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Box jelly sting off Bamaga prompts warning

Image of stinger

26 February 2021

A box jellyfish sting in the waters off Bamaga has prompted renewed warnings for Cape York, Torres Strait and Northern Peninsula Area residents to take care.

“The recent incident at Bamaga is a timely warning to take precautions when swimming in the sea in any northern waters,’’ Torres and Cape Hospital and Health Service Northern Director of Medical Services Dr Marlow Coates said.

“We are seeing sightings of both box jellyfish and jellyfish that cause Irukandji syndrome in our waters,’’ he said.

Dr Coates said swimmers could avoid being stung by wearing stinger protective clothing such a wetsuit or lycra suit, or simply staying out of the water if they had no protective clothing.

“If you don’t have a protective suit and you know there could be stingers or jellyfish in the water, just don’t go in,’’ he said.

“It’s also important that people are familiar with resuscitation methods – early resuscitation after major stings from box jellies has saved lives in the past few years.’’

Dr Coates said the effects of an encounter with a jellyfish could range from receiving a painful sting, right through to a potentially fatal sting from a box jellyfish or one of the jellyfishes causing Irukandji syndrome.’’

Several types of jellyfish in tropical Australian waters can cause pain. Each is different in appearance and requires different treatment.

The three significant ones are: Jellyfish that cause Irukandji syndrome, the box jellyfish (Chironex fleckeri) and the blue bottle (Physalia utriculus).

Of these, the box jellyfish and jellyfish causing Irukandji syndrome were known to cause potential fatalities, Dr Coates said.

“It can be difficult to work out which species of jellyfish has caused a sting, so if in doubt, treat as if it was potentially serious,’’ he said.

“In terms of treatment for any sting, the priority is to keep the patient stable and safe. Medical
advice should always be sought if pain persists.’’

Jellyfish causing Irukandji syndrome

These jellyfish are found under the surface of the water. They are considered strong swimmers. There are several different types but the main type found in tropical waters is the Carukia barnesi.

They may be found in the water for just a few days or for weeks on end. So, you must always remain alert during the ‘stinger season’, which generally extends from November to the end of May but may start earlier and finish later.

A sting from these jellyfish may take from a few minutes to 45 minutes to develop.

It can cause nausea, anxiety, headache, waves of spasms in the back and stomach, dizziness, a terrible sense of dread and difficulty in breathing, so it is important to call an ambulance if someone has evidence of any serious sting or symptoms from a sting.

First aid is to use vinegar liberally to wash Irukandji stings and neutralise them. The patient should then be transported to the nearest hospital for medical assessment.

Box jellyfish

The Australian box jellyfish, Chironex fleckeri, is extremely dangerous and a constant threat through the warmer months on the Northern Queensland coast.

It is a large but almost transparent jellyfish with a box-shaped bell (with four corners).

A major Chironex sting is immediately and excruciatingly painful. It should be considered life threatening. Large box jellies such as Chironex have caused more than 70 fatalities in Australia.

DO NOT use salt or fresh water to treat Chironex – it will cause the stinging cells to discharge and worsen the sting. Use vinegar instead and do not rub the sting or try to remove tentacles.

Blue bottle

The common blue bottle found in Australia is the Physalia utriculus.

The blue bottle jellyfish floats on top of the water. It has an air-filled sac of up to 8 cm in length, usually with a single, long, blue, main fishing tentacle hanging underneath.

The pain is immediate and intense but not considered life-threatening.
If the sting is clearly from a blue bottle do not use vinegar but instead wash off the tentacles with water.

Soaking the affected area in hot but not scalding water (ideally 45 C) for 20 minutes may relieve the pain. This is not suitable for infants, the very elderly, or those with poor skin condition as hot water may burn the skin.

The Australian Resuscitation Council provides the following general advice for all jellyfish stings in tropical Australia:

  • Call for help (call for an ambulance immediately on 000 if the patient is extremely unwell).
  • Check for level of consciousness and assess airway, breathing, circulation, and resuscitate if required – early resuscitation after major stings from Chironex box jellies has saved lives in the past few years.
  • Douse the sting site liberally for 30 seconds with vinegar to neutralise the stinging cells – UNLESS the sting is from a blue bottle, in which case wash off with water.
  • Apply a cold pack or ice in a dry plastic bag for analgesia. DO NOT allow or apply fresh water directly onto the sting because it may cause discharge of undischarged
  • Seek medical aid as soon as possible. Call for an ambulance if this has not already occurred, if there is persistent pain or any ongoing or worsening symptoms.

Dr Coates said in-hospital treatment for a marine sting could vary depending upon the severity of the sting and the type of symptoms being exhibited.

Antivenom was available for Chironex fleckeri and other multi-tentacled box jellyfish stings but not for jellyfish causing Irukandji syndrome, he said.

Generally, pain management and observation are the most important factors.

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Last updated: 3 March 2021