for locomotion. From these project numerous silky or bristlelike setae, which are capable of puncturing the
victim.
The chitinous urticating bristles are arranged in soft rows about the body. When a worm is stimulated,
its body contracts and the bristles are erected. There are no associated venom-producing cells. Easily
detached, the bristles penetrate skin like cactus spines and are difficult to remove. The ubiquitous bottom-
dwelling bristleworm Hermodice carunculata is frequently handled in Floridian and Caribbean waters by
snorkelers and divers. This worm can attain a length of 1 foot and a width of 1 inch. It is found on coral, under
rocks, and moving among sponges. The body is green or reddish with tufts of white bristles. Chloeia flava is
found along the Malayan coast, Chloeia viridus in the West Indies, Gulf of California, and Gulf of Mexico
south to Panama, and Euythoe complanata in Australia and other tropical seas. Other worms, such as Chloeia
euglochis ehlers, are free swimming. Some marine worms possess strong chitinous jaws with pharyngeal teeth
and can inflict painful bites.
Clinical Aspects. The bite or sting of an annelid worm may induce intense inflammation typified by a
burning sensation with a raised, erythematous, and urticarial rash, most frequently on the hands and fingers.
Edema and papules ensue, with rare necrosis. The setae are easily fractured into the skin and are generally not
visible on external inspection, although the victim may report a sensation of pricking or abrasion. Untreated,
the pain is generally self-limited over the course of a few hours, but the inflammatory component of erythema
and urticaria may last for 2 to 3 days, with total resolution of the skin discoloration over 7 to 10 days. With
multiple stings, marked local soft tissue edema and pruritus may develop. Secondary infections and cellulitis
may occur if the eczematous component is severe.
Treatment. All large visible bristles should be removed with forceps. The skin should be dried
(without scraping, to avoid breaking or embedding the spines further into the skin) so that a layer of adhesive
tape may be applied to remove the remaining smaller spines, which are too tiny for individual extraction.
Alternatively, a facial "peel" or thin layer of rubber cement may be applied and removed. After this
maneuver, acetic acid 5% (vinegar), isopropyl alcohol 40% to 70%, dilute ammonia, or a paste or solution of
unseasoned meat tenderizer (papain) or application of a papain scrub brush may provide some pain relief. If
the inflammatory reaction becomes severe, the victim may benefit from the administration of a topical or
systemic corticosteroid.
MOLLUSKS
The phylum Mollusca (45,000 species) encompasses a group of unsegmented, soft-bodied
invertebrates, many of which secrete calcareous shells. Generally a muscular foot is present with various
modifications. There are five main classes, of which three predominate in their hazard to humans: the
pelecypods (such as scallops, oysters, clams, and mussels), the gastropods (such as snails and slugs), and the
cephalopods (such as squids, octopuses, and cuttlefish). Mollusks are often implicated as the transvectors in
poisonous ingestions.
Cone Snails ("Cone Shells")
Life and Habits. There are approximately 300 species of these circumtropical, beautiful, yet potentially
lethal, univalve and cone-shaped shelled mollusks of the class Gastropoda, family Conidae, genus Conus.
Most of these carnivores carry a highly developed venom apparatus, and at least 18 species have been
implicated in human envenomations, with occasional fatalities (approximately 16 to 30 have been recorded).
These include Conus aulicus (court), C. geographus (geographer), C. gloria-maris (glory of the sea), C.
omaria (marbled), C. striatus (striated), C. textile (textile), and C. tulipa (tulip).
Most harmful cone snails ("cones") are creatures of shallow Indo-Pacific waters; the variance in
feeding habits and venom production accounts for the varying toxicity. Atlantic species, such as C. ermineus
(turtle) are less toxic. Conus regious (crown or queen) and C. spurius (Chinese alphabet) are found in Florida
waters. Apparently, cones that feed on fish or mollusks are the most dangerous. Less toxic stings are
attributed to cones that feed on marine worms. Predominantly nocturnal creatures, cones burrow in the sand
and coral during the daytime, emerging at night to feed.
Venom and Venom Apparatus. Cone snails are predators that feed by injecting rapid-acting venom by
means of a detachable, dartlike radular tooth ("radula"). To do this, the head of the animal must extend out of
the shell. The venom apparatus is composed of a set of minute, harpoonlike, chitinous, and hollow radular
teeth associated with a venom bulb, long convoluted duct, and radular sheath.
The barbed teeth, which may
