A FOUR-YEAR-OLD Australian boy races into the sea soon after his family arrive on Koh Mak, a tropical island in the Gulf of Thailand. Moments later, Lewis Jones was unconscious from a box jellyfish sting and only frantic efforts by his parents and a quick-thinking resort chef saved his life.
As many as 200 people die each year from lethal stingers, and Australian experts warn more potentially fatal incidents are likely in tropical regions as rising water temperatures lengthen the stinger season and extend the danger to new areas.
However, there's good news with a new treatment developed in Australia for stings.

Andrew Jones told the ABC of the terror of his son’s near-death experience.

“I blindly raced into the water to retrieve my hysterical boy and brought him onto the beach. As I instinctively peeled gooey, translucent jellyfish tentacles from his quivering legs, millions and millions of stinging cells were firing deadly venom into his blood stream.

“After a few minutes he stopped screaming and lay still and quiet on the sand. His breathing stopped, his face turned blue and his heart halted under the onslaught of toxin.

“His panic-stricken mother ran with his limp body to our bungalow resort while I followed dizzy and in severe pain from my own small sting. The resort's chef emerged from the kitchen with vinegar and doused the wound, neutralizing the tentacles' stinging cells (nematocysts), stopping the injection of more venom.

“After three to four minutes Lewis regained consciousness. The experts say this was nothing short of a miracle: Most wouldn't, and don't, survive such a massive attack.”

Irukandji – the world’s most venomous creature


The Box jellyfish (Chironex fleckeri) has many tentacles arising from each corner of its clear bell, while the smaller Irukandji box jellyfish has a single tentacle arising in each corner.

Believed to be the world’s most venomous creature, the Irukandji inhabits Australian waters. Only 2.5 centimeters in diameter, it is difficult to spot.

Box jellyfish species are found along the coast of tropical northern Australia from Gladstone in Queensland across to Exmouth in Western Australia, during the wet season (from October to June), although stings can occur at any time of the year.

Around 80 people have died from box jellyfish stings in Australia over the last 100 years.

Sting leaves burn-like welts


Irukandji syndrome symptoms are a catastrophic complex of clinical signs and symptoms. The initial sting is typically mild and is followed, minutes to hours later, by vomiting, profuse sweating, headache, agitation, rapid heart rate, and very high blood pressure.

The increase in blood pressure may be life threatening and can be associated with abnormal heartbeat and heart failure. The symptoms may last from hours to several days.

Victims usually require hospitalisation and are left with burn-like welt marks.

In rare cases, the victim suffers potentially fatal pulmonary edema.

Stingers found throughout Asia and beyond

Fatal box jellyfish stings have been recorded in the Philippines, Thailand, Malaysia, Sarawak, Brunei, Sabah, the Solomon Islands, and Papua New Guinea and in the US.

Although anecdotal reports suggest the number of deaths is much higher than official records, especially in certain parts of Africa, South East Asia and India.

In recent years, there have been documented fatal and near fatal stings in some of Thailand's most popular tourist areas – Koh Samui, Koh Pha Ngan, Koh Phi Phi, Koh Lanta and Koh Mak. Scientists from the Phuket Marine Biological Centre trapped several box jellyfish species near Krabi and Phuket.

The syndrome has also been described throughout the Pacific and recently from waters of Florida.

Father determined to raise awareness

Andrew Jones said the Thai Government and local authorities have begun warning tourists not to swim where box jellyfish have been spotted.

“In Queensland, signs up and down the coast clearly indicate where and when stingers are found, but in Thailand there were no warnings, anywhere,” he said.

“I did not want anyone else to go through what Lewis had and was determined to do all I could to raise awareness of the box jellyfish living in Thai waters.

“I made contact with the fiancé of a Melbourne man killed by a box jellyfish on Koh Phangan in 2002 and some of Australia's best experts.

“All these experts were amazing, generous people with extraordinary knowledge who wanted to help the Thais with their box jellyfish research, in order to bring about policy change.

“But three months after Lewis was stung, we received the devastating news of the tragic death of a 10-year-old Swedish girl. She died at Koh Lanta, just south of Phuket, where she had been playing with her sister on a lilo in the water. She died within minutes of being stung.

“I felt this was the death we could have had. Lewis and all of us were the lucky ones.”

More stings likely as jellyfish move south

An Australian expert on jellyfish says changing human behaviour, rather than Irukandji numbers, are to blame for an increase in stings.

At least 10 people were treated for Irukandji stings at Broome Hospital last year – more than double the previous wet season.

James Cook University's Marine and Tropical Biology associate
professor, Jamie Seymour, says the increase in stings will continue.

"This problem is not going to go away,” Dr Seymour said. “It's only going to get worse for two reasons: first, more and more people (are going) in the water, so more people are going to get stung, second, what we're seeing on the east coast, and I suspect it's happening in the west as well, is that with increased water temperatures and temperatures staying higher for longer, we're now seeing a consistent increase in the length of the stinger season."

The Irukandji jellyfish has been seen in Fraser Island, 250km north of Brisbane.

Dr Seymour said the tourist industry should be warning people about the jellyfish because global warming may be changing water temperatures allowing the dangerous Irukandji jellies to live in new areas including some tourist destinations.

Aussie doctor discovers an effective treatment

Dr Michael Corkeron, director of intensive care at the state's Townsville Hospital, has discovered a remarkably simple yet effective treatment for the potentially fatal stings of the venomous Irukandji jellyfish.

He has successfully treated patients with magnesium infusions delivered by intravenous drip. The magnesium neutralises the jellyfish's lethal venom.

"The remarkable thing is that magnesium infusion is a long-established, very safe, and inexpensive treatment," Dr Corkeron said.

Advice for travellers

Travelvax has these tips for travellers to Thailand or other tropical country:
Before you take the plunge:

• Before swimming, check if box jellyfish have been found in the area. Avoid swimming in areas where box jellyfish have been spotted.

• Full-length lycra swimwear offers the best protection against stingers. It will also protect against sunburn.

If you or someone else is stung:

• Douse the affected area with vinegar for 30 seconds to stop stinging cells from firing.

• Pull off the tentacles, but don't rub or scratch them off – this only makes the sting worse.

• If the person loses consciousness, begin CPR.

• Get expert, emergency help as quickly as possible.