recorded as scarlet fever. Dr. James Todd, chief of the infectious disease department, was not convinced. “He was too sick,” Todd recalls. “It was much more severe than the usual case of scarlet fever.”

Two similar cases occurred early in 1977. A menstruating girl of 11 was so sick she required kidney dialysis but survived; in the second, an 8-year-old boy died. The virulence of the symptoms convinced Todd and his staff that they were dealing with an undiagnosed illness. After recognizing that it was induced by toxins in the bloodstream, not bacteria, and that the patients were clearly in shock, they gave it a name: toxic shock syndrome.

In November 1977 a 15-year-old girl, also menstruating, was brought in. “She was the first one where we thought we knew what we were doing,” Todd recalls. The girl spent seven days in a coma before recovering.

In spite of Todd’s investigations, other medical authorities were not at all sure he had identified a new disease. “When we were ready to publish our findings in 1978, the first journal we contacted turned down the report,” Todd says. They sent it to London where a British medical journal, The Lancet, published it in November 1978—”but,” adds Dr. Todd, “nobody really believed it.”

Skepticism ended abruptly this summer (see page 39). “We suddenly went from nobody believing to everybody believing—and overreacting,” says Todd. He has been busy dispelling myths about toxic shock. He dismisses the “scratchy tampon theory” as “nonsense” and charges the Center for Disease Control with “not showing proper scientific restraint, making premature disclosures and paying too much attention to one brand of tampon.” He is concerned with the public reaction to that. “What may happen now is that women will say, ‘Whew, Rely is off the market, no more TSS,’ ” he warns. “But it may be the way they are using the tampon, not the tampon itself. Otherwise, how can we explain how men and children, menstruating women, non-menstruating women, women with hysterectomies, get it?” Todd acknowledges, however, that “tampons may create the proper environment for the staph to grow.”

Such a cautious approach is in character. “I was always really straight, always persistent,” says Todd, 36, the son of a Detroit lawyer and businessman. He was a Phi Beta Kappa graduate of the University of Michigan and a summa cum laude at the university’s medical school in Ann Arbor. While interning as a pediatrician at Detroit’s Wayne County General Hospital, he met the nurse who became his wife. Today, Jim and Barbara Todd, the parents of three sons and expecting their fourth child in December, are in their ninth year in Denver. Todd splits his day between his regular practice, teaching at the University of Colorado and TSS research.

“As the number of cases goes up, the rate of fatalities goes down,” says Todd of the TSS furor. “Now we can anticipate the illness and begin treatment immediately.” In any case, he insists that it is so rare as to be no cause for hysteria. “Let me put it this way,” he says. “You run a greater risk of dying in your car on the way to the store to buy tampons than you do from toxic shock.”