There’s something in the water: an overview of jellyfish, their stings, and treatment
Abstract
An increasing presence on many beaches worldwide, jellyfish are a diverse group of Cnidarians equipped
with stinging cells termed cnidocytes. Though few of the over 10,000 species are dangerous to humans,
and most that are produce no more than a painful sting, some jellyfish can produce systemic symptoms
and even death. Chironex fleckeri, the Australian box jellyfish, has a venom potent enough to kill in less
than 10 minutes, and for which there is an antivenom of debatable efficacy. Stings from Carukia barnesi
can cause Irukandji syndrome, characterised by severe pain and hypertension. Jellyfish stings have also
been associated with Guillain-Barre syndrome and anaphylaxis. Though optimal treatment of stings remains
controversial, after removal from the water and addressing any immediate life threats, the tentacles should
be removed and the area washed, with seawater being the best choice due to its low likelihood of inducing
further cnidocyte discharge. Hot water immersion may be beneficial for pain control for non-tropical jellyfish
stings, and cold packs for tropical stings. In general, there is no consensus for the optimal treatment
of jellyfish stings, and so further research is needed into species-specific guidelines and whether there
are any overarching rules.
Keywords: jellyfishvenomsmarine envenomation
References
- Lakkis NA, Maalouf GJ, Mahmassani DM. Jellyfish stings: a practical approach. Wilderness Environ Med. 2015; 26(3): 422–429.
- Premmaneesakul H, Sithisarankul P. Toxic jellyfish in Thailand. Int Marit Health. 2019; 70(1): 22–26.
- Ryan RYM, Seymour J, Loukas A, et al. Immunological responses to envenomation. Front Immunol. 2021; 12: 661082.
- Pereira JC, Szpilman D, Haddad Junior V. Anaphylactic reaction/angioedema associated with jellyfish sting. Rev Soc Bras Med Trop. 2018; 51(1): 115–117.
- Montgomery L, Seys J, Mees J. To pee, or not to pee: a review on envenomation and treatment in European jellyfish species. Mar Drugs. 2016; 14(7).
- Suriyan S, Haruethaikan K, Piyachat RE. A survey of jellyfish sting knowledge among Thai divers in Thailand. Int Marit Health. 2019; 70(1): 11–16.
- Kong EL, Nappe TM. Irukandji Syndrome. StatPearls[Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan.
- Ames CL, Klompen AML, Badhiwala K, et al. Cassiosomes are stinging-cell structures in the mucus of the upside-down jellyfish Cassiopea xamachana. Commun Biol. 2020; 3(67).
- Tibballs J, Yanagihara AA, Turner HC, et al. Immunological and toxinological responses to jellyfish stings. Inflamm Allergy Drug Targets. 2011; 10(5): 438–446.
- Mao C, Hsu CC, Chen KT. Ocular Jellyfish Stings: Report of 2 Cases and Literature Review. Wilderness Environ Med. 2016; 27(3): 421–424.
- Amato G, Vita F, Gemelli F, et al. Jellyfish anaphylaxis: A wide spectrum of sensitization routes. Allergy Asthma Proc. 2020; 41(3): 158–166.
- Tibballs J, Li R, Tibballs HA, et al. Australian venomous jellyfish, envenomation syndromes, toxins and therapy. Toxicon. 2006; 48(7): 830–859.
- Cegolon L, Heymann WC, Lange JH, et al. Jellyfish stings and their management: a review. Mar Drugs. 2013; 11(2): 523–550.
- Remigante A, Costa R, Morabito R, et al. Impact of scyphozoan venoms on human health and current first aid options for stings. Toxins (Basel). 2018; 10(4).
- Doyle TK, Headlam JL, Wilcox CL, et al. Evaluation of cyanea capillata sting management protocols using ex vivo and in vitro envenomation models. Toxins (Basel). 2017; 9(7).
- Yanagihara AA, Wilcox CL. Cubozoan sting-site seawater rinse, scraping, and ice can increase venom load: upending current first aid recommendations. Toxins (Basel). 2017; 9(3): 105.
- Honeycutt JD, Jonas CE, Smith RF. FPIN's clinical inquiries: treatment of jellyfish envenomation. Am Fam Physician. 2014; 89(10): Online.