When Sara Manitoski was found dead on an overnight school trip in March 2017, friends and family were left wondering what exactly happened to the normally healthy 16-year-old. More than a year later, the coroner has finally determined the cause of her death: toxic shock syndrome.
On March 14, 2017, Manitoski said she was not feeling well and had menstrual cramps during the Georges P. Vanier Secondary School’s trip to British Columbia’s Hornby Island, reported Newsweek.
She was “heard breathing rapidly and shallowly in the middle of the night for a short period of time and then stopped,” according to the British Columbia Coroners Service report.
When the 11th grader’s roommates woke up in the morning, they thought their classmate was simply asleep and went to get breakfast without her. After eating, they went back to the room and heard Manitoski’s phone alarm going off yet she was not stirring. That’s when school staff was alerted.
Her fellow students and teachers tried performing CPR, as did emergency responders when they arrived on the scene, but she could not be revived.
The coroner, Courtney Cote, has officially determined that the Canadian teenager died on March 15, 2017, from toxic shock syndrome due to the bacteria staphylococcus aureus being found on a tampon inside of her.
“I classify this death as natural,” said Cote in her report, adding, “the symptoms Sara exhibited immediately prior to her death are all consistent with the effects of toxic shock syndrome.”
Newsweek spoke to Dr. Heather Currie, the spokeswoman for the Royal College of Obstetricians and Gynaecologists in the United Kingdom, who told the publication that “for reasons that are still not understood, women who use tampons, particularly tampons that are designed to be super absorbent, are at a slightly higher risk of developing toxic shock syndrome.
“Evidence suggests that if a tampon is left in a woman’s vagina for some time, it can become a breeding ground for bacteria. Women are recommended to change their tampon frequently, every four to eight hours,” she said.
The rare but life-threatening infection — which can also affect men — gets into the body’s bloodstream, releasing poisonous toxins, and escalates very fast.
“The toxins can damage tissue, including the skin and organs, and can disturb many vital organ functions,” explained Currie.
Dr. Michael Cackovic, a maternal-fetal medicine specialist at the Ohio State University Wexner Medical Center, told Live Science that the rate of toxic shock syndrome in menstruating women is currently about one in 100,000. Symptoms to look out for include high fever, chills, nausea, vomiting, diarrhea, and dizziness.