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Mar. Drugs 2013, 11(2), 523-550; doi:10.3390/md11020523

Jellyfish Stings and Their Management: A Review

1,2,* , 3
1 Department of Molecular Medicine, Padua University, Padua 35128, Italy 2 School of Public Health, Imperial College London, St. Mary's Campus, London WC2 1PG, UK 3 Sarasota County Health Department, Sarasota, FL 34237, USA 4 Envirosafe Training and Consultants, 2366 Golden Mile Highway, Pittsburgh, PA 15239, USA
* Author to whom correspondence should be addressed.
Received: 28 November 2012 / Revised: 22 December 2012 / Accepted: 25 January 2013 / Published: 22 February 2013
(This article belongs to the Special Issue Marine Neurotoxins)
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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 jellyfish; cnidarians; cubozoans; stings; envenomation; pain; evidence-based treatment; vinegar; hot water; ice pack
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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Cegolon, L.; Heymann, W.C.; Lange, J.H.; Mastrangelo, G. Jellyfish Stings and Their Management: A Review. Mar. Drugs 2013, 11, 523-550.

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