- A Review on Envenomation and Treatment in European Jellyfish Species
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Abstract:
- There is growing concern about jellyfish envenomation in European seas because of jellyfish blooms, climate change and globalisation displacing species. Treatment of envenomation involves the prevention of further nematocyst release, and the relief of local cutaneous and systemic symptoms. While many anecdotal treatments are available, a species-specific first aid response is essential for effective treatment. A literature review and citizen science questionnaire distributed to European lifeguards on jellyfish envenomation and treatment revealed a lack of knowledge and confusion on species identification and sting protocol. From the literature review there is evidence that oral analgesics, seawater, baking soda slurry and 42-45°C hot water cause nematocyst inhibition and/or provide pain relief. The application of topical vinegar for 30s is only recommended for Carybdea marsupialis and Chrysaora hysoscella. Treatments which produce osmotic changes or mechanical stimulation can exacerbate the initial sting and aggravate symptoms, common among many anecdotal treatments. There is a lack of evidence-based medicine with most available methods of first aid response founded on weak evidence. It is advised that randomized clinical trials are undertaken to establish species-specific sting treatment. An increase in directed research on the effect of environmental factors on envenoming mechanisms is recommended, as well as the regulation of coastal development to reduce favourable settlement sites for jellyfish polyps in touristic areas. Suitable signage on jellyfish species and cutaneous sting markings as well as standardised first aid protocols with emphasis on protective equipment to minimise stings should be implemented in high-risk touristic areas such as the Mediterranean coast.
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