Marine Envenomation
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MEDICINE
Marine Envenomation Toru Hifumi 1
&
Yoshimune Fukuchi 2 & Norio Otani 1
Accepted: 25 August 2020 # The Author(s) 2020
Abstract With global warming and an increasing frequency of human interaction with venomous marine organisms, physicians are likely to encounter more cases of marine envenomation in clinical practice in Japan and around the world. Few review articles regarding the clinical characteristics of marine envenomation have been published and there has been no comprehensive review of available antivenoms, which are the definitive treatment. We discuss the epidemiology, venom activity, clinical symptoms, diagnosis, and treatment of marine envenomation by the Okinawan box jellyfish, stonefish, Portuguese man-of-war, geography cone, and blueringed octopus. A comprehensive review of available antivenom treatments is also presented. Keywords Marine envenomation . Epidemiology . Diagnosis . Treatment . Antivenom
Background The annual incidence of marine envenomation in Florida and eastern Australia is approximately 100,000 [1]. Previous clinical reports of marine envenomation include an outbreak of Portuguese man-of-war envenomation in southeastern Brazil [2] and a compilation of human injuries and fatalities due to envenomation by the geography cone, which is the most dangerous species to humans [3]. Currently, it appears that the incidence of marine envenomation in Japan and around the world is likely to increase due to global warming and increasing frequency of human interactions with venomous marine organisms [4–6]. However, few clinical reviews of marine envenomation have been published [7–9], and there has been no comprehensive review of available antivenoms, which are This article is part of the Topical Collection on Medicine * Toru Hifumi [email protected] Yoshimune Fukuchi [email protected] Norio Otani [email protected] 1
Department of Emergency and Critical Care Medicine, St. Luke’s International Hospital, Emergency Medical Center, 9-1 Akashi-cho, Chuo-ku, Tokyo 104-8560, Japan
2
Okinawa Prefectural Institute of Health and Environment, Okinawa, Japan
the definitive treatment. In this review, we discuss the epidemiology, venom activity, clinical symptoms, diagnosis, and treatment of marine envenomation by the box jellyfish, stonefish, Portuguese man-of-war, geography cone, and blueringed octopus and also provide a comprehensive review of available antivenoms.
Main Text Box Jellyfish Scientific name: Chironex yamaguchii Appearance: The diameter of the hood is approximately 10–14 cm, and the body length can reach approximately 1.5 m with tentacles extended. This jellyfish possesses seven tentacles attached to four arms (Fig. 1). Epidemiology: Jellyfish appear in large numbers in swimming areas, particularly inlets and beaches where waves are subdued. Several jellyfish sting cases have been reported in the literature [10–12] and recently, Hifumi et al. comprehensively described the clinical characteristics of jellyfish stings in Japan [13]. One urban emergency department in Ha
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