A 16-year-old girl who died on a school retreat in Vancouver passed away as a result of toxic shock syndrome, 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 her bunk-mates awoke and found her still in bed they left to go to breakfast, according to the Daily Mail.
When they returned, she hadn't moved and appeared lifeless as her alarm was going off.
Georges P. Vanier Secondary School staff, students and emergency responders performed CPR to no avail.
The grade 11 student could not be revived.
The night before she had complained to friends about having menstrual cramps and not feeling well, but took part in the day's activities, according to the Vancouver Sun.
She also didn't eat much at dinner, headed to a bonfire, and went back to her cabin at 9.50pm for the evening.
The report says a strain of staphylococcus aureus was discovered on a tampon found in place, as well as other symptoms consistent with toxic shock syndrome.
"We know there is an association. And again, it's very rare," Island Health Medical Health Officer Dee Hoyano told CTV Vancouver Island on Monday.
"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."
Symptoms of TSS are similar to the flu, with high fever nausea, vomiting, diarrhoea, dizziness, fainting and disorientation.