Toxic shock syndrome in Utah--1976 to 1983.

The sustained high incidence of staphylococcal toxic shock syndrome (TSS) in Utah provided an opportunity to examine changes in the epidemiology of this disease during a period of greater media attention to the syndrome and increased scientific understanding of its etiology and pathogenesis. An apparent peak in the statewide incidence of TSS in 1980 appears in part attributable to self-reporting of outpatient cases. The incidence of the syndrome in patients having a nasal operation appears equal to or greater than the incidence in menstrual-age women. The case-fatality ratio and recurrence rate of TSS have declined since widespread recognition of the syndrome, possibly related to earlier diagnosis and initiation of antistaphylococcal therapy. Identifying milder cases has also contributed to a lower mortality.