The cause of death of a 16-year-old Canadian girl who died during a school retreat in Vancouver is said to be toxic shock syndrome caused allegedly from tampon infection. According to the province's coroner service report, Sara Manitoski from British Columbia was on the trip to Hornby Island, off Vancouver Island, in March 2017, when she was found unresponsive.

According to reports, the student’s friend tried to wake her up for breakfast in the morning but she didn't respond. Believing she was asleep, her other friends too did not disturb her anymore, but hours later Manitoski still remained in bed and wasn't moving. The students informed school staff and emergency responders arrived at the scene to perform CPR in order to revive the teenager.

While her cause of death was unknown at the time, a recent report from the local Coroners Service determined her death was caused due to toxic shock syndrome (TSS), a rare deadly complication of infection resulting from bacteria. A strain of Staphylococcus aureus bacteria was found on a tampon Manitoski had used in the hours leading up to her death, Daily Mail reported.

Mayo Clinic, on its website, states TSS can be caused due to Staphylococcus aureus (staph). The syndrome can also be caused by group A Streptococcus (strep) bacteria.

The coroner’s report also said that the tampon was not the only possible factor.

"The risk for toxic shock syndrome (TSS) is increased with tampon use, however, tampon use is not the sole cause,” it read, according to reports.

Island Health Medical Health Officer Dee Hoyano told CTV Vancouver Island on Monday: "We know there is an association. And again, it's very rare... Certainly we know a person needs to have this particular bacteria to get sick, and then there may be something with tampon use, maybe prolonged tampon use, that puts that risk higher for developing a more widespread infection."

Possible signs and symptoms of toxic shock syndrome include sudden high fever, low blood pressure (hypotension), vomiting or diarrhea, rash resembling a sunburn, confusion, muscle aches, redness of eyes, mouth and throat, seizures, headaches, dizziness, fainting.