Abstract
BackgroundDespite recent deaths caused by box jellyfish envenomation occurring on the islands of Samui and Pha-ngan in the Gulf of Thailand, many people do not believe box jellyfish can kill humans and many people dismiss the problem as insignificant. More evidence has been requested from the communities in order to evaluate the need for and the implementation of sustainable prevention measures. We aimed to determine the magnitude of cases of severe stinging by box jellyfish and describe the characteristics of these cases on the islands of Samui and Pha-ngan in Surat Thani Province from 1997 to 2015.MethodsVarious strategies were integrated prospectively. Toxic jellyfish networks and surveillance system were established. Outbreak investigations were conducted retrospectively and prospectively from 2008 to 2015.ResultsThere were 15 box jellyfish cases. A small majority of them were women (60.0) with a median age of 26.0 years (range 5.0–45.0 years). The highest incidence by month were August (33.3 %), September and October (20.0 %), and July (13.3 %). Eight cases occurred on Samui (53.3 %), 6 cases on Pha-ngan island (40.0 %), and one case on the boat. All cases developed symptoms and signs immediately after being stung. More than half of the cases were unconscious. There were six fatal cases (46.7 %). The wound characteristics had an appearance similar to caterpillar tracks or step ladder-like burn marks. Almost all cases involved Chirodropidae. One fatal case received fresh water and ice packs applied to the wounds (16.7 %). Among the cases with known first aid, only one out of six fatal cases had vinegar applied to the wounds (16.7 %), while haft of six surviving cases received the vinegar treatment.ConclusionsThe islands of Samui and Pha-ngan have the highest incidence of fatal and near fatal box jellyfish cases in Thailand. There is an urgent need for informed pre-clinical emergent care. Optimal pre-clinical care is an area of active research.
Highlights
Despite recent deaths caused by box jellyfish envenomation occurring on the islands of Samui and Pha-ngan in the Gulf of Thailand, many people do not believe box jellyfish can kill humans and many people dismiss the problem as insignificant
The injured person who received a high dose of toxin can die within a few minutes [2, 4, 5, 7,8,9,10], Local physicians, nurses and other health personnel still lack the necessary knowledge regarding box jellyfish, despite there being reports of envenomation incidents in Thailand
Diagnosis of Irukandji syndrome and other box jellyfish envenomation sequelae has been rare in Thailand [1]
Summary
Despite recent deaths caused by box jellyfish envenomation occurring on the islands of Samui and Pha-ngan in the Gulf of Thailand, many people do not believe box jellyfish can kill humans and many people dismiss the problem as insignificant. We aimed to determine the magnitude of cases of severe stinging by box jellyfish and describe the characteristics of these cases on the islands of Samui and Pha-ngan in Surat Thani Province from 1997 to 2015. The injured person who received a high dose of toxin can die within a few minutes [2, 4, 5, 7,8,9,10], Local physicians, nurses and other health personnel still lack the necessary knowledge regarding box jellyfish, despite there being reports of envenomation incidents in Thailand. According to Thaikruea et al [11] a study of the morbidity and mortality rates of toxic jellyfish stings
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