DOCSLIB.ORG

Picture As Pdf Download

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Picture As Pdf Download BITES AND STINGS Irukandji syndrome in northern Western Australia: an emerging health problem Conrad J Macrokanis, Nicole L Hall and Jacki K Mein rukandji syndrome is a collection of ABSTRACT hypercatecholaminergic symptoms aris- ing from jellyfish envenomation.1 This Objectives: (1) To assess the number and severity of episodes of Irukandji syndrome in I Broome, Western Australia. (2) To correlate demographic, seasonal, geographic and variable syndrome includes severe general- ised pain, distress, hypertension, cardiomy- climatic features of Irukandji stings. (3) To assess treatment of Irukandji syndrome at opathy and cardiogenic pulmonary oedema. Broome Health Service. (4) To assess the public health impact. Irukandji syndrome was first described in Design and setting: (1) A retrospective analysis of jellyfish data forms and charts Cairns by Flecker in 1952 and named after of 111 patients, identified from Broome Health Service Emergency Department with a 2,3 discharge diagnosis of marine sting between 1 January 2001 and 1 July 2003. the localThe AboriginalMedical Journal tribe. of Barnes Australia first ISSN:cor- (2) Correlation between climate and Irukandji envenomation data. related0025-729X Irukandji 6/20syndrome December with 2004 the 181small 11/ box (cubozoan) jellyfish Carukia barnesi.2 Main outcome measures: Number of patients with Irukandji syndrome; their 12 699-702 The ©Thesyndrome Medical is Journalwell documented of Australia 2004in demographic and environmental features; the clinical syndrome; treatment requirements. Queenslandwww.mja.com.au north of the Tropic of Capricorn Results: 111 patients were prospectively identified with marine stings; 88 were 4,5 and inBites the and Northern stings Territory, with two identified with Irukandji syndrome. Non-Irukandji syndrome data were excluded for deaths recently reported from north Queens- analysis. The “jellyfish season” extends from January to May, although stings occur all 6 land. Although a recent published series of year round. Only 38% of patients had vinegar applied to the sting site before hospital cardiac toxicity and pulmonary oedema from presentation. Signs and symptoms were variable between individuals, with 20% having Irukandji syndrome included one case from no signs of sting at all and welts found in 16%. Fifty per cent of patients were 7 Broome, little is known about the incidence hypertensive at presentation. Distress was found in the majority of patients, with 90% and severity in Western Australia. C. barnesi requiring opioid analgesia (morphine equivalent: mean, 20 mg; median, 13 mg) and 17% has never been identified in Western Aus- requiring admission. There was one evacuation to Perth with cardiotoxic marine tralia. envenomation resulting in pulmonary oedema, which necessitated 4 days in intensive The risk of envenomation has a large care. Stings were significantly more common when the ambient median temperature potential impact on public health, com- was greater than 28.3°C, after midday, on an incoming high tide and on windy days. merce, leisure and tourism in tropical Aus- 8 Conclusion: The rate of envenomation in northern WA is likely to be the highest tralian communities. Our aims were to currently documented in Australia. There is syndromic variability when compared with characterise the incidence, demographics, the north Queensland experience. This implies different causative jellyfish species that and management of Irukandji syndrome in are not yet identified. Stings in Broome can be severe and life threatening; there are Broome, WA, over the past three seasons, significant commercial and public health implications as a result. Management at and to correlate the incident data with sea- Broome Hospital is contemporary and effective. sonal and climatic changes. MJA 2004; 181: 699–702 METHODS tients and emergency department patients Patient symptoms and signs in the emer- Broome has a population of about 16 000 identified by jellyfish forms were exam- gency department were examined, and the from October to March, which rises to about ined retrospectively for the period 1 Janu- maximum values recorded. Pain scores 40 000 in the April to September tourist ary 2001 to 1 July 2003. Irukandji were assessed using verbal pain scales. All 9 season. This is increasing annually. Broome syndrome was diagnosed if the criteria in opiates were calculated as morphine District Hospital is the sole provider of Box 1 were met. equivalents: 1 mg morphine = 10 mg emergency care. The jellyfish data forms collected patient pethidine = 10 µg fentanyl. All jellyfish stings were recorded pro- demographic details, details of jellyfish The Broome Bureau of Meteorology pro- spectively using jellyfish data forms. To stings (including site and timing), first aid identify patients with Irukandji syndrome, management, jellyfish awareness, patient vided wind speed, moon phase, tides, air the medical records of all hospital inpa- symptoms and signs, and treatment. temperature, and cloud cover information for the study period. The National Tidal FOR EDITORIAL COMMENT, SEE PAGE 685 Facility provided data on Broome Port Department of Medicine, Broome Health Service, Broome, WA. water temperatures. Time of sting was then Conrad J Macrokanis, MB BS, FRACGP, BSc(Hons), District Medical Officer. correlated with meteorological data. A Department of Medicine, University of Western Australia, Perth, WA. control day (when no sting occurred) was Nicole L Hall, Medical Student. allotted for each case as close as possible Department of Public Health, Kimberley Population Health Unit, Broome, WA. Jacki K Mein, MB BS, FACCHP, MAE, Kimberley Public Health Medical Officer. from two days before to a week after the Reprints will not be available from the authors. Correspondence: Dr C J Macrokanis, day of the sting. Each climatic variable for Department of Medicine, Broome Health Service, PO Box 62, Broome, WA 6725. both case and control days was compared [email protected] using χ2 with Intercooled STATA 7.10 MJA • Volume 181 Number 11/12 • 6/20 December 2004 699 BITES AND STINGS Treatment and outcomes 1 Case definition for Irukandji 2 Comparison of features of syndrome Of the 58% of Irukandji syndrome victims Irukandji syndrome in Broome who had vinegar applied to the sting site, • and north Queensland Contact with seawater within 60 minutes two-thirds received it before hospital arrival. • Minor skin pain at envenomation site Opiate analgesia was required by nearly North • 5–60 minutes’ delay to symptom onset 90% of all adults. The average adult mor- Broome, Queensland, • At least three of the following: severe low phine-equivalent given was 20 mg (median, 2001–2003 199611 back pain; muscle cramps in all four limbs, 13 mg; range, 5–90 mg). Three patients Number of 88 62 the abdomen and chest; sweating; received intravenous magnesium sulfate as a patients anxiety; restlessness; nausea; vomiting; bolus or infusion (10–80 mmol) before headache Age range 1–63 18–56 receiving opiates. In all three patients, the (years) initial response to magnesium was dramatic, with reduction in pain scores from 10 to less Male 57% 47% This process was considered an audit of than 5 within minutes. In all three patients, Peak season January December existing data and did not require ethics although magnesium infusions were estab- for sting to May to January approval. lished at different times, the infusion alone Clinical features was ineffective in establishing effective anal- Pain score 10/10 45% Not available RESULTS gesia, and breakthrough pain occurred between 15 and 35 minutes. Fifteen people Abdominal 57% 40% During the study period, 137 jellyfish data were admitted to hospital (median stay, 1 cramps forms were collected. Twenty-six forms did day). Two patients developed pulmonary Back pain 58% 39% not have a corresponding hospital medical oedema, one requiring air evacuation and a Leg cramps 49% 34% record, were duplicated, or were not jelly- 4-day stay in a Perth tertiary hospital inten- fish stings (eg, diving-related injuries). sive care unit.7 The other recovered in Chest tightness 31% 26% These were excluded. Twenty-three were Broome. Hypertension 49% 50% non-Irukandji marine stings. There were no Chironex Nausea and 33% 39% recognised box jellyfish stings. Climate Irukandji syndrome was diagnosed in 88 vomiting patients (see Box 2 for comparison with Climate correlations with Irukandji syn- Distress 84% 24% drome included both water and air temper- north Queensland data). Sixty per cent were Flushing 28% Not available locals. Twenty-five per cent of patients iden- ature greater than the yearly median of ° Diaphoresis 22% Not available tified as Indigenous. Most (57%) were aware 28.3 C (OR, 5.5; 95% CI, 2.6–11.7) and of jellyfish risk from swimming, but only wind speed greater than the median of Treatment and outcomes 15 km/h (OR, 3.3; 95% CI, 1.6–6.7). There 14% stated that they had seen warning signs Vinegar used 58% 81% at the beach. Thirty-five per cent of tourists were fewer stings in the morning and on P Opiates used 90% 61% were jellyfish aware. low or incoming tides ( <0.001). There was no significant correlation with phase of (mean dose)* (20 mg) (not available) the moon or cloud cover. 17% 28% Seasonality and geography Admission rate The median time of sting was nearly 15:00, Pulmonary 2 patients 2 patients with a median 30-minute delay to emer- DISCUSSION oedema gency department presentation. Ninety per This is the first reported series of Irukandji Climatic variables cent of stings occurred from January to May syndrome in WA and the second-largest Time Afternoon Not available (Box 3). collection of hospital records nation- Water > 28.3°C Higher Reported stings increased at both Cable 5,11,12 ally. Cairns averages 40 Irukandji temperature (median) than Beach and Roebuck Bay/Beach in 2003. In stings per season, with about a million Higher than average December–March, 90% of stings occurred people swimming each year (Dr J Seymour, average in the east-facing Roebuck Bay, and in Senior Lecturer, School of Tropical Biology, No Less than March–June 95% of stings occurred at west- Rain James Cook University, Cairns, personal correlation average in facing Cable Beach (Box 4).
Load more

Recommended publications
  • Etiology of Irukandji Syndrome with Particular Focus on the Venom Ecology and Life History of One Medically Significant Carybdeid Box Jellyfish Alatina Moseri
    ResearchOnline@JCU This file is part of the following reference: Carrette, Teresa Jo (2014) Etiology of Irukandji Syndrome with particular focus on the venom ecology and life history of one medically significant carybdeid box jellyfish Alatina moseri. PhD thesis, James Cook University. Access to this file is available from: http://researchonline.jcu.edu.au/40748/ The author has certified to JCU that they have made a reasonable effort to gain permission and acknowledge the owner of any third party copyright material included in this document. If you believe that this is not the case, please contact [email protected] and quote http://researchonline.jcu.edu.au/40748/ Etiology of Irukandji Syndrome with particular focus on the venom ecology and life history of one medically significant carybdeid box jellyfish Alatina moseri Thesis submitted by Teresa Jo Carrette BSc MSc December 2014 For the degree of Doctor of Philosophy in Zoology and Tropical Ecology within the College of Marine and Environmental Sciences James Cook University Dedication: “The sea, once it casts its spell, holds one in its net of wonder forever.” Jacques Yves Cousteau To my family – and my ocean home ii Acknowledgements Firstly, I have to acknowledge my primary supervisor Associate Professor Jamie Seymour. We have spent the last 17 years in a variable state of fatigue, blind enthusiasm, inspiration, reluctance, pain-killer driven delusion, hope and misery. I have you to blame/thank for it all. Just when I think all hope is lost and am about to throw it all in you seem to step in with the words of wisdom that I need.
    [Show full text]
  • Marine Stingers Factsheet
    Marine Stingers Frequently Asked Questions What are Irukandji? Irukandji is a group of jellyfish which are known to cause symptoms of a potentially dangerous syndrome called Irukandji Syndrome. There are currently 14 known species of Irukandji, however only a few of these species have the potential to occur in the waters around the Whitsundays. Irukandji can occur coastally and around the reef and islands. What is Irukandji Syndrome? Irukandji Syndrome is a syndrome which can affect people who have been stung by an Irukandji jellyfish. While the Irukandji sting itself can be relatively mild, the symptoms of the Irukandji Syndrome, in very rare cases, can be life-threatening. Symptoms of Irukandji Syndrome can take 5 to 45 (typically 20-30) minutes to develop after being stung. Some symptoms include: • Lower backache, overall body pain and muscular cramps. The pain from this can be severe. • Nausea/vomiting • Chest pain and difficulty breathing • Pins and needles • Anxiety and a feeling of “impending doom” • Headache, usually severe • Increased respiratory rate • Piloerection (hair standing on end) • High blood pressure which can lead to stroke or heart failure • A sting is rarely evident – usually just a pale red mark with goose pimples or sweating. Are Irukandji only prevalent in Australia? No. Species of Irukandji occur in South East Asia, the Caribbean, Hawaii, South Africa and even the United Kingdom. Australia is leading the study of these creatures, which is probably the reason why the jellyfish may be wrongly associated with occurring only in Australia. What are Box Jellyfish? While globally the term ‘Box Jellyfish’ is the general term given to any jellyfish which has a bell (head) shaped like a box, in Australia, the name always refers to a particular species of jellyfish called Chironex fleckeri.
    [Show full text]
  • 'Irukandji' Jellyfish: Carukia Barnesi
    ResearchOnline@JCU This file is part of the following reference: Courtney, Robert (2016) Life cycle, prey capture ecology, and physiological tolerances of Medusae and polyps of the 'Irukandji' jellyfish: Carukia barnesi. PhD thesis, James Cook University. Access to this file is available from: http://researchonline.jcu.edu.au/49935/ The author has certified to JCU that they have made a reasonable effort to gain permission and acknowledge the owner of any third party copyright material included in this document. If you believe that this is not the case, please contact [email protected] and quote http://researchonline.jcu.edu.au/49935/ Life Cycle, Prey Capture Ecology, and Physiological Tolerances of Medusae and Polyps of the ‘Irukandji’ Jellyfish: Carukia barnesi Thesis Submitted by: Robert Courtney BSc (Hons 1A) November 11, 2016 For the Degree of: Doctor of Philosophy College of Public Health, Medical and Veterinary Sciences James Cook University Supervisors: Principle Supervisor: Associate Professor Jamie Seymour, Australian Institute of Tropical Health and Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns [email protected] Co-Supervisor: Emeritus Professor Rhondda Jones, Australian Institute of Tropical Health and Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville [email protected] Co-Supervisor: Dr Nik Sachlikidis, NGSAquatic, [email protected] Thesis Dedication: I would like to dedicate this thesis to The Lions Foundation of Australia, for their continual financial support dedicated to stinger research, and to Dr. Jack Barnes, for his pioneering work in the field of Irukandji research. i Statement of the Contribution of Others: Robert Courtney is the primary author of this Thesis and was extensively involved in all aspects of this work under the supervision of: Associate Professor Jamie Seymour; Emeritus Professor Rhondda Jones; and Dr Nik Sachlikidis.
    [Show full text]
  • An Emerging Model for Studying Venom, Vision and Sex Cheryl Lewis Ames1,2*, Joseph F
    Lewis Ames et al. BMC Genomics (2016) 17:650 DOI 10.1186/s12864-016-2944-3 RESEARCH ARTICLE Open Access A new transcriptome and transcriptome profiling of adult and larval tissue in the box jellyfish Alatina alata: an emerging model for studying venom, vision and sex Cheryl Lewis Ames1,2*, Joseph F. Ryan3,4, Alexandra E. Bely5, Paulyn Cartwright6 and Allen G. Collins1,7 Abstract Background: Cubozoans (box jellyfish) are cnidarians that have evolved a number of distinguishing features. Many cubozoans have a particularly potent sting, effected by stinging structures called nematocysts; cubozoans have well-developed light sensation, possessing both image-forming lens eyes and light-sensitive eye spots; and some cubozoans have complex mating behaviors, including aggregations, copulation and internal fertilization. The cubozoan Alatina alata is emerging as a cnidarian model because it forms predictable monthly nearshore breeding aggregations in tropical to subtropical waters worldwide, making both adult and larval material reliably accessible. To develop resources for A. alata, this study generated a functionally annotated transcriptome of adult and larval tissue, applying preliminary differential expression analyses to identify candidate genes involved in nematogenesis and venom production, vision and extraocular sensory perception, and sexual reproduction, which for brevity we refer to as “venom”, “vision” and “sex”. Results: We assembled a transcriptome de novo from RNA-Seq data pooled from multiple body parts (gastric cirri, ovaries, tentacle (with pedalium base) and rhopalium) of an adult female A. alata medusa and larval planulae. Our transcriptome comprises ~32 K transcripts, after filtering, and provides a basis for analyzing patterns of gene expression in adult and larval box jellyfish tissues.
    [Show full text]
  • Jellyfish Gone Wild
    NSF - Jellyfish Gone Wild Special Report Text-only Jellyfish Gone Wild HOME Enviromental Change and Jellyfish Swarms 1. 1/3 of the total weight of all life in Monterey Bay is from gelatinous animals. Jellyfish Gone Wild — Home 2. 3 minutes after a person is stung by a deadly box jellyfish, s/he may be dead. Introduction 3. 8 years after fast-reproducing comb jellies invaded in the Black Sea, they dominated it. Biology 4. 20 to 40 people are killed annually from box jellyfish stings in the Philippines alone. Ecology 5. 100 foot-long tentacles may dangle from the lion’s mane jelly. Swarms 6. 400 vast Dead Zones in world oceans are too polluted for almost all life except jellyfish. Locations 7. 1,000+ fist-sized comb jellies filled each cubic meter of water in Black Sea jelly blooms. Gallery 8. 45,000 eggs may be released daily by a single jellyfish. Resources 9. 500,000 people are stung by jellyfish in the Chesapeake Bay annually. 10. 500 million refrigerator-sized jellyfish float into the Sea of Japan daily during blooms. NSF - Jellyfish Gone Wild Special Report Text-only Introduction When distributed in reasonable numbers, native jellyfish play important ecological roles. But when jellyfish populations run wild, they may jam hundreds and perhaps even thousands of square miles with their pulsating, gelatinous bodies. Jellyfish Gone Wild — Home In recent years, massive blooms of stinging jellyfish and jellyfish-like creatures have overrun some of the world’s most important fisheries and tourist destinations--even Introduction transforming large swaths of them into veritable jellytoriums.
    [Show full text]
  • Marine Stingers
    Table of Contents Introduction ......................................................................................................................................................................... 2 Rationale ......................................................................................................................................................................... 2 Definitions ....................................................................................................................................................................... 2 Objectives ....................................................................................................................................................................... 2 Marine Stingers ................................................................................................................................................................... 3 Major Types (including distribution) ................................................................................................................................. 3 Chironex (Box Jellyfish) ............................................................................................................................................... 3 Irukandji ....................................................................................................................................................................... 3 Other problem jellyfish (includes, but not restricted to):..................................................................................................
    [Show full text]
  • Jellyfish Irukandji
    Irukandji Jellyfish Irukandji Jellyfish Carukia barnesi The Irukandji is a small jellyfish with an approximately 2cm diameter bell, that is responsible for an unusual and dramatic syndrome observed following stings in Northern Australia, especially North Queensland. While they are related to the Box Jellyfish, they differ to the large Box Jellyfish in a number of ways. Description The small, translucent Irukandji Jellyfish has a single retractile tentacle, from 50 to 500mm long, hanging from each of BOX JELLYFISH the four corners of its bell. This species has a maximum size of 20- 40mm across the body, however different species can reach 60-90mm across. They often have a rectangular body shape ( rather than square). Their tentacles can be up to 1 metre in length. The numbers of nematocysts , involved in these stings are very small, but they still hurt the victim immensely. Habitat Irukandji are mostly found north of the Tropic of Capricorn in offshore areas including around reefs and islands but can also be found inshore when onshore currents carry them. At times they may occur in epidemic proportions close to shore. Season Irukandji Syndrome Usually Irukandji Jellyfish are found If you happen to get stung by one of these from around November to May, but jellyfish, the initial sting causes a low level there have been stings recorded during irritation, but main symptoms are delayed the entire year in the Cairns region. usually 20 – 30 minutes. These symptoms are termed Irukandji Syndrome and can cause Lower back ache Stomach cramps Nausea Very intense overall body pain Sweating Goosebumps Anxiety In a small percentage of victims symptoms may include Pulmonary oedemas Venom Cardiac damage Elevated blood pressure Even though the size of the Irukandji jellyfish can be very tiny, it is potentially deadly.
    [Show full text]
  • Cubozoan Jellyfish (Chironex Fleckeri and Carukia Barnesi)
    CLOSE ENCOUNTERS WITH THE ENVIRONMENT Aquatic Antagonists: Cubozoan Jellyfish (Chironex fleckeri and Carukia barnesi) Patrick Thomas Ottuso, MD ome of the most venomous creatures on earth sense organs, including eyes known as ocelli. Ocelli belong to the class Cubozoa, commonly known can detect light and dark, including shadows. In as box jellyfish (Figure 1). There are a number the case of C fleckeri, the jellyfish will swim around S 3 of species within this class, most of medical and objects, including humans, if given enough time. It dermatological significance. Two species are of par- is unknown how information is processed, as these ticular relevance to the dermatologist and intensiv- organisms do not have a brain. Statocysts, structures ist: Chironex fleckeri and Carukia barnesi. Chironex located below the eyes, are sense organs involved fleckeri, also called the sea wasp, is a known cause of with spatial orientation, allowing cubozoans to deter- severe envenomations with more than 100 fatalities mine their position in the water.4 associated with its contact in AustraliaCUTIS and Indo- Pacific waters. Carukia barnesi, the cause of Irukandji Chironex fleckeri syndrome,1 also is found in Australian waters. Other Symptoms of Envenomation—Chironex fleckeri may pos- jellyfish including an addition to the class Cubozoa, sess up to 60 thick ribbonlike tentacles that are 3 m or Malo kingi,2 and the hydrozoan Physalia physalis more in length with a bell equal to or larger than an Do Not Copy3 (Portuguese man-of-war) also have been implicated adult human head. Contained within the tentacles in Irukandji-like syndromes.
    [Show full text]
  • Comparative Evaluation of Polyclonal Antibodies in the Characterization Of
    Preprints (www.preprints.org) | NOT PEER-REVIEWED | Posted: 29 August 2018 doi:10.20944/preprints201808.0481.v1 1 Research Article 2 Comparative evaluation of polyclonal antibodies in 3 the characterization of nematocyst proteins from 4 Australian Irukandji and Chironex fleckeri species 5 Griselda Ávila-Soria1,2*, Lisa-Ann Gershwin 3,4, Kenneth D. Winkel 5, 6 and James N. Burnell2 6 7 8 1 Reef System Unit Institute of Marine Sciences and Limnology (ICML) of the National Autonomous 9 University of Mexico (UNAM), Puerto Morelos, Quintana Roo, México 10 [email protected] 11 12 2 Comparative Genomics Centre, Department of Biochemistry and Molecular Biology, School of Pharmacy 13 and Molecular Sciences, James Cook University, Townsville, Qld 4814; [email protected] 14 15 3 16 17 4 CSIRO Oceans and Atmosphere, Castray Esplanade, Hobart, Tasmania, Australia; 18 [email protected] 19 20 5 Australian Marine Stinger Advisory Services, 5/20 Hampden Road, Battery Point, Tasmania, Australia; 21 [email protected] 22 23 6 Australian Venom Research Unit (AVRU), Department of Pharmacology, The University of Melbourne. 24 25 7 Indigenous Health Equity Unit, Centre for Health Equity, School of Population and Global Health, 26 Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne; [email protected] 27 28 29 * Correspondence: [email protected]; Tel.: +52-984-235-1034 30 31 Abstract: Carukia barnesi (Cb), Malo kingi (Mk) and Chironex fleckeri (Cf) are dangerous Australian 32 box jellyfish species that provoke distinct and not well understood envenomation syndromes. 33 Specifically, Cb and Mk are small, rare and able to induce a systemic syndrome of generalised 34 muscle pain and catecholamine excess termed “Irukandji syndrome”; Cf has been widely regarded 35 as one of the most venomous organisms in the animal kingdom causing severe sting site pain 36 combined with potentially lethal cardiotoxicity.
    [Show full text]
  • Chapter 18 TOXINS from VENOMS and POISONS
    Toxins From Venoms and Poisons Chapter 18 TOXINS FROM VENOMS AND POISONS SCOTT A. WEINSTEIN, PhD, MD,* and JULIAN WHITE, MD† INTRODUCTION SOME DEFINITIONS: VENOMS, TOXINS, AND POISONS NONWARFARE EPIDEMIOLOGY OF VENOM-INDUCED DISEASES AND RELATED TOXINS Venomous Bites and Stings Venomous Snakes Scorpions, Spiders, and Other Arachnids Insects Marine Envenoming: Sea Snakes, Cnidarians, and Venomous Fish Poisoning by Animals, Plants, and Mushrooms Relevance to Biological Warfare MAJOR TOXIN CLASSES AND THEIR CLINICAL EFFECTS Paralytic Neurotoxins Excitatory Neurotoxins Myotoxins Hemostasis-Active Toxins Hemorrhagic and Hemolytic Toxins Cardiotoxins Nephrotoxins Nectrotoxins Other Toxins CONCLUSIONS AND DIRECTIONS FOR RESEARCH *Physician, Toxinologist, Toxinology Division, Women’s & Children’s Hospital, 72 King William Road, North Adelaide, South Australia 5006, Australia †Head of Toxinology, Toxinology Division, Women’s & Children’s Hospital, 72 King William Road, North Adelaide, South Australia 5006, Australia 415 Bio Ch 18 - mark EEI - pp415-460.indd 415 6/21/18 1:02 PM Medical Aspects of Biological Warfare INTRODUCTION This chapter considers toxins that might be ex- venom-derived toxins have not generally been con- ploited as offensive biological weapons, or that may sidered suitable for use as a mass offensive weapon; have medical relevance to deployed military per- however, primarily fungal- or plant-derived toxins sonnel. The major characteristics of important toxin certainly have been weaponized (eg, ricin; see chapter classes are summarized, and their medical effects are 16). Using venoms as a weapon is also obviously dis- covered. Venom toxins are emphasized because little tinct from the weaponization of toxins from bacteria. information is available about venomous animals in However, many toxins found in animals, plants, relation to military medicine.
    [Show full text]
  • Jellyfish Stings
    WILDERNESS & ENVIRONMENTAL MEDICINE, ], ]]]–]]] (2015) REVIEW ARTICLE Jellyfish Stings: A Practical Approach Najla A. Lakkis, MD, MPH; Grace J. Maalouf, MD; Dina M. Mahmassani, RN From the Department of Family Medicine, American University of Beirut Medical Center, Beirut, Lebanon. Jellyfish have a worldwide distribution. Their stings can cause different reactions, ranging from cutaneous, localized, and self-limited to serious systemic or fatal ones, depending on the envenoming species. Several first aid treatments are used to manage such stings but few have evidence behind their use. This review of the literature describes and discusses the different related first aid and treatment recommendations, ending with a summarized practical approach. Further randomized controlled trials in this field are needed. Key words: jellyfish, medusa, marine stings, marine envenomation, Cnideria Introduction considered to be an order in the class Scyphozoa, however, recent genetic studies suggested they should Jellyfish envenomation has become a serious health be elevated to class of their own; unlike most jellyfish, problem on coastal beaches throughout the world, but they do not have a free-swimming medusa stage, rather, especially subtropical and tropical Atlantic, Pacific, the adult animal is a sessile polyp.3 Species distribution Asian, and Australian coasts where the most notorious varies geographically (Table 1).4 jellyfish species prevail.1 Jellyfish are marine Cnidaria classically have bodies consisting of a jellylike invertebrates belonging to the phylum Cnidaria, which substance enclosing the internal structures, from which is subdivided into 5 classes (Table 1): 1) Hydrozoa, structures called tentacles are suspended. Each tentacle is which are not considered true jellyfish and include the covered with thousands of cells called cnidocytes or Physalia species, which are siphonophores; the 2 major nematocytes that house an organelle called a cnidocyst or Physalias are Physalia physalis, known as the nematocyst containing stinging barbed threads or tubules.
    [Show full text]
  • Early Warning Systems to Minimize the Risk of Box Jellyfish Stings by Empowering Stakeholders
    Final Report Early warning systems to minimize the risk of box jellyfish stings by empowering stakeholders Scott A. Condie, Lisa Gershwin, Michael Kingsford, Kylie Pitt, Anthony J. Richardson and Linda Thomas Early warning systems to minimize the risk of box jellyfish stings by empowering stakeholders Scott A. Condie1, Lisa Gershwin1, Michael Kingsford2, Kylie Pitt3, Anthony J. Richardson1 and Linda Thomas1 1 CSIRO Oceans and Atmosphere 2 College of Science and Engineering, James Cook University 3 School of Environment and Science, Griffith University Supported by the Australian Government’s National Environmental Science Program Project 2.2.3 Early warning systems to minimize the risk of box jellyfish stings by empowering stakeholders © CSIRO, 2018 Creative Commons Attribution Early warning systems to minimize the risk of box jellyfish stings by empowering stakeholders is licensed by the CSIRO for use under a Creative Commons Attribution 4.0 Australia licence. For licence conditions see: https://creativecommons.org/licenses/by/4.0/ National Library of Australia Cataloguing-in-Publication entry: 978-1-925514-29-2 This report should be cited as: Condie, S. A., Gershwin, L. A., Kingsford, M. J., Pitt, K. A., Richardson, A. J. and Thomas, L. (2018) Early warning systems to minimize the risk of box jellyfish stings by empowering stakeholders. Report to the National Environmental Science Program. Reef and Rainforest Research Centre Limited, Cairns (44pp.). Published by the Reef and Rainforest Research Centre on behalf of the Australian Government’s National Environmental Science Program (NESP) Tropical Water Quality (TWQ) Hub. The Tropical Water Quality Hub is part of the Australian Government’s National Environmental Science Program and is administered by the Reef and Rainforest Research Centre Limited (RRRC).
    [Show full text]