Jellyfish stings on Langkawi Island, Malaysia (original) (raw)
Related papers
Fatal and Severe Box Jellyfish Stings, Including Irukandji Stings, in Malaysia, 2000-2010
Journal of Travel Medicine, 2011
Background. Jellyfish are a common cause of injury throughout the world, with fatalities and severe systemic events not uncommon after tropical stings. The internet is a recent innovation to gain information on real-time health issues of travel destinations, including Southeast Asia. Methods. We applied the model of internet-based retrospective health data aggregation, through the Divers Alert Network Asia-Pacific (DAN AP), together with more conventional methods of literature and media searches, to document the health significance, and clinical spectrum, of box jellyfish stings in Malaysia for the period January 1, 2000 to July 30, 2010. Results. Three fatalities, consistent with chirodropid envenomation, were identified for the period-all tourists to Malaysia. Non-fatal chirodropid stings were also documented. During 2010, seven cases consistent with moderately severe Irukandji syndrome were reported to DAN and two representative cases are discussed here. Photographs of chirodropid (multi-tentacled), carybdeid (four-tentacled) box jellyfish, and of severe sting lesions were also submitted to DAN during this period.
Clinical characteristics of jellyfish stings in Japan
Acute Medicine & Surgery, 2019
Aim: Jellyfish known as "habu-kurage" (Chironex yamaguchii) inhabit the waters surrounding Okinawa and Amami, Japan, and jellyfish stings are limited to areas outside the Japanese main island. However, the shifts promoted by global warming and increasingly intensive interactions with people have led to concerns regarding the possibility of increased jellyfish stings on the main island of Japan. Similar concerns are being raised all over the world. However, studies examining clinical characteristics of jellyfish stings have been limited to Australia, the USA, Europe, and SouthEast Asia. Thus, this study aimed to examine for the first time the clinical characteristics of jellyfish stings in Japan. Methods: We undertook retrospective questionnaire surveys from January 2013 to December 2017 to determine patient characteristics, treatment, and clinical outcomes. We compared patient characteristics between tourists and non-tourists. The primary end-point of the present study was to clarify the clinical characteristics of jellyfish stings. Results: Over the 5-year study period, 204 patients were identified from eight hospitals based on the basic questionnaire, and 35 patients with moderate-to-severe jellyfish stings were also identified. All patients recovered well, including five patients with severe jellyfish stings. Antivenom was not given. The time intervals from the occurrence of jellyfish stings to hospital arrival significantly differed between tourists and non-tourists (P = 0.049), and all tourists visited the emergency department (P = 0.009). Conclusions: Approximately 40 cases of jellyfish stings occurred annually in Japan between 2013 and 2017. Patients recovered well without the use of antivenom.
Skin and Systemic Manifestations of Jellyfish Stings in Iraqi Fishermen
Libyan Journal of Medicine, 2008
Background: Jellyfish stings are common worldwide with an estimated 150 million cases annually, and their stings cause a wide range of clinical manifestations from skin inflammation to cardiovascular and respiratory collapse. No studies on jellyfish stings have been carried out in Basra, Iraq. Objectives: To describe the immediate and delayed skin reactions to White Jellyfish (Rhizostoma sp.) stings and the types of local treatment used by fishermen. Methods and Materials: 150 fishermen were enrolled at three Marine stations in Basra, Iraq. Demographic data, types of skin reactions, systemic manifestations and kinds of treatments were collected. Results: Overall, 79% of fishermen in all three Marine stations gave a history of having been stung. The common sites of sings were the hands and arms followed by the legs. Most fishermen claimed that stings led to skin reactions within 5 minutes. The presenting complaints were itching, burning sensation, and erythematic wheals. A few days after the sting, new groups of painless and itchy erythematous monomorphic papular rashes developed at the site of the sting in 62% of cases as a delayed type of skin reaction that resolved spontaneously. The local remedies commonly used by the fishermen were seawater, tap water and ice. A few fishermen considered stings as insignificant and did not think there was a need to seek medical help. Conclusions: We conclude that jellyfish causes many stings among fishermen in the Basra region. Their stings lead to immediate and delayed skin reactions. Selftreatment by topical remedies is common.
Fatal and Nonfatal Severe Jellyfish Stings in Thai Waters
Journal of Travel Medicine, 2010
O n November 3, 2008, the Governor of Phuket released a media statement: ''people throughout the region should be alerted to the dangers of box jellyfish.'' 1 Two days later, the Minister for Natural Resources and the Environment also released: ''People swimming in the sea where box jellyfish are present should exercise caution.'' 2 Quickly, travel advisories were posted on numerous government web sites, including Australia, United States, and Thailand. Internet search provides a modest estimate of the confusion this caused, as most people, previously unaware of the problem, were now demanding to know about the appearance of this danger, and how? General consensus was that fatal and severe jellyfish stings were new to Thailand, whereas we argue that they have long occurred throughout the Indo-Pacific, including Thailand (Nakorn, personal communication). 3 We summarize and review current knowledge on life-threatening jellyfish stings in Thailand, hoping this report will provide a stimulus for improved awareness and management of jellyfish problems throughout Southeast Asia. Two kinds of potentially deadly jellyfish are confirmed in Thai waters: chirodropid box jellyfish and Irukandji box jellyfish (L. Gershwin, unpublished data). Hundreds of other species of jellyfish are also present but are not considered as life threatening. Chirodropids are large box-shaped jellyfish (ie, ''box jellyfish'') with multiple tentacles arising from each of the four lower corners of the bell. Irukandji are easily distinguished from chirodropids, as their box-shaped body has just a single tentacle at each lower corner. Chironex kill by massive envenomation, causing respiratory arrest or cardiac arrest in systole in as little as 2 to 3 min. Their stings have caused multiple
Irukandji-like syndrome caused by single-tentacle box jellyfish found in Thailand, 2007–2019
International Maritime Health
Background: Irukandji syndrome definition is still widely misunderstood. Irukandji-like syndrome is more unclear than Irukandji syndrome. This study aimed to describe Irukandji-like syndrome in cases involving stinging by single-tentacle box jellyfish species in Thailand. Materials and methods: Surveillance system and networks of toxic jellyfish incidents were established to enable case detection. In the period 2007 to 2019, all cases of stinging by single-tentacle box jellyfish resulting in collapse, hospital attendance or death were investigated. Results: The majority of the 19 Irukandji-like syndrome cases were male (68.2%), median age 35.0 years (range 6.0-60.0), and Thai nationality (52.3%). Clinical manifestations of Irukandji-like syndrome were categorised as severe wound pain with immediate systemic reaction (66.7%), moderate wound pain with gradual systemic reaction (16.7%), and moderate wound pain with the immediate systemic reaction after a physical/chemical trigger (16.7%). The pain occurring when being stung differed from the pain occurring during the systemic reaction. The five most common symptoms were pain (100.0%), high blood pressure (100.0%), palpitations (86.7%), respiratory distress (52.6%), and near collapse/collapse (31.6%). The pain occurs when being stung was excruciating or burning pain at the wounds, felt like an electric shock, and rapidly expanded to heart pain. While the pain occurring during the systemic reaction was back pain, muscle pain, joint pain, abdominal pain, and body aches. The marks from the tentacles appeared similar in appearance to the caterpillar tracks of tanks. In 6 cases the species could be identified and all of them involving the Morbakka spp. Conclusions: This was the largest study of Irukandji-like syndrome cases involving stings by single-tentacle box jellyfish in Thailand and the different clinical manifestations might be caused by different species of single-tentacle box jellyfish.
A survey of jellyfish sting knowledge among Thai divers in Thailand
International Maritime Health, 2019
Background: In tropical regions, jellyfish envenomation is a persistent hazard for people who spend time in the sea. Jellyfish stings can be dangerous, and among the people who face the greatest risk are scuba divers. This study therefore sought to determine the level of knowledge divers in Thailand have about the threat of jellyfish envenomation. Materials and methods: In April 2018, a total of 238 divers responded to a questionnaire, thereby providing data for further statistical analysis. Results: The findings revealed that 31.91% of the study participants cited jellyfish stings as their most frequently encountered injury, with 68.09% having personal experience of the problem, or having seen others injured by jellyfish. However, 34.03% of the sample respondents believed their own level of knowledge to be "low" or "none". The mean score was 71%, which can be considered satisfactory, but the scores for items concerning the recognition of signs of envenomation and items about first aid responses (52.74% and 59.13%, respectively) were not acceptable. Conclusions: Divers frequently experience jellyfish stings, and diving personnel were highly rated for their knowledge in this area. However, very few were fully confident in their first aid capabilities, and therefore it can be argued that it is necessary to improve the level of medical education and to provide training to eliminate this weakness.
Journal of Clinical Nursing, 2010
Aim. This manuscript presents both demographic and descriptive data related to a distressing clinical condition known as Irukandji syndrome. Chart audit and observation data were collected to explore trends in patient characteristics and to review the current practices surrounding the management of the syndrome by advanced practice ED nurses. Background. Irukandji syndrome, a known health emergency in northern Australia, causes severe symptoms such as muscle pains, nausea and vomiting, headache and chest pain causing clinical challenges for emergency nurses. Little is written about this condition from a nursing perspective. Design. A mixed methods case study approach. Methods. Data were collected by observation and chart audit from 186 patients diagnosed with Irukandji syndrome between 2001-2007. Results. Of the 186 patients, 44AE1% were local residents and 58AE6% were men. Median age of the patients was 27 years (range 16-77). There was a time trend with a greater number of stings occurring out at the Great Barrier Reef than at mainland beaches (p < 0AE001). Important results were found regarding waiting times for pain management and intuitive rather than documented assessment practices of advanced practice nursing staff. Conclusion. Irukandji syndrome causes severe emotional distress and acute pain, however, people continue to swim in marine sting environments and fail to make use of available protective clothing such as body suits. Local residents continue to be stung regardless of the educational information available suggesting a review of the current public education campaign is required. Relevance to clinical practice. Nurses failed to document assessment processes limiting adequately the ability to assess trends in the patient's condition effectively and treat symptoms efficiently. It is, therefore, timely to review the critical role that assessment plays in clinical care.