Toxic Shock Syndrome Study Group*

ton. Case reports were solicited through biweekly contact with all acute-care hospitals. One hundred sixteen definite and 63 probable cases were reported; 85010 of the cases oc-curred in female patients and 15010 in male patients. Among cases in females, 83 (55010) were menstrual; the mean age of the patients with menstrual cases was 23 years (range, 12-46 years). The overall incidence of TSS was 0.53/100,000. The cumulative incidence varied significantly by region, ranging from 1.23/100,000 in Oklahoma to 0.22/100,000 in New Jersey (P =.0001); the incidence in all other areas ranged from 0.39/100,000 to 0.70/100,000. The incidence of menstrual TSS was 1.05/100,000 women 15-44 years of age and peaked in women between the ages of 15 and 19 years at 1.521100,000. The inci-dence was higher in whites than in nonwhites for both menstrual TSS (1.211100,000 vs. 0.34/100,000, P =.002) and nonmenstrual TSS (0.30/100,000 vs. 0.14/100,000, P =.031). Our data indicate that TSS continues to be a cause of morbidity. Although there is under-reporting in national passive surveillance, the proportion of menstrual cases reported through active surveillance was similar to that reported to the passive system in 1986