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Jellyfish Stings and Their Management: A Review
Department of Molecular Medicine, Padua University, Padua 35128, Italy
School of Public Health, Imperial College London, St. Mary's Campus, London WC2 1PG, UK
Sarasota County Health Department, Sarasota, FL 34237, USA
Envirosafe Training and Consultants, 2366 Golden Mile Highway, Pittsburgh, PA 15239, USA
* Author to whom correspondence should be addressed.
Received: 28 November 2012; in revised form: 22 December 2012 / Accepted: 25 January 2013 / Published: 22 February 2013
Abstract: Jellyfish (cnidarians) have a worldwide distribution. Despite most being harmless, some species may cause local and also systemic reactions. Treatment of jellyfish envenomation is directed at: alleviating the local effects of venom, preventing further nematocyst discharges and controlling systemic reactions, including shock. In severe cases, the most important step is stabilizing and maintaining vital functions. With some differences between species, there seems to be evidence and consensus on oral/topical analgesics, hot water and ice packs as effective painkillers and on 30 s application of domestic vinegar (4%–6% acetic acid) to prevent further discharge of unfired nematocysts remaining on the skin. Conversely, alcohol, methylated spirits and fresh water should be carefully avoided, since they could massively discharge nematocysts; pressure immobilization bandaging should also be avoided, as laboratory studies show that it stimulates additional venom discharge from nematocysts. Most treatment approaches are presently founded on relatively weak evidence; therefore, further research (especially randomized clinical trials) is strongly recommended. Dissemination of appropriate treatment modalities should be deployed to better inform and educate those at risk. Adequate signage should be placed at beaches to notify tourists of the jellyfish risk. Swimmers in risky areas should wear protective equipment.
Keywords: jellyfish; cnidarians; cubozoans; stings; envenomation; pain; evidence-based treatment; vinegar; hot water; ice pack
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Cite This Article
MDPI and ACS Style
Cegolon, L.; Heymann, W.C.; Lange, J.H.; Mastrangelo, G. Jellyfish Stings and Their Management: A Review. Mar. Drugs 2013, 11, 523-550.
Cegolon L, Heymann WC, Lange JH, Mastrangelo G. Jellyfish Stings and Their Management: A Review. Marine Drugs. 2013; 11(2):523-550.
Cegolon, Luca; Heymann, William C.; Lange, John H.; Mastrangelo, Giuseppe. 2013. "Jellyfish Stings and Their Management: A Review." Mar. Drugs 11, no. 2: 523-550.