Vol 72, No 4 (2021)
Review article
Published online: 2021-12-30

open access

Page views 6457
Article views/downloads 749
Get Citation

Connect on Social Media

Connect on Social Media

Marine creatures dangerous for divers in tropical waters

Jarosław Krzyżak1, Krzysztof Korzeniewski23
Pubmed: 35146740
IMH 2021;72(4):283-292.


Diving has been gaining in popularity in recent years with spectacular dive sites in tropical waters. Before anyone goes diving, they should learn about the risk factors associated with the exposure to hyperbaric conditions and also the risks from exposure to marine life. Apart from amazing views of the coral reefs, divers may be astonished by the magnitude of marine species diversity in local waters, ranging from predators (sharks, barracuda, moray eels) to venomous or stinging fish (jellyfish, anemones) and sea snakes. If travelers are unprepared and know little about the existing risk factors, a diving trip that was much looked forward to may turn out to have some very unpleasant consequences. The article describes the most common marine species which divers can come across in tropical waters. It also discusses the management of injuries caused by dangerous marine creatures.

Article available in PDF format

View PDF Download PDF file


  1. Krzyżak J, Korzeniewski K. Medicine for divers [in Polish]. Publishing House 4Font, Poznań 2020, pp. 674–707.
  2. Gatti CM, Chung K, Oehler E, et al. Screening for predictors of chronic ciguatera poisoning: an exploratory analysis among hospitalized cases from french polynesia. Toxins (Basel). 2021; 13(9).
  3. Neves CK, Goldani LZ. Ciguatera fish poisoning in Brazilian traveler to Caribbean. Braz J Infect Dis. 2019; 23(3): 200–202.
  4. Caldicott D, Mahajani R, Kuhn M. The anatomy of a shark attack: a case report and review of the literature. Injury. 2001; 32(6): 445–453.
  5. Ganske W, Sharma R, Kaminski S, et al. Shark-Related injuries in the united states: a national trauma data bank analysis. Am Surg. 2021 [Epub ahead of print]: 31348211024171.
  6. Sprivulis P. Western Australia coastal shark bites: a risk assessment. Australas Med J. 2014; 7(2): 137–142.
  7. Lippmann J. Fatal shark attacks on divers in Australia, 1960-2017. Diving Hyperb Med. 2018; 48(4): 224–228.
  8. Korzeniewski K. [Land and marine fauna constituting a threat for recreational divers in the tropics]. Pol Merkur Lekarski. 2008; 25(147): 294–297.
  9. Ballen GA. Nomenclature of the Sphyraenidae (Teleostei: Carangaria): a synthesis of fossil- and extant-based classification systems. Zootaxa. 2019; 4686(3): zootaxa.4686.3.5.
  10. Smith DG, Bogorodsky SV, Mal AO, et al. Review of the moray eels (Anguilliformes: Muraenidae) of the Red Sea, with description of a new species. Zootaxa. 2019; 4704(1): zootaxa.4704.1.1.
  11. Riordan C, Hussain M, McCann J. Moray eel attack in the tropics: a case report and review of the literature. Wilderness Environ Med. 2004; 15(3): 194–197.
  12. Matsuura K. Taxonomy and systematics of tetraodontiform fishes: a review focusing primarily on progress in the period from 1980 to 2014. Ichthyol Res. 2014; 62(1): 72–113.
  13. Rimmer M, Glamuzina B. A review of grouper (Family Serranidae: Subfamily Epinephelinae) aquaculture from a sustainability science perspective. Rev Aquac. 2017; 11(1): 58–87.
  14. Sorenson L, Santini F, Carnevale G, et al. A multi-locus timetree of surgeonfishes (Acanthuridae, Percomorpha), with revised family taxonomy. Mol Phylogenet Evol. 2013; 68(1): 150–160.
  15. Brown TP. Diagnosis and management of injuries from dangerous marine life. MedGenMed. 2005; 7(3): 5.
  16. Hornbeak KB, Auerbach PS. Marine envenomation. Emerg Med Clin North Am. 2017; 35(2): 321–337.
  17. Henn A, Pérignon A, Monsel G, et al. Marine envenomations in returning French travellers seen in a tropical diseases unit, 2008-13. J Travel Med. 2016; 23(2): tav022.
  18. Todd J, Edsell M. A diver's guide to subaquatic envenomation in the Mediterranean. Diving Hyperb Med. 2019; 49(3): 225–228.
  19. Alcoba G. [Sea bathing dangers: marine envenoming, trauma, and infections]. Rev Med Suisse. 2020; 16(693): 984–988.
  20. Diaz JH. Marine scorpaenidae envenomation in travelers: epidemiology, management, and prevention. J Travel Med. 2015; 22(4): 251–258.
  21. Prentice O, Fernandez WG, Luyber TJ, et al. Stonefish envenomation. Am J Emerg Med. 2008; 26(8): 972.e1–972.e2.
  22. Gorman LM, Judge SJ, Fezai M, et al. The venoms of the lesser (Echiichthys vipera) and greater (Trachinus draco) weever fish: a review. Toxicon X. 2020; 6: 100025.
  23. Fricke R. Two new species of stargazers of the genus Uranoscopus (Teleostei: Uranoscopidae) from the western Pacific Ocean. Zootaxa. 2018; 4476(1): 157–167.
  24. Borsa P, Lemer S, Aurelle D. Patterns of lineage diversification in rabbitfishes. Mol Phylogenet Evol. 2007; 44(1): 427–435.
  25. Jouiaei M, Yanagihara AA, Madio B, et al. Ancient venom systems: a review on cnidaria toxins. Toxins (Basel). 2015; 7(6): 2251–2271.
  26. D'Ambra I, Lauritano C. A review of toxins from cnidaria. Mar Drugs. 2020; 18(10).
  27. Silva Cavalcante MM, Ribeiro Rodrigues ZM, Hauser-Davis RA, et al. Health-risk assessment of Portuguese man-of-war (Physalia physalis) envenomations on urban beaches in São Luís city, in the state of Maranhão, Brazil. Rev Soc Bras Med Trop. 2020; 53: e20200216.
  28. Piontek M, Seymour JE, Wong Y, et al. The pathology of venom and known biological mechanisms. Toxicon X. 2020; 6: 100026.
  29. Carrette TJ, Underwood AH, Seymour JE. Irukandji syndrome: a widely misunderstood and poorly researched tropical marine envenoming. Diving Hyperb Med. 2012; 42(4): 214–223.
  30. Little M, Pereira P, Seymour J. Differences in cardiac effects of venoms from tentacles and the bell of live: using non-invasive pulse wave Doppler. Toxins (Basel). 2020; 13(1).
  31. Pereira JC, Szpilman D, Haddad Junior V. Anaphylactic reaction/angioedema associated with jellyfish sting. Rev Soc Bras Med Trop. 2018; 51(1): 115–117.
  32. Tibballs J. Australian venomous jellyfish, envenomation syndromes, toxins and therapy. Toxicon. 2006; 48(7): 830–859.
  33. O'Reilly GM, Isbister GK, Lawrie PM, et al. Prospective study of jellyfish stings from tropical Australia, including the major box jellyfish Chironex fleckeri. Med J Aust. 2001; 175(11-12): 652–655.
  34. Frazão B, Vasconcelos V, Antunes A. Sea anemone (Cnidaria, Anthozoa, Actiniaria) toxins: an overview. Mar Drugs. 2012; 10(8): 1812–1851.
  35. McIntosh JM, Jones RM. Cone venom–from accidental stings to deliberate injection. Toxicon. 2001; 39(10): 1447–1451.
  36. Prator CA, Murayama KM, Schulz JR. Venom variation during prey capture by the cone snail, Conus textile. PLoS One. 2014; 9(6): e98991.
  37. Yotsu-Yamashita M, Mebs D, Flachsenberger W. Distribution of tetrodotoxin in the body of the blue-ringed octopus (Hapalochlaena maculosa). Toxicon. 2007; 49(3): 410–412.
  38. Fingerhut LC, Strugnell JM, Faou P, et al. Shotgun proteomics analysis of saliva and salivary gland tissue from the common octopus octopus vulgaris. J Proteome Res. 2018; 17(11): 3866–3876.
  39. Bédry R, de Haro L, Bentur Y, et al. Toxicological risks on the human health of populations living around the Mediterranean Sea linked to the invasion of non-indigenous marine species from the Red Sea: A review. Toxicon. 2021; 191: 69–82.
  40. Wang Bo, Wang Q, Wang C, et al. A comparative analysis of the proteomes and biological activities of the venoms from two sea snakes, Hydrophis curtus and Hydrophis cyanocinctus, from Hainan, China. Toxicon. 2020; 187: 35–46.
  41. Kularatne SAM, Hettiarachchi R, Dalpathadu J, et al. Enhydrina schistosa (Elapidae: Hydrophiinae) the most dangerous sea snake in Sri Lanka: three case studies of severe envenoming. Toxicon. 2014; 77: 78–86.
  42. Kumar SS, Ragunanthanan S, Ramesh D, et al. Case reports of two interesting patients with sea snake envenomation. J Assoc Physicians India. 2020; 68(12): 78–81.
  43. Kishida T, Toda M, Go Y, et al. Population history and genomic admixture of sea snakes of the genus Laticauda in the West Pacific. Mol Phylogenet Evol. 2021; 155: 107005.
  44. Tan CH, Wong KY, Tan KYi, et al. Venom proteome of the yellow-lipped sea krait, Laticauda colubrina from Bali: Insights into subvenomic diversity, venom antigenicity and cross-neutralization by antivenom. J Proteomics. 2017; 166: 48–58.
  45. Lillywhite HB, Sheehy CM, Brischoux F, et al. Pelagic sea snakes dehydrate at sea. Proc Biol Sci. 2014; 281(1782): 20140119.
  46. Laustsen AH, Gutiérrez JM, Rasmussen AR, et al. Danger in the reef: Proteome, toxicity, and neutralization of the venom of the olive sea snake, Aipysurus laevis. Toxicon. 2015; 107(Pt B): 187–196.
  47. Fuehrer J, Kong EL, Murphy-Lavoie HM. Sea Snake Toxicity. StatPearls [Internet]. Treasure Island, Florida: StatPearls Publishing. 2021 Jan 11.
  48. Watters MR, Stommel EW. Marine neurotoxins: envenomations and contact toxins. Curr Treat Options Neurol. 2004; 6(2): 115–123.