THERE are about 18 cases of toxic shock syndrome (TSS) in the UK every year associated with women and tampons - one of them fatal.

Paul Flynn, a consultant gynaecologist at the Royal Victoria Infirmary, Newcastle, has seen only one case in his 11 years in practice. Many of his colleagues will never treat a TSS patient.

He said TSS was difficult to diagnose because the initial symptoms could be mistaken for a minor illness.

Mr Flynn said: "It is such an uncommon condition, and the first symptoms of TSS are fairly non-specific.

"Feeling nauseous and dizzy could be put down to any number of viral infections.

"Women who cannot stand up without feeling dizzy and are wearing or using tampons should think to themselves about getting medical help."

TSS moves quickly. Often by the time women and girls present the more worrying symptoms, which show something more serious is wrong, they may be beyond helping themselves.

Mr Flynn said it was important for partners, parents, siblings and friends to know the signs of TSS and get help for anyone they suspect to be suffering as soon as possible.

TOXIC shock syndrome (TSS) is an extremely rare but potentially serious illness.

It is a type of blood poisoning that makes people severely ill very quickly.

The syndrome is caused by a common bacteria, staphylococcus aureus, which normally lives harmlessly on the skin, and in the nose, armpit, groin or vagina in one of every three people.

In rare cases, certain strains of these bacteria can produce the toxins that cause TSS.

It is very rare, and most doctors will never even see a case. There are probably about 40 cases of TSS in the UK every year.

About half the reported cases of TSS are associated with women using tampons.

The risk of TSS is higher in younger people because older people are more likely to have antibodies to protect them.

With early diagnosis, TSS can be successfully treated with antibiotics and other medicines.

THE symptoms of toxic shock syndrome are much like severe flu and usually include some or all of the following:

* A sudden high fever

* Vomiting

* A sunburn-like rash

* Diarrhoea

* Fainting or feeling faint

* Muscle aches

* Dizziness

* Confusion

If you have these symptoms, consult your doctor at once.

If you are wearing a tampon, remove it and tell your doctor. Do not worry about being alarmist, it is important to rule out the possibility of TSS.

Information about TSS is available in the manufacturer's leaflet which comes with tampon.

While the link between tampon use and TSS is unclear, research suggests tampon absorbency is a factor.

For that reason it is important women always use a tampon with the lowest absorbency suitable for the period flow and alternate with sanitary towels or liners during the period.