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Keywords = cubozoans

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15 pages, 2093 KB  
Article
Use of eDNA to Determine Source Locations of Deadly Jellyfish (Cubozoa) in an Open Coastal System
by Scott J. Morrissey, Dean R. Jerry and Michael J. Kingsford
Coasts 2024, 4(1), 198-212; https://doi.org/10.3390/coasts4010011 - 5 Mar 2024
Cited by 7 | Viewed by 3359
Abstract
Challenges associated with cubozoan jellyfish detection and the limitations of current detection techniques limit the ability of scientists to fill critical knowledge gaps surrounding their ecology. Environmental DNA (eDNA), however, has proven useful as an ecological survey tool to detect and study these [...] Read more.
Challenges associated with cubozoan jellyfish detection and the limitations of current detection techniques limit the ability of scientists to fill critical knowledge gaps surrounding their ecology. Environmental DNA (eDNA), however, has proven useful as an ecological survey tool to detect and study these deadly jellyfish. This study aimed to leverage the power of eDNA to detect and explore the distribution of the Australian box jellyfish (Chironex fleckeri), encompassing both its medusae and polyp life history stages, within an open coastal bay (Horseshoe Bay) of Magnetic Island, Queensland, Australia. Our investigation focused on a hypothesis concerning the source locations of the jellyfish within Horseshoe Bay and, through a comparison of both life history stage distributions, aimed to determine potential population stock boundaries. eDNA results aligned with the predicted nearshore distribution of medusae. Further, the elusive benthic polyp stage was also detected. These findings confirmed Horseshoe Bay as a source location of the jellyfish. Moreover, our evidence supported a model that the area likely represents a population stock of the species. This adds to growing evidence suggesting some cubozoan jellyfish have population stocks of small spatial scales in both open and relatively closed ecosystems such as estuaries. In conclusion, this study serves as a notable example of eDNA’s ability to resolve critical knowledge gaps surrounding cubozoan ecology and to enhance the management ability of these deadly jellyfish to reduce envenomations. Full article
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20 pages, 2349 KB  
Article
Genetic Detection and a Method to Study the Ecology of Deadly Cubozoan Jellyfish
by Scott J. Morrissey, Dean R. Jerry and Michael J. Kingsford
Diversity 2022, 14(12), 1139; https://doi.org/10.3390/d14121139 - 19 Dec 2022
Cited by 13 | Viewed by 4735
Abstract
Cubozoan jellyfish pose a risk of envenomation to humans and a threat to many businesses, yet crucial gaps exist in determining threats to stakeholders and understanding their ecology. Environmental DNA (eDNA) provides a cost-effective method for detection that is less labour intensive and [...] Read more.
Cubozoan jellyfish pose a risk of envenomation to humans and a threat to many businesses, yet crucial gaps exist in determining threats to stakeholders and understanding their ecology. Environmental DNA (eDNA) provides a cost-effective method for detection that is less labour intensive and provides a higher probability of detection. The objective of this study was to develop, optimise and trial the use of eDNA to detect the Australian box jellyfish, Chironex fleckeri. This species was the focus of this study as it is known to have the strongest venom of any cubozoan; it is responsible for more than 200 recorded deaths in the Indo-Pacific region. Further, its ecology is poorly known. Herein, a specific and sensitive probe-based assay, multiplexed with an endogenous control assay, was developed, and successfully utilised to detect the deadly jellyfish species and differentiate them from closely related taxa. A rapid eDNA decay rate of greater than 99% within 27 h was found with no detectable influence from temperature. The robustness of the technique indicates that it will be of high utility for detection and to address knowledge gaps in the ecology of C. fleckeri; further, it has broad applicability to other types of zooplankton. Full article
(This article belongs to the Special Issue Advances in the Diversity and Ecology of Zooplankton)
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27 pages, 13401 KB  
Review
Raising Awareness on the Clinical and Forensic Aspects of Jellyfish Stings: A Worldwide Increasing Threat
by Sara Almeida Cunha and Ricardo Jorge Dinis-Oliveira
Int. J. Environ. Res. Public Health 2022, 19(14), 8430; https://doi.org/10.3390/ijerph19148430 - 10 Jul 2022
Cited by 33 | Viewed by 22746
Abstract
Jellyfish are ubiquitous animals registering a high and increasing number of contacts with humans in coastal areas. These encounters result in a multitude of symptoms, ranging from mild erythema to death. This work aims to review the state-of-the-art regarding pathophysiology, diagnosis, treatment, and [...] Read more.
Jellyfish are ubiquitous animals registering a high and increasing number of contacts with humans in coastal areas. These encounters result in a multitude of symptoms, ranging from mild erythema to death. This work aims to review the state-of-the-art regarding pathophysiology, diagnosis, treatment, and relevant clinical and forensic aspects of jellyfish stings. There are three major classes of jellyfish, causing various clinical scenarios. Most envenomations result in an erythematous lesion with morphological characteristics that may help identify the class of jellyfish responsible. In rare cases, the sting may result in delayed, persistent, or systemic symptoms. Lethal encounters have been described, but most of those cases happened in the Indo-Pacific region, where cubozoans, the deadliest jellyfish class, can be found. The diagnosis is mostly clinical but can be aided by dermoscopy, skin scrapings/sticky tape, confocal reflectance microscopy, immunological essays, among others. Treatment is currently based on preventing further envenomation, inactivating the venom, and alleviating local and systemic symptoms. However, the strategy used to achieve these effects remains under debate. Only one antivenom is currently used and covers merely one species (Chironex fleckeri). Other antivenoms have been produced experimentally but were not tested on human envenomation settings. The increased number of cases, especially due to climate changes, justifies further research in the study of clinical aspects of jellyfish envenoming. Full article
(This article belongs to the Special Issue Climate Change and Environment Health)
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12 pages, 2101 KB  
Article
New Records of Cubozoan and Scyphozoan Jellyfish from Sabah Waters, Malaysia
by Chee Hoe Chuan, Balu Alagar Venmathi Maran, Tzuen Kiat Yap, Kai Ching Cheong, Muhammad Ali Syed Hussein and Ejria Saleh
Diversity 2021, 13(9), 420; https://doi.org/10.3390/d13090420 - 31 Aug 2021
Cited by 10 | Viewed by 13640
Abstract
Jellyfish play a vital role in the ocean’s ecosystem, acting as a nursery for young fishes, crabs, and brittle stars, as well as a source of food for certain charismatic megafauna, such as sunfish and sea turtles. They also pose a threat to [...] Read more.
Jellyfish play a vital role in the ocean’s ecosystem, acting as a nursery for young fishes, crabs, and brittle stars, as well as a source of food for certain charismatic megafauna, such as sunfish and sea turtles. They also pose a threat to human activities, with jellyfish blooms negatively impacting fisheries, power generation, and tourism. However, very little information is available on the biodiversity of jellyfish within the waters of Borneo. Here, we present new records of jellyfish found along the coast of Sabah, Malaysia, located in northern Borneo, bordering the megadiverse region of the Coral Triangle. A total of six species belonging to two classes and six families hitherto not recorded to the state are reported, Chironex yamaguchii, Acromitus maculosus, Crambione mastigophora, Linuche aquila, Netrostoma sp., and Phyllorhiza punctata. Of these, two species (C. yamaguchii and L. aquila) are harmful to humans, with C. yamaguchii capable of causing human fatalities. Reports of harmful jellyfish are useful to the medical and tourism industry, as some of these species may inflict stings and adverse reactions to humans ranging from rashes and skin irritation to fatal envenomation. A checklist has also been provided for all collected jellyfish species from Sabah waters of Borneo, Malaysia. Full article
(This article belongs to the Collection Collection of Experts’ Researches on Aquatic Life (CEREAL))
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11 pages, 1617 KB  
Article
Differing Effects of Vinegar on Pelagia noctiluca (Cnidaria: Scyphozoa) and Carybdea marsupialis (Cnidaria: Cubozoa) Stings—Implications for First Aid Protocols
by Ainara Ballesteros, Macarena Marambio, Verónica Fuentes, Mridvika Narda, Andreu Santín and Josep-Maria Gili
Toxins 2021, 13(8), 509; https://doi.org/10.3390/toxins13080509 - 21 Jul 2021
Cited by 16 | Viewed by 8080
Abstract
The jellyfish species that inhabit the Mediterranean coastal waters are not lethal, but their stings can cause severe pain and systemic effects that pose a health risk to humans. Despite the frequent occurrence of jellyfish stings, currently no consensus exists among the scientific [...] Read more.
The jellyfish species that inhabit the Mediterranean coastal waters are not lethal, but their stings can cause severe pain and systemic effects that pose a health risk to humans. Despite the frequent occurrence of jellyfish stings, currently no consensus exists among the scientific community regarding the most appropriate first-aid protocol. Over the years, several different rinse solutions have been proposed. Vinegar, or acetic acid, is one of the most established of these solutions, with efficacy data published. We investigated the effect of vinegar and seawater on the nematocyst discharge process in two species representative of the Mediterranean region: Pelagia noctiluca (Scyphozoa) and Carybdea marsupialis (Cubozoa), by means of (1) direct observation of nematocyst discharge on light microscopy (tentacle solution assay) and (2) quantification of hemolytic area (tentacle skin blood agarose assay). In both species, nematocyst discharge was not stimulated by seawater, which was classified as a neutral solution. In P. noctiluca, vinegar produced nematocyst discharge per se, but inhibited nematocyst discharge from C. marsupialis. These results suggest that the use of vinegar cannot be universally recommended. Whereas in case of a cubozoan C. marsupialis sting, the inhibitory effect of vinegar makes it the ideal rinse solution, in case of a scyphozoan P. noctiluca sting, vinegar application may be counterproductive, worsening the pain and discomfort of the stung area. Full article
(This article belongs to the Special Issue Cnidarian Venom)
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16 pages, 1493 KB  
Review
Population Structures and Levels of Connectivity for Scyphozoan and Cubozoan Jellyfish
by Michael J. Kingsford, Jodie A. Schlaefer and Scott J. Morrissey
Diversity 2021, 13(4), 174; https://doi.org/10.3390/d13040174 - 19 Apr 2021
Cited by 16 | Viewed by 10779
Abstract
Understanding the hierarchy of populations from the scale of metapopulations to mesopopulations and member local populations is fundamental to understanding the population dynamics of any species. Jellyfish by definition are planktonic and it would be assumed that connectivity would be high among local [...] Read more.
Understanding the hierarchy of populations from the scale of metapopulations to mesopopulations and member local populations is fundamental to understanding the population dynamics of any species. Jellyfish by definition are planktonic and it would be assumed that connectivity would be high among local populations, and that populations would minimally vary in both ecological and genetic clade-level differences over broad spatial scales (i.e., hundreds to thousands of km). Although data exists on the connectivity of scyphozoan jellyfish, there are few data on cubozoans. Cubozoans are capable swimmers and have more complex and sophisticated visual abilities than scyphozoans. We predict, therefore, that cubozoans have the potential to have finer spatial scale differences in population structure than their relatives, the scyphozoans. Here we review the data available on the population structures of scyphozoans and what is known about cubozoans. The evidence from realized connectivity and estimates of potential connectivity for scyphozoans indicates the following. Some jellyfish taxa have a large metapopulation and very large stocks (>1000 s of km), while others have clade-level differences on the scale of tens of km. Data on distributions, genetics of medusa and polyps, statolith shape, elemental chemistry of statoliths and biophysical modelling of connectivity suggest that some of the ~50 species of cubozoans have populations of surprisingly small spatial scales and low levels of connectivity. Despite their classification as plankton, therefore, some scyphozoans and cubozoans have stocks of small spatial scales. Causal factors that influence the population structure in many taxa include the distribution of polyps, behavior of medusa, local geomorphology and hydrodynamics. Finally, the resolution of patterns of connectivity and population structures will be greatest when multiple methods are used. Full article
(This article belongs to the Special Issue Patterns and Ecology of Jellyfish in Marine Environment)
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12 pages, 3674 KB  
Article
Rapid and Accurate Species-Specific PCR for the Identification of Lethal Chironex Box Jellyfish in Thailand
by Nuankanya Sathirapongsasuti, Kasetsin Khonchom, Thunyaporn Poonsawat, Mitila Pransilpa, Supaporn Ongsara, Usawadee Detsri, Suwimon Bungbai, Sam-ang Lawanangkoon, Worawut Pattanaporkrattana and Satariya Trakulsrichai
Int. J. Environ. Res. Public Health 2021, 18(1), 219; https://doi.org/10.3390/ijerph18010219 - 30 Dec 2020
Cited by 13 | Viewed by 5441
Abstract
Box jellyfish are extremely potent venom-producing marine organisms. While they have been found worldwide, the highest health burden has been anticipated to be the tropical Indo-Pacific of Southeast Asia (SEA). At least 12 Cubozoan species have now been documented in Thai waters, and [...] Read more.
Box jellyfish are extremely potent venom-producing marine organisms. While they have been found worldwide, the highest health burden has been anticipated to be the tropical Indo-Pacific of Southeast Asia (SEA). At least 12 Cubozoan species have now been documented in Thai waters, and many of them inflict acutely lethal strings, especially those under the order Chirodropida. Our previous study has successfully differentiated species of box jellyfish using DNA sequencing to support the morphological study. In this study, we specifically designed polymerase chain reaction (PCR) primers for the 16S ribosomal RNA (rRNA) gene and the mitochondrial DNA cytochrome oxidase subunit I (COI) gene of lethal Thai Chironex species. The SYBR green-based real-time PCR panel was performed for rapid species identification. The sensitivity and specificity of the panel were determined by testing samples of different species. Moreover, we applied the panel to the tentacle sample from a real patient, which helped confirm the animal-of-cause of envenomation. Our results show a success for species identification of box jellyfish using 16S rRNA and COI PCR panel, which revealed congruence between molecular and morphological identification. Furthermore, the panel worked very well with the unknown samples and jellyfish tissue from the real envenomation case. The results demonstrated that molecular panels were able to identify three species of Chironex box jellyfish both rapidly and accurately, and can be performed without having a complete specimen or morphological study. Full article
(This article belongs to the Section Toxicology and Public Health)
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12 pages, 12546 KB  
Article
Differences in Cardiac Effects of Venoms from Tentacles and the Bell of Live Carukia barnesi: Using Non-Invasive Pulse Wave Doppler
by Mark Little, Peter Pereira and Jamie Seymour
Toxins 2021, 13(1), 19; https://doi.org/10.3390/toxins13010019 - 29 Dec 2020
Cited by 5 | Viewed by 3317
Abstract
Carukia barnesi was the first in an expanding list of cubozoan jellyfish whose sting was identified as causing Irukandji syndrome. Nematocysts present on both the bell and tentacles are known to produce localised stings, though their individual roles in Irukandji syndrome have remained [...] Read more.
Carukia barnesi was the first in an expanding list of cubozoan jellyfish whose sting was identified as causing Irukandji syndrome. Nematocysts present on both the bell and tentacles are known to produce localised stings, though their individual roles in Irukandji syndrome have remained speculative. This research examines differences through venom profiling and pulse wave Doppler in a murine model. The latter demonstrates marked measurable differences in cardiac parameters. The venom from tentacles (CBVt) resulted in cardiac decompensation and death in all mice at a mean of 40 min (95% CL: ± 11 min), whereas the venom from the bell (CBVb) did not produce any cardiac dysfunction nor death in mice at 60 min post-exposure. This difference is pronounced, and we propose that bell exposure is unlikely to be causative in severe Irukandji syndrome. To date, all previously published cubozoan venom research utilised parenterally administered venom in their animal models, with many acknowledging their questionable applicability to real-world envenomation. Our model used live cubozoans on anaesthetised mice to simulate normal envenomation mechanics and actual expressed venoms. Consequently, we provide validity to the parenteral methodology used by previous cubozoan venom research. Full article
(This article belongs to the Section Animal Venoms)
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21 pages, 1349 KB  
Article
Isolation, Structure Determination, and Synthesis of Cyclic Tetraglutamic Acids from Box Jellyfish Species Alatina alata and Chironex yamaguchii
by Justin Reinicke, Ryuju Kitatani, Shadi Sedghi Masoud, Kelly Kawabata Galbraith, Wesley Yoshida, Ayako Igarashi, Kazuo Nagasawa, Gideon Berger, Angel Yanagihara, Hiroshi Nagai and F. David Horgen
Molecules 2020, 25(4), 883; https://doi.org/10.3390/molecules25040883 - 17 Feb 2020
Cited by 9 | Viewed by 8927
Abstract
Cubozoan nematocyst venoms contain known cytolytic and hemolytic proteins, but small molecule components have not been previously reported from cubozoan venom. We screened nematocyst extracts of Alatina alata and Chironex yamaguchii by LC-MS for the presence of small molecule metabolites. Three isomeric compounds, [...] Read more.
Cubozoan nematocyst venoms contain known cytolytic and hemolytic proteins, but small molecule components have not been previously reported from cubozoan venom. We screened nematocyst extracts of Alatina alata and Chironex yamaguchii by LC-MS for the presence of small molecule metabolites. Three isomeric compounds, cnidarins 4A (1), 4B (2), and 4C (3), were isolated from venom extracts and characterized by NMR and MS, which revealed their planar structure as cyclic γ-linked tetraglutamic acids. The full configurational assignments were established by syntheses of all six possible stereoisomers, comparison of spectral data and optical rotations, and stereochemical analysis of derivatized degradation products. Compounds 13 were subsequently detected by LC-MS in tissues of eight other cnidarian species. The most abundant of these compounds, cnidarin 4A (1), showed no mammalian cell toxicity or hemolytic activity, which may suggest a role for these cyclic tetraglutamates in nematocyst discharge. Full article
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12 pages, 2631 KB  
Article
Structural Characterisation of Predicted Helical Regions in the Chironex fleckeri CfTX-1 Toxin
by Athena Andreosso, Paramjit S. Bansal, Michael J. Smout, David Wilson, Jamie E. Seymour and Norelle L. Daly
Mar. Drugs 2018, 16(6), 201; https://doi.org/10.3390/md16060201 - 7 Jun 2018
Cited by 10 | Viewed by 7527
Abstract
The Australian jellyfish Chironex fleckeri, belongs to a family of cubozoan jellyfish known for their potent venoms. CfTX-1 and -2 are two highly abundant toxins in the venom, but there is no structural data available for these proteins. Structural information on toxins [...] Read more.
The Australian jellyfish Chironex fleckeri, belongs to a family of cubozoan jellyfish known for their potent venoms. CfTX-1 and -2 are two highly abundant toxins in the venom, but there is no structural data available for these proteins. Structural information on toxins is integral to the understanding of the mechanism of these toxins and the development of an effective treatment. Two regions of CfTX-1 have been predicted to have helical structures that are involved with the mechanism of action. Here we have synthesized peptides corresponding to these regions and analyzed their structures using NMR spectroscopy. The peptide corresponding to the predicted N-terminal amphiphilic helix appears unstructured in aqueous solution. This lack of structure concurs with structural disorder predicted for this region of the protein using the Protein DisOrder prediction System PrDOS. Conversely, a peptide corresponding to a predicted transmembrane region is very hydrophobic, insoluble in aqueous solution and predicted to be structured by PrDOS. In the presence of SDS-micelles both peptides have well-defined helical structures showing that a membrane mimicking environment stabilizes the structures of both peptides and supports the prediction of the transmembrane region in CfTX-1. This is the first study to experimentally analyze the structure of regions of a C. fleckeri protein. Full article
(This article belongs to the Special Issue Marine Invertebrate Toxins)
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15 pages, 2217 KB  
Article
Cubozoan Sting-Site Seawater Rinse, Scraping, and Ice Can Increase Venom Load: Upending Current First Aid Recommendations
by Angel Anne Yanagihara and Christie L. Wilcox
Toxins 2017, 9(3), 105; https://doi.org/10.3390/toxins9030105 - 15 Mar 2017
Cited by 30 | Viewed by 44446
Abstract
Cnidarian envenomations are the leading cause of severe and lethal human sting injuries from marine life. The total amount of venom discharged into sting-site tissues, sometimes referred to as “venom load”, has been previously shown to correlate with tentacle contact length and sequelae [...] Read more.
Cnidarian envenomations are the leading cause of severe and lethal human sting injuries from marine life. The total amount of venom discharged into sting-site tissues, sometimes referred to as “venom load”, has been previously shown to correlate with tentacle contact length and sequelae severity. Since <1% of cnidae discharge upon initial tentacle contact, effective and safe removal of adherent tentacles is of paramount importance in the management of life-threatening cubozoan stings. We evaluated whether common rinse solutions or scraping increased venom load as measured in a direct functional assay of venom activity (hemolysis). Scraping significantly increased hemolysis by increasing cnidae discharge. For Alatina alata, increases did not occur if the tentacles were first doused with vinegar or if heat was applied. However, in Chironex fleckeri, vinegar dousing and heat treatment were less effective, and the best outcomes occurred with the use of venom-inhibiting technologies (Sting No More® products). Seawater rinsing, considered a “no-harm” alternative, significantly increased venom load. The application of ice severely exacerbated A. alata stings, but had a less pronounced effect on C. fleckeri stings, while heat application markedly reduced hemolysis for both species. Our results do not support scraping or seawater rinsing to remove adherent tentacles. Full article
(This article belongs to the Section Animal Venoms)
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21 pages, 7356 KB  
Article
Experimental Assays to Assess the Efficacy of Vinegar and Other Topical First-Aid Approaches on Cubozoan (Alatina alata) Tentacle Firing and Venom Toxicity
by Angel A. Yanagihara, Christie Wilcox, Rebecca King, Kikiana Hurwitz and Ann M. Castelfranco
Toxins 2016, 8(1), 19; https://doi.org/10.3390/toxins8010019 - 11 Jan 2016
Cited by 33 | Viewed by 20131
Abstract
Despite the medical urgency presented by cubozoan envenomations, ineffective and contradictory first-aid management recommendations persist. A critical barrier to progress has been the lack of readily available and reproducible envenomation assays that (1) recapitulate live-tentacle stings; (2) allow quantitation and imaging of cnidae [...] Read more.
Despite the medical urgency presented by cubozoan envenomations, ineffective and contradictory first-aid management recommendations persist. A critical barrier to progress has been the lack of readily available and reproducible envenomation assays that (1) recapitulate live-tentacle stings; (2) allow quantitation and imaging of cnidae discharge; (3) allow primary quantitation of venom toxicity; and (4) employ rigorous controls. We report the implementation of an integrated array of three experimental approaches designed to meet the above-stated criteria. Mechanistically overlapping, yet distinct, the three approaches comprised (1) direct application of test solutions on live tentacles (termed tentacle solution assay, or TSA) with single image- and video-microscopy; (2) spontaneous stinging assay using freshly excised tentacles overlaid on substrate of live human red blood cells suspended in agarose (tentacle blood agarose assays, or TBAA); and (3) a “skin” covered adaptation of TBAA (tentacle skin blood agarose assay, or TSBAA). We report the use and results of these assays to evaluate the efficacy of topical first-aid approaches to inhibit tentacle firing and venom activity. TSA results included the potent stimulation of massive cnidae discharge by alcohols but only moderate induction by urine, freshwater, and “cola” (carbonated soft drink). Although vinegar, the 40-year field standard of first aid for the removal of adherent tentacles, completely inhibited cnidae firing in TSA and TSBAA ex vivo models, the most striking inhibition of both tentacle firing and subsequent venom-induced hemolysis was observed using newly-developed proprietary formulations (Sting No More™) containing copper gluconate, magnesium sulfate, and urea. Full article
(This article belongs to the Section Animal Venoms)
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28 pages, 751 KB  
Review
Jellyfish Stings and Their Management: A Review
by Luca Cegolon, William C. Heymann, John H. Lange and Giuseppe Mastrangelo
Mar. Drugs 2013, 11(2), 523-550; https://doi.org/10.3390/md11020523 - 22 Feb 2013
Cited by 189 | Viewed by 36701
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 [...] Read more.
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. Full article
(This article belongs to the Special Issue Marine Neurotoxins)
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