The primary cause of toxic shock syndrome is toxic shock syndrome toxin 1 (TSST-1), a 22,049-dalton exotoxin. Approximately 20% of Staphylococcus aureus isolates produce TSST-1; the production of this toxin is therefore a variable genetic trait. The TSST-1 gene and its flanking sequences are found on a genetic element that is present in TSST-1-positive isolates and absent in TSST-1-negative isolates. Preliminary sequence data and Southern hybridization experiments with the cloned flanking sequences have provided evidence that the TSST-1 element is 4-7 kilobases in size. Hybridization analysis of whole-cell DNA from two genetically mapped TSST-1-positive strains has demonstrated that the TSST-1 element has at least two chromosomal locations. This finding suggests that the element is mobile. Biotyping of 75 TSST-1-positive isolates showed that the large majority were tryptophan-negative, and Southern hybridization analysis of whole-cell DNA from these isolates revealed a common blotting pattern--an observation suggesting that these strains are clonal.