"Prevention is better than cure," according to Prof Peter Fenner, co-author of ‘Fatal and nonfatal severe jellyfish stings in Thai waters’, in the latest International Society of Travel Medicine’s journal.

“Tourists must be made aware of the danger and alternates (destinations) made available to them.

“Honest and accurate educational material must be freely available and provided by tourism agencies arranging holidays in Thailand and other Indo-Pacific countries where the problem exists.

“It should be freely available at airports and resorts.”

Signs, nets, protective swimwear and rapid treatment needed

The report also called for:


• Restricted access to some beaches.
• Walkways with multilingual signs warning of possible stinger presence.
• Vinegar (used to neutralise stinger venom) to be freely available on all beaches.
• Stinger-resistant nets where beach profiles allow.
• The presence of suitably trained lifeguards.
• Mandatory protective clothing provided by tourism operators in risk areas where swimming, snorkelling, diving, or other in-water activities are popular.

“Stings and even fatalities will never be prevented completely,” Prof Fenner said.

“However, such measures would greatly reduce the possibility of serious envenomations (stings) and will not detract from tourism.”

In fact, greater protection from stingers would enhance tourism by virtue of greater safety, the report claimed.

Jellyfish stings can kill in minutes

The study confirmed there are two kinds of potentially deadly jellyfish in Thai waters: the large box-shaped chirodropid box jellyfish and the smaller Irukandji box jellyfish. Hundreds of other species of jellyfish are also present in Thai waters but are not considered as life threatening.

Box jellyfish kill by massive envenomation, causing respiratory or cardiac arrest in as little as two or three minutes. Their stings cause sudden severe skin pain, obvious severe whip-like skin marks (often on the legs in shallow water), rapid loss of consciousness, and life-threatening breathing and/or cardiac problems.

Irukandji stings may or may not cause skin pain, but are always followed 10 to 30 minutes later by characteristic severe systemic symptoms called ‘Irukandji syndrome’. Symptoms include severe back pains, muscle cramping, headache, nausea, vomiting, sweating, breathing difficulties, anxiety, and feelings of restlessness and ‘impending doom’.

Jellyfish are widespread during summer – even in Wales

According to the report their stings have caused multiple human fatalities throughout the Indo-Pacific, including the Maldives, southern India, Myanmar, the Malaysian archipelago (east and west coasts), Indonesia, Brunei, Sarawak, Sabah, the Philippines and Solomon Islands, Okinawa (Japan), and Australia. Irukandji syndrome has also been confirmed from Hawaii, Florida, the Caribbean, North Wales (UK), New Guinea, and throughout the tropical Pacific.

Chirodropids appear mainly in the summer months in the northern and southern hemispheres, usually during the local rainy or monsoonal season, and most commonly around sandy beaches near mangrove areas. Their season is longest at the equator, where it can last all year, and reduces closer to both Tropics.

Irukandji are also commonest in the warmer months, although seasonal patterns of some different species in Australia have been recorded in all months of the year and are probably similar elsewhere.

Stinger fatalities are not new

Australia’s first recorded stinger death was in 1884.

Recent fatal stings in Thailand were first attributed to global warming. However, severe stings and fatalities have long been present in Thailand and surrounding waters, the study found.

“What is new is the widespread recognition of the problem and a whole-of-government approach to managing it,” Prof Fenner said.

In December 2008 and April 2009, Australian experts gave seminars and workshops in Thailand to educate the Government and tourism bodies how to reduce stings in line with the current advice in Australia.

Last year the Australian Government sponsored Thai scientists and physicians on a visit to Australia to learn state-of-the-art marine stinger prediction, prevention, and treatment methods from a variety of Australian experts. The safety measures could become a model for other Asia-Pacific countries.

Common plant used to treat stings

The information was not all one way. The team found Thai fishermen had successfully used a ‘potion’ made from a local plant, Ipomoea pes-caprae, to prevent and treat jellyfish stings. The plant is found in abundance along tropical seashores in both hemispheres.

As reported in the January edition of the Travelvax Report, 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 Irukandji stings
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 countries:

Before you take the plunge:

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