20081216

Tentacle Terror

Close call for 3 year old girl stung by deadly box jellyfish

Published: Monday, 15-Dec-2008
News-Medical.net

A three year old girl is lucky to be alive after she was stung by a deadly box jellyfish at a remote beach in Milingimbi in the Northern Territory, Australia.

The youngster was reportedly playing in the shallows when she stepped on the adult jellyfish, which injected her with venom.

She collapsed and her family rushed her to a nearby local health clinic where doctors and nurses worked desperately to revive her.

The Arnhem Land community of Milingimbi is about 440km east of Darwin and visiting community GP Dr. Paul Spillane says the girl was "lucky to survive" and was saved because there were experienced nursing and medical staff in the health centre at the time who were able to resuscitate her before she was evacuated to Gove District Hospital.

Dr. Paul Spillane says she was very lucky that the health centre was so close to the beach as had it been any further away she may not have lived.

Dr. Spillane says children are worst affected by the creature's venom and he has warned families to avoid swimming in the sea during stinger season which is from October to May.

Dr. Spillane says during the stinger season parents need to realise a day on the beach can quickly turn into a life-or-death situation and the best strategy is prevention and avoiding the water altogether.

Since first reported in 1883, box jellyfish have been responsible for at least 64 deaths in Australia - the last fatality was also a Northern Territory child, a six-year-old boy, who was also playing the shallows near the Milikapiti barge landing at Snake Bay on Melville Island in November last year which was the first stinger fatality in the Territory in more than a decade - the previous death was a three-year-old girl at a remote community in February 1996.

As many as 30 deaths have been recorded from jellyfish stings in the Territory and ten have been children.

The Department of Health and Families says first aid is essential, victims must be got out of the water and the stung area immediately doused with vinegar and if the person is seriously ill, CPR may need to be carried out.

Box Jellyfish (Chironex Fleckeri) are pale blue and transparent and bell or cubed shaped with four distinct sides - they can measure up to 20 cm along each side of the cube or bell and have as many as 15 tentacles on each corner which can be 3 metres in length with up to 5,000 stinging cells.

The box jellyfish swims along at speeds of up 4 knots in a jet-like motion and appears along the shore in calm waters when the tide is rising - they are often found near the mouths of rivers, estuaries and creeks following the rain and feed on small fish and crustaceans.

The box jellyfish season starts with the onset of the wet across the top of northern Australia, usually around October and lasts until April - further south along the northern Queensland or northern Western Australia coast the season is usually from November to March and prevents swimming in the sea unless the beaches have protective stinger nets or a purpose designed stinger suit is worn; fortunately the Great Barrier Reef is free of box jellyfish through all the seasons.

The venomous sting causes such excruciating pain that victims go into shock and can drown before reaching the shore and unless treated immediately, a victim has virtually no chance of surviving.

In treating the sting methylated spirit or alcohol must not be used as only domestic vinegars poured liberally over the tentacles inactivate the stinging cells allowing the tentacles to be removed.

Where antivenom is unavailable, pressure-immobilisation may be used on limbs after the stinging cells have been inactivated and artificial respiration and cardiac massage may be needed until medical assistance is available.

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