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Wilderness Medical Society - snowmass 2005 (Page 340)

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Wilderness Medical Society - snowmass 2005
a U.S. Patent in 1999 for a method and composition containing polymeric quaternary ammonium salts for
protecting the skin from jellyfish stings.
True sea lice are parasites on marine creatures and do not cause this disorder.
Scyphozoa
This group of animals comprises the larger medusae or jellyfish, including the deadly box-jellyfish and
sea wasps (for example, Chironex, Cyanea, and Chiropsalmus). These creatures are armed with some of the
most potent venoms in existence. Jellyfish are mostly free-swimming pelagic creatures; however, some can be
found at depths of more than 2000 fathoms. They may be transparent or multicolored and range in size from a
few millimeters to more than 2 m in width across the bell, with tentacles up to 40 m in length. Like physaliae,
the scyphozoans depend on the wind, currents, and tides for transport and are widely distributed. Some
vertical motion may be produced by rhythmic contractions of the gelatinous bell, from which originate the
feeding tentacles.
Some jellyfish contain less than 5% solid organic matter. Regardless, they can withstand remarkable
temperature and salinity variations, although they do not fare well with violent activity and thus may descend
to the depths during stormy surface weather. Some scyphozoans avoid sunlight; others follow an opposite
pattern. Certain jellyfish have adapted to local nutrient (largely algal) supply and lost their ability to sting
humans.
In the eastern coastal waters of the North American continent, the creatures appear to grow larger as
they progress north, so that true giant jellyfish, typified by Cyanea capillata (lion's mane), are found in arctic
waters. Tentacles (which may number up to 1200) of larger specimens may exceed 100 feet in length. Pelagia
species (purple-striped or "mauve"-pink stingers) are commonly found in large numbers off the California
coast and appear in the Mediterranean Sea in abundance every 10 to 12 years. P. noctiluca phosphoresces at
night, hence its name. Olindias sambaquiensis is a jellyfish that stings bathers in South American coastal
waters. Rhopilema nomadica is a tropical jellyfish that has invaded the eastern Mediterranean. As a further
example, stings from Stomolophus nomurai in the Bohai waters of China produce severe pulmonary edema,
coma, convulsions, psychoses, and death. Australian jellyfish include the blubber jellyfish (Catostylus
species), hair jellyfish (Cyanea species), little mauve stinger (Pelagia noctiluca), and the cuboid-shaped
jellyfish (Chironex fleckeri and Chiropsalmus quadrigatus). A number of cubomedusan ("box-shaped
jellyfish") scyphozoans of highly toxic nature inhabit Indo-Pacific and, less frequently, Caribbean waters.
These include Carybdea rastoni (jimble) and C. marsupialis (sea wasp), Chiropsalmus quadrumanus (box-
jellyfish or sea wasp), C. quadrigatus (sea wasp), and Chironex fleckeri (box-jellyfish). The "carybdeids" of
Order Carybdeidea have four tentacles only, while the "chirodropids" of Order Chirodropidea may have up to
60 tentacles. All are frequently called "box jellyfishes."
Chironex (Box-Jellyfish). The dreaded chirodropid box-jellyfish (Chironex fleckeri Southcott), often
misnamed the "sea wasp," is the most venomous sea creature and can induce death in less than 60 seconds
with its potent sting. Like all other scyphozoans, it is a carnivore, adapted to deal rapidly with prey. It is a
member of the group of Cubomedusae jellyfish and ranges in size from 2 to 30 cm across the bell. Although
these creatures seem to prefer quiet, protected, and shallow areas, chiefly in the waters off northern
Queensland, Australia, they can be found in the open ocean. A seasonal alternation of polypoid and medusoid
generations from winter to summer, respectively, appears to account for the shift in preferred habitat from
tidal estuaries to the open eulittoral zone. The "stinger season" in the Northern Territory of Australia is from
October 1 to May 31). Its presence precludes swimming and bathing in littoral and estuarine waters of
Indonesia, Malaysia, and Northern Australia during this season, which coincides with the hottest tropical
months in the southern hemisphere. Chironex are fragile and photosensitive and thus are found submerged in
bright sunlight, seeking the surface in the early morning, afternoon, and evening. They are swift and graceful
travelers, capable of sailing along at a steady 2 knots.
An
adult
Chironex carries up to 15 broad tentacles in each corner of its bell (up to 60 tentacles total,
each with a length of up to 3 m) and has enough venom (in excess of 10 ml) to kill three adults. Two fractions
have been isolated from the venom: a "lethal" fraction of molecular weight 150,000, and a lethal-hemolytic-
dermatonecrotic fraction of molecular weight 79,000. At least 72 fatalities have been verified in Australian
and Southeast Asian waters, with greater numbers probably lacking official documentation. Thus the box-
jellyfish is a much greater true hazard than the more fearsome shark. Other jellyfishes, such as Carybdea

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