Medical aspects of jellyfish envenomation: pathogenesis, case reporting and therapy

Abstract

With larger human population numbers and their need for recreation, contact between humans and jellyfish is increasing. The pathogenesis of cnidarian stings is discussed here and some of the factors influencing the variability in adverse reactions they produce are mentioned. The pharmakinetics of venom delivery determines the organ site of damage and the extent of abnormality. Since venoms can injure man by allergic or toxic reactions, the differences between these processes is elucidated. Toxic reactions predominate and allergic ones are unusual. A more complete list of disease entities caused by jellyfish stings has been compiled. These sting reactions may be local, systemic, chronic or fatal. Most follow cutaneous stinging but some occur after stings to the eye or following ingestion. Increased case loads and experience has also lead to a more comprehensive understanding of sting pathogenesis and treatment. Accordingly, the principles of prevention and first aid therapy are outlined. Finally, some recommendations for more complete recording of adverse stings are suggested.

The purpose of this paper is to increase the understanding of marine biologists about the medical aspects of jellyfish stingings by: (1) stressing the importance of pathogenesis including the process of envenomation, the pharmokinetics of the stinging, the role of allergy and toxicity in the disease state, and the importance of prior exposure to other animal venoms, (II) suggesting a scheme for adequate history taking and case recording, (III) cataloguing the jellyfish envenomation syndromes, and (IV) outlining the best therapeutic and prevention techniques.