A report released by the B.C. Coroners Service says a Comox Valley teen who died in her sleep during a school trip to Hornby Island died from toxic shock syndrome.

Sara Manitoski was a Grade 11 student at Vanier Secondary School when she took part in a sleepover at Hornby’s Tribune Bay in March 2017.

The report details how the young girl’s friends got up for breakfast and thought she was still sleeping so they went without her.

When they returned to the cabin, Manitoski’s alarm was going off, but she wouldn’t wake up.

Staff, students and emergency responders performed CPR, but she could not be revived.

The report released on Monday discovered a strain of staphylococcus aureus on a tampon found in place.

That as well as symptoms the teen had before she died are consistent with toxic shock syndrome, but the report notes tampon use is not the only cause of toxic shock.

"We don't understand fully what is the cause that might be related. We know there's an association. Again, it's very rare,” said Island Health Medical Health Officer Dee Hoyano. “Certainly we know that 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 more widespread infection."

Hoyano stresses toxic shock occurs when a particular strain of bacteria produces a toxin that can get into the blood stream and then overwhelm the immune system and cause organs to shut down. 

Symptoms of the condition include fever, dizziness, low blood pressure and a bright red skin rash.

In light of the report and Manitoski’s tragic death, Island Health says it doesn’t want to raise the alarm, but encourages people to educate themselves about the safe use of tampons.