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Published May 29th, 13:11
Dealing with jelly fish stings
Portuguese Man O' War

Advice on jelly fish stings has been issued by the Public Health Regulation Division.

In a statement it said symptoms following a bite from a jellyfish included an intense, stinging pain, itching, rash and raised welts. Other effects were rare.

When stung by a jelly fish, oneshould:

* Soak or rinse the area in sea water. Fresh water should not be used as this would lead more toxins to be released;

* Remove tentacles with a stick, card or a pair of tweezers, being careful not to touch them with other areas of the skin to avoid secondary stinging;

* Apply alcohol to the area;

* Not rub the area;

* Not apply ice or hot water;

* Seek immediate medical treatment in case of difficulty in breathing or swallowing, chest pain or intense pain at the site of the sting.

One should avoid exposure to jelly fish by:

* Not going to known jellyfish-infested areas or where large numbers of jellyfish were reported;

* Not picking up dead jellyfish. These could still have live nematocysts that could release toxins (even if dried up);

* Wearing protective clothing when swimming in jellyfish-infested areas.

The division referred to unconfirmed reports of sighting of Portuguese Man O' War in the Mediterranean Sea.

This, it said, was not a jelly fish but a colony of marine invertebrates, the stings of which usually caused severe pain leaving whip-like, red welts on the skin.

Occasionally, a sting was accompanied by fever, shock, and interference with heart and lung action. Rarely, svere stings were associated with death.

The division said one should seek medical advice if:

*the pain persisted or was intense;

* there was an extreme reaction, or the rash worsened;

*a feeling of overall illness developed;

* ared streak developed between swollen lymph nodes and the sting;

* the affected area became red, warm and tender, or

* breathing became difficult.

The best treatment was similar to that of a jelly fish. In such cases hot water followed by the application of an icepack was helpful. Vinegar should not be used, the division said.

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Comments

Ron Adley (on 15/8/09)
Hey Joseph M.....the NY Times is absolutely on the nose...without any question, the gold standard for relief from jellyfish stings is vinegar...new product out with 5% acetic acid (vinegar on steroids) that is proven effective...EMT/Ocean rescue units...lab tested...safe...Lidocaine free....the stuff works...check it out www.stingmate.comti
Joseph Mizzi (on 13/8/09)
Alcohol or vinegar? I think vinegar is the better option. An article in the New York Times states that 'according to several studies [vinegar] can deactivate the venomous nematocysts that jellyfish release. A study published in The Medical Journal of Australia showed that removing any tentacles left by a jellyfish, then dousing an injured body part with commercial vinegar or its crucial ingredient, acetic acid, could alleviate pain and “rapidly and completely” prevent the release of more venom.'

Moreover, the same articles states that rubbing alcohol is a well known method that does not work.

http://www.nytimes.com/2007/08/14/health/14real.html?_r=1

Dr Francis Saliba (on 26/7/09)
Anyone with alkaline freshly passed urine would be better employed seeing his doctor rather than splashing it on jellyfish stings
G. Fenech (on 4/6/09)
@ Karl farrugia

Australia deals with huge amounts of sharks / jellyfish / crocodiles / spiders / snakes and plenty of other deadly creatures. They know what they're doing. Although vinegar is known NOT to work on all jellyfish stings, it does cover the majority of them.

Malta, however, deals with mosquitos and the occasional jellyfish in summer. I would take advice from a country that has more experience.
Karl Farrugia (on 31/5/09)
Mr. Pulis
Studies have shown that VINEGAR does not aid in any way, as acidic substances do nothing to kill the toxins. There is also no evidence that urine, an age old remedy to jellyfish stings, can help with its alkaline pH. I believe the Australian authorities should update their research material, since it seems to be dated back to 1928.

Karl Farrugia,
Malta
Paul Pulis (on 31/5/09)
I think the Public Health Regulation Division. should check with World research on Jelly fish stings, in Sundays article it says not to USE VINEGAR.?
Well here in Australia VINEGAR is supplied on every beach in Far North Queensland,,

I suggest that they do some research on Jelly Fish..

Paul Pulis
Australia
E.Compagno (on 30/5/09)
Today, during 4 hours of the afternoon, about 60 jellyfish had been fished out of a small stretch of about 60 feet of beach in Birzebbuga. Why isn't this infestation being taken seriously by authorities? Maybe the people in charge need to remember that not all of us have a bungalow or villa with pool.
J. Fenech (on 30/5/09)
just look it up!!!

http://firstaid.about.com/od/bitesstings/ht/06_jellyfish.htm
http://chemistry.about.com/b/2008/06/08/treating-jellyfish-stings-and-man-o-war-stings.htm

The article is correct. If you apply ice or hot water you're basically applying fresh water thereby releasing more toxins. So don't do it. An icepack on the otherhand does not allow water to come in contact with the skin meaning it can be used safely.

The authorities should make an effort to confirm if the sightings reported are authentic or just someone's sick idea of a joke. We really can do without the alarmism.

http://www.guardian.co.uk/world/2009/apr/29/portuguese-man-of-war-mediterranean ... probably this is the source of it all
Ron Adley (on 30/5/09)
Based on a triple blind, random, medically observed study verified on 96 randomly selected patients stung by the Man of War..Australian Medical Journal

Results: 49 patients received hot water immersion and 47 received ice packs with similar baseline features, except patients treated with hot water had more severe initial pain. After 10 minutes, 53% of the hot water group reported less pain versus 32% treated with ice. After 20 minutes, 87% of the hot water group reported less pain versus 33% treated with ice. The trial was stopped after the halfway interim analysis because hot water immersion was shown to be effective. Hot water was more effective at 20 minutes in nematocyst-confirmed stings. Systemic effects were uncommon in both groups. Conclusions: Immersion in water at 45° C for 20 minutes is an effective and practical treatment for pain from bluebottle stings. Medical journal of Australia

Rinse with salt water, apply a product named Stingmate®..scrape the wound clear of tentacles..apply heat (113 degress water immersion or heat pack) the results are very effective.

Hopefully this clears up the ice/heat/vinegar confusion...protocol w/StingMate is being regularly used by beach rescue units along the East Coast and the Gulf States, U.S. Good luck..
Alexander Azzopardi (on 30/5/09)
D.fava
from what i can understand tru: http://en.wikipedia.org/wiki/Portuguese_Man_o%27_War
the best is alcahol or sea water

the so called jellyfish in the picture isnt a jellyfish but a Marine siphonophore so the application should be diferent!!

I have noticed yesterday that there are two typesof new "jellyfish" I was @ lapsi & in wied iz zurieq and there another kind of jelly fish which shares the same colours but more intense and it doesn't have the bag shape floating out of the water like the potuguese man o war . Its Familiar to the normal jelly fish we know

D. Fava (on 30/5/09)
I'm confused too!!! Can someone make it clear if ice/hot water should be used or not?
In the article there seems to be a contradiction about this!!!! Booooqqqqqq...
m. cuschieri (on 30/5/09)
i saw one of those man o war before i actually knew tht they were in malta. i was walking along the sliema front near the boats and spot a baby brown jellyfish. right next to it was a small blue one. i was like cool never seen a blue one then went home and googled it and saw it was a man o war. freaky that the sea i love and felt safe to swim in is now so dangerous.
Mario Buttigieg (on 29/5/09)
Use hot/cold water or not? I have read elsewhere that vinegar should be used. And what are the chances of getting Red Sea jelly fish over here?
Eric Gahn (on 29/5/09)
@ Miguel Micallef: It all depends if it is a North Sea jellyfish or a Red Sea one.
v.pulis (on 29/5/09)
In previous reports it was advised to apply sea water and ICE. What should one really do?!
Miguel Micallef (on 29/5/09)
"When stung by a jelly fish, oneshould:

* Not apply ice or hot water;"

Later:

"The best treatment was similar to that of a jelly fish. In such cases hot water followed by the application of an icepack was helpful."

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