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Abstract
Stinging jellyfish outbreaks represent a health hazard, causing contact dermatitis and systemic reactions. This study investigated the epidemiology, severity, and treatment protocols of jellyfish stings in a coastal area with high tourist development and frequent stinging jellyfish outbreaks of the central Mediterranean (Salento, Southern Italy), and the associated costs for the Italian National Health Service. In 2007–2011, 1,733 bathers (mostly children and females) sought medical assistance following jellyfish stings, the main cause of human pathologies due to contact with marine organisms. The majority of events were reported in the years 2007–2009, whereas the occurrence of cnidarian jellyfish outbreaks has been increasingly reported in the same area since summer 2010. Most symptoms were limited to local and cutaneous reactions; conversely, 8.7% of cases evoked complications, mainly due to allergic reactions. The main drugs used were corticosteroids, locally applied and systemic (46% and 43%, respectively), and with ammonia (74%) as the main non-pharmacological treatment. The estimated cost of jellyfish-related first-aid services along the Salento coastline over the 5-year period was approximately 400,000 Euros. Therefore the management of jellyfish outbreak phenomena need coordinated research efforts towards a better understanding of underlying ecological mechanisms, together with the adoption of effective prevention policy, mitigation strategies, and appropriate planning of health services at tourist hot spots.
Highlights
Interest in jellyfish grew considerably in recent years as a result of “anomalous” proliferations seen with increasing frequency in all seas and the new appearance of invasive species in temperate seas [1], linked to multiple causes such as climate change, overfishing and pollution [2,3,4]
The aim of the present study was to investigate the epidemiology, severity and treatment of jellyfish stings over summer seasons across five years (2007–2011) in the Salento area (Southern Italy), their socio-economic impacts and policy implications for the Italian Health Service, with a preliminary comparison with the available information on jellyfish abundances gathered from an ongoing citizen science jellyfish monitoring campaign
For each patient an anonymous report was compiled with information regarding the date and time of the assistance provided, the place where the patient was stung by jellyfish, demographic data and clinical information
Summary
Interest in jellyfish grew considerably in recent years as a result of “anomalous” proliferations seen with increasing frequency in all seas and the new appearance of invasive species in temperate seas [1], linked to multiple causes such as climate change, overfishing and pollution [2,3,4]. Cnidarian jellyfish are characterised by the possession of highly specialized mechano-receptor cell types in the animal kingdom: cnidocytes or stinging cells. These are used for prey capture and defense from predators by injection of venoms, represented by variety of proteinaceous and non-proteinaceous compounds, which may have cytotoxic, cytolytic and enzymatic properties [10,12,13,14]. Human envenomations by cnidarian toxins may produce immediate toxicity (from minutes to few hours), in combination with immediate or delayed allergic responses, determining local symptoms (dermatitis, oedema and swelling, itching, stiffness, necrosis, pain) or more severe systemic effects, including neurotoxic, cardiovascular, motory and respiratory problems, as well as anaphylaxis or anaphylactoid syndromes [10,15]
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