Dangerous Australian box jellyfish.

Abstract

Each year in the tropical waters of Australia, just south of the Tropic of Capricorn on the east coast and extending northwards and then westwards to Exmouth in Western Australia, serious envenomation can occur from two major species of box jellyfish. Chironex fleckeri, a multi-tentacled box jellyfish (chirodropid) has caused 68 fatal stings since 1883. Injuries vary from life-threatening stings affecting the conscious state, the breathing or the circulation of the victim, to smaller stings that cause severe local skin pain. Carukia barnesi, commonly known as the ‘Irukandji’, is a single-tentacled box jellyfish (carybdeid) causing stings that produce severe, rarely life-threatening systemic symptoms. The number of stings from this species varies considerably from year to year from a few to several hundred. However, in some years potentially life-threatening stings present, suggesting there may be two main ‘groups’ of Irukandji – the first, Carukia barnesi, causing the classical syndrome with its severe, unpleasant but non-life-threatening systemic symptoms; and the other, a different species or group, causing a severe syndrome responsible for two human fatalities in 2003. This article describes the symptoms caused by each species and the first-aid and medical treatment of the stings.