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CP) - A 17-year-old Newfoundland girl is believed to have died from toxic shock syndrome - and the infection that killed her may have resulted from a nipple piercing, the province's chief medical examiner says. PIf body piercing did lead to the teen's death, it will underscore warnings from medical experts about the need to ensure such procedures are done by trained, experienced operators with sound infection control practices.PPThe St. John's teen, whose name has not been released, died Thursday after being admitted to hospital two days earlier "with medical problems that were quite complex," Dr. Simon Avis said Friday in an interview from St. John's.PPBut Avis said it is too early to say for certain that the apparent toxic shock syndrome arose from an infection at the site of the piercing.PPAn autopsy was performed, but other tests need to be conducted before the source of the staphylococcus infection can be pinpointed, he said. Results from those tests could take days to weeks.PP"We're still in the process of investigating," he said. "We can't be absolutely sure that body piercing had anything to do with the infection."PPStill, Avis conceded that of the many possible origins of the toxic shock syndrome, "I think it would be fair to say that we're suspicious that that (body piercing) was the source of the infection, yes."PPToxic shock syndrome is characterized by sudden fever, chills, vomiting, diarrhea, muscle aches and rash, says the U.S. Centers for Disease Control and Prevention. The cause is usually toxins produced by strains of Staphylococcus aureus, a bacterium commonly found on the skin and on mucous memanes, such as the mouth.PPToxic shock can occur as a complication of skin abscesses or surgery. In females, it has been linked to the use of tampons and intravaginal contraceptive devices.PP"This girl came to hospital almost moribund," Avis said of the teen, who was a senior at Booth Memorial High School in St. John's. "All we know is she had a piercing recently. We are now trying to investigate when that was done."PPDr. Margaret Fast, medical officer of health for the Winnipeg Regional Health Authority, said anyone thinking of having body piercing or tattooing should first carefully check out the studio and operator.PP"Given that it's a very common procedure, I think that the best public health advice to give people is to have it done in a facility that's reputable, that uses proper infection control practices, that has equipment to ensure sterility and that you ensure every step of the procedure is done according to good techniques and good practice," Fast said.PPShe even advises that would-be recipients of body jewelry look at a piercing parlour's floors to make sure they're clean and that operators aren't wearing grubby clothes.PPWinnipeg recently amended its "body modification" bylaw to add piercing after concerns arose about poor infection control by one operator in particular. A teenage client who had jewelry inserted through her nipple ended up hospital and needed treatment for a serious infection at the site.PPThe bylaw requires all operators to be licensed and they must adhere to rigorous safety measures, said Fast.PPJim Weber, a spokesman for the Association of Professional Piercers, said not all jurisdictions in Canada and the United States have legislation regulating studios, so it's up to the consumer to do their homework first.PPWhile any procedure that "compromises the integrity of the body" poses a danger of subsequent infection, "done properly, the risks from body piercing are minimal," said Weber, operator of Infinite Body Piercing in Philadelphia.PPMeanwhile, Avis said his office will be investigating where, when and under what cir***stances the St. John's teen had her nipple pierced. PHe said her death might be "an extreme example" of what can occur when people have lips, tongues, eyeows, genitals and other body parts punctured in the name of fashion. P"This is health dollars that are essentially wasted treating infections that shouldn't have occurred because of some desire to have a piece of metal sticking out of your body. It doesn't make much sense to me." P- PPYahoo NewsP