German tourist dies from box jellyfish attack on Samui

[limbos]

This seem to me to be ultimate solution to jellyfish protection! Has anybody tried this?:

http://www.medicaldaily.com/safe-sea-jellyfish-sting-preventer-sunblock-combo-promises-protection-both-stings-and-uv-305002

“It didn’t completely inhibit the stings, but it came pretty darn close,” - Sound good enough for me

This will absolutely not help with box jelly fish stings. P{lease feel free to test this on yourself but don't promote it to other people.

Vinegar is the only advised primary care item to use with box jelly fish stings. As already mentioned plenty of times in this thread, the vinegar doesn't relief the pain but it stops the stingers from firing off more venom into the wounds.

NOTHING ELSE works.

This is not what I read:

Does Safe-Sea® protect swimmers against all types of jellyfish and sea lice?

Yes, Safe-Sea® eliminates stinging cells discharge and prevents skin penetration by the cnidaria sting mechanism. There are 15,000 specimens of jellyfish, coral hydroids and anemones and their toxins content is highly variable, but they share 30 types of stinging cells with same mode of action. Safe-Sea® inactivates the stinging mechanism and is therefore designed to work for all types. Trials have shown it to be effective against toxic jellyfish from different types.

Was Safe-Sea® tested against many types of jellyfish?

Safe-Sea® is the only product which has been tested and proven to be effective against jellyfish stings. This includes clinical tests under double blind conditions in several medical centers against several types of jellyfish. These clinical tests were conducted on Sea Nettle in Stanford Hospital University, Box Jellyfish in Bert Fish Medical Center in Florida, and Rhopilema (toxic Mediterranean jellyfish) in Rambam Hospital, Israel. All tests demonstrated that that Safe-Sea® provides effective protection against jellyfish stings. Other tests conducted by an independent Japanese team indicated that Safe-Sea® provides protection against Blue Bottle, Sea Wasp and Box Jellyfish (clinical test reports can be provided on request). These tests indicate that Safe-Sea® is effective against even the most dangerous jellyfish.

What I have understood from what I read about this is that it greatly reduces the severity of jelly stings in general but it is not specifically teated against the Thai Box jelly variant.

But how do you know that "This will absolutely not help with box jelly fish stings"?? Have you tested that or heard about others that has??

And I don't "promote" it. I just wonder if peoply have tried it because it would be a very good solution if it worked. Wearing a stinger suit or staying out of the water is not imho

Let's say they work 70-80% on box jelly fish, the remaining %-tage can be deadly.

I have no idea why you claim stinger suits don't work, when all specialist in the field highly recommend them. When your skin is covered, even as by as little as 0.5mm, the stingers can't touch you.

I also don't quite get your statement that staying out of the water is not a solution, imho, that is about the best solution in the world to prevent you from ever getting stung by a box jelly fish.

How come all specialists in the field of box jelly fish recommend stinger suits and not a single one has ever stood up or advised to use this cream or lotion?

The manufactures have never proven that their product gives 100% protection. I know what I will use and prefer, given these simple facts.

Just the fact that you seemingly are willing to go unprotected in waters known to be inhabited by box jelly fish, relying on a lotion that no known box jelly fish specialist or researcher has ever stood up for and solely can rely on it's own claims, well, that is a choice I leave up to you but which I will politely decline and use the other two options that you decline or seem not appropriate; using a stinger suit or stay put of the water. The life's of my dear ones and my own are precious and I'm not going to leave those into the hands of some unproven products.

The problem is that this lotion doesn't work.

[Basil B]

I learned my lesson in Indonesia when I got sting by a dozen "Sea Wasps" all over my back..........I carry a bottle of Vinigar when I go to the beach.......have had to use it several times - on other people.

Growing up with Portugueze Man of War stings, always peed in my hands and rubbed it on the stings - it worked. I have read some people saying "don't pee on it!!" Life guards where I grew up has ammonia on hand for jellyfish stings, so whatever works - use it.

Box jelly stings are not the same as other jellyfish........The Box Jelly isn't even a regular jellyfish the vinegar is NOT to ease pain it is to paralyse the venom injections......rubbing ANYTHING even vinegar is considered highly dangerous.

you POUR the vinegar onto the tentacles still attached before pulling them off - I hope to

god that is what the poster did or he/she would have made the situation a whole lot worse.

I doubt anyone stung by a jellyfish would have even seen it, (nor anyone going to their aid), let alone be able ID as a Box Jellyfish or not.

Therefore treatment should be for the worst case scenario, even though there is some questioning of the use of vinegar it is still recommended as the best treatment.

I feel everyone should carry their own vinegar, I would like to see special small sachet's like the ones that we get in self service restaurants with malt vinegar but with a white vinegar that can be sold cheaply in 7/11's etc or handed out by hotels for guests going to the beach.

The other thing I would like to see is AED's (automated external defibrillators) and Ambu bags carried on ambulances, maybe make it a legal requirement for hotels with pools to have such equipment at the hotel reception, reason being I believe jellyfish stings can work in two ways, first is localised causing tissue damage and pain, but the other is as a toxin causing paralysis in particular the heart but I also believe this to be short lived as I have never heard of anyone suffering a long term heart condition due to a jellyfish sting, so being able to sustain CPR until someone gets to hospital is important.

Also I would like to see compulsory first aid training in schools ... in ever country worldwide, just half a day ever year, not a lot to ask.

Ambu Bag

Edited October 17, 2015 by Basil B

[balo]

I think its worst at night , am I right ? The jelly fish is closer to the beach at night . So really they should put out some warning signs . Innocent tourists do not read any news about this before it's too late.

[oncearugge]

Information about the Box Jellyfish and the advice given/precautions taken by Australians is in the link

http://cairnsdiveadventures.com.au/reef-info/cairns-jellyfish/

[limbos]

I learned my lesson in Indonesia when I got sting by a dozen "Sea Wasps" all over my back..........I carry a bottle of Vinigar when I go to the beach.......have had to use it several times - on other people.

Growing up with Portugueze Man of War stings, always peed in my hands and rubbed it on the stings - it worked. I have read some people saying "don't pee on it!!" Life guards where I grew up has ammonia on hand for jellyfish stings, so whatever works - use it.

Box jelly stings are not the same as other jellyfish........The Box Jelly isn't even a regular jellyfish the vinegar is NOT to ease pain it is to paralyse the venom injections......rubbing ANYTHING even vinegar is considered highly dangerous.

you POUR the vinegar onto the tentacles still attached before pulling them off - I hope to

god that is what the poster did or he/she would have made the situation a whole lot worse.

I doubt anyone stung by a jellyfish would have even seen it, (nor anyone going to their aid), let alone be able ID as a Box Jellyfish or not.

Therefore treatment should be for the worst case scenario, even though there is some questioning of the use of vinegar it is still recommended as the best treatment.

I feel everyone should carry their own vinegar, I would like to see special small sachet's like the ones that we get in self service restaurants with malt vinegar but with a white vinegar that can be sold cheaply in 7/11's etc or handed out by hotels for guests going to the beach.

The other thing I would like to see is AED's (automated external defibrillators) and Ambu bags carried on ambulances, maybe make it a legal requirement for hotels with pools to have such equipment at the hotel reception, reason being I believe jellyfish stings can work in two ways, first is localised causing tissue damage and pain, but the other is as a toxin causing paralysis in particular the heart but I also believe this to be short lived as I have never heard of anyone suffering a long term heart condition due to a jellyfish sting, so being able to sustain CPR until someone gets to hospital is important.

Also I would like to see compulsory first aid training in schools ... in ever country worldwide, just half a day ever year, not a lot to ask.

300px-Ballon_ventilation_1.jpg

Ambu Bag

Hi Basil,

Wounds from a box jelly fish are very distinct and very easily recognizable.

There is no questioning at all about vinegar being the best treatment, please take the time and go back in this thread, in two posts I gave information on why vinegar is still the best treatment.

AED's have long been illegal to be used in Thailand by laymen. This is slowly changing, Samui airport departures has now an AED machine. This is very recent, this change in attitude/allowing AED's, just a few months old and needs to work its way down the 'food chain' so to speak. Very limited amount of hotels on Samui do actually have an AED at the premises. If they would be used, you might get sued if you use them on a Thai person and they die. Hoepfully that attitude change will continue, for the better.

The first 20 minutes seem to be the important ones when stung by a box jelly, heart failure may happen within minutes and PR is needed. If you survive the first 15-20 minutes, it's indeed very likely that you will survive the incident.

From post # 57:

In case you're referring to research done recently in Australia, here's the answer to that from Dr. Lisa Gershwin, box jelly fish researcher;

"There were several things questionable about the research, in no particular order:

The authors forced nematocyst discharge with an electrical current. The nematocysts fired into a membrane, then venom was collected under the membrane, then vinegar was applied to the tentacles, then they collected venom again from under the membrane. They found that 60% more venom was obtained in the second round. They therefore concluded that the vinegar was causing vinegar to come out of the already discharged nematocysts.

First, There is no evidence that demonstrates that electrocuted tentacles behave like natural stings. In particular, it seems more likely that natural stings leave little venom behind, whereas electrocuted tentacles are likely to cause abortive firing, or incomplete firing, thus quite possibly leaving some venom behind. If this is the case, then the model does not represent real stings.

Second, their experimental design did not control for venom initially discharged into the membrane or pooled above the membrane, only what came through with each wash. Therefore it may be that some venom was lodged in or above the membrane from the initial electrocution, and was subsequently recovered by the second wash, giving misleading conclusions.

Third, the post-vinegar recovery was of very low venom potency, suggesting that it was diluted, supporting the idea that the venom came from in or above the membrane, not from secondary discharge. In this case, vinegar would be a better solvent than originally realised, and therefore an even better first aid option.

Fourth, and perhaps most importantly, the percentages tell the whole story. The authors estimated that 20-30% of nematocysts fire initially (I estimate 10-20%, but the difference doesn't matter for this argument). So 60% of 20-30% is about 10-15% additional venom load. But even if their hypothesis turns out to be entirely correct, that still leaves the other 70-80% of nematocysts armed and dangerous. It's that 70-80% that you want to disable, not the 10-15%. So if vinegar causes 10-15% more but it also causes 70-80% less, then by using vinegar you're still some 60-70% better off to use vinegar. Sorry my math is probably not so good this time of night (2am), but you get the idea hopefully.

Finally, much of the media quoted one of the authors of the study as saying that they found that vinegar makes stings worse. That's not true -- that's not what they found. They didn't test stings. They tested electrocuted tentacles in a lab. But their incomplete procedures even make what they did find debatable. "

Vinegar is at this moment the best solution for box jelly stings

Edited October 18, 2015 by limbos

[limbos]

I think its worst at night , am I right ? The jelly fish is closer to the beach at night . So really they should put out some warning signs . Innocent tourists do not read any news about this before it's too late.

No balo, you're not right, Many box jelly fish stings and sightings are during the day time, assuming that it's worse during the night time may give you unfortunately a false sense of security.

[oncearugge]

I learned my lesson in Indonesia when I got sting by a dozen "Sea Wasps" all over my back..........I carry a bottle of Vinigar when I go to the beach.......have had to use it several times - on other people.

Growing up with Portugueze Man of War stings, always peed in my hands and rubbed it on the stings - it worked. I have read some people saying "don't pee on it!!" Life guards where I grew up has ammonia on hand for jellyfish stings, so whatever works - use it.

Box jelly stings are not the same as other jellyfish........The Box Jelly isn't even a regular jellyfish the vinegar is NOT to ease pain it is to paralyse the venom injections......rubbing ANYTHING even vinegar is considered highly dangerous.

you POUR the vinegar onto the tentacles still attached before pulling them off - I hope to

god that is what the poster did or he/she would have made the situation a whole lot worse.

I doubt anyone stung by a jellyfish would have even seen it, (nor anyone going to their aid), let alone be able ID as a Box Jellyfish or not.

Therefore treatment should be for the worst case scenario, even though there is some questioning of the use of vinegar it is still recommended as the best treatment.

I feel everyone should carry their own vinegar, I would like to see special small sachet's like the ones that we get in self service restaurants with malt vinegar but with a white vinegar that can be sold cheaply in 7/11's etc or handed out by hotels for guests going to the beach.

The other thing I would like to see is AED's (automated external defibrillators) and Ambu bags carried on ambulances, maybe make it a legal requirement for hotels with pools to have such equipment at the hotel reception, reason being I believe jellyfish stings can work in two ways, first is localised causing tissue damage and pain, but the other is as a toxin causing paralysis in particular the heart but I also believe this to be short lived as I have never heard of anyone suffering a long term heart condition due to a jellyfish sting, so being able to sustain CPR until someone gets to hospital is important.

Also I would like to see compulsory first aid training in schools ... in ever country worldwide, just half a day ever year, not a lot to ask.

300px-Ballon_ventilation_1.jpg

Ambu Bag

Hi Basil,

Wounds from a box jelly fish are very distinct and very easily recognizable.

There is no questioning at all about vinegar being the best treatment, please take the time and go back in this thread, in two posts I gave information on why vinegar is still the best treatment.

AED's have long been illegal to be used in Thailand by laymen. This is slowly changing, Samui airport departures has now an AED machine. This is very recent, this change in attitude/allowing AED's, just a few months old and needs to work its way down the 'food chain' so to speak. Very limited amount of hotels on Samui do actually have an AED at the premises. If they would be used, you might get sued if you use them on a Thai person and they die. Hoepfully that attitude change will continue, for the better.

The first 20 minutes seem to be the important ones when stung by a box jelly, heart failure may happen within minutes and PR is needed. If you survive the first 15-20 minutes, it's indeed very likely that you will survive the incident.

From post # 57:

In case you're referring to research done recently in Australia, here's the answer to that from Dr. Lisa Gershwin, box jelly fish researcher;

"There were several things questionable about the research, in no particular order:

The authors forced nematocyst discharge with an electrical current. The nematocysts fired into a membrane, then venom was collected under the membrane, then vinegar was applied to the tentacles, then they collected venom again from under the membrane. They found that 60% more venom was obtained in the second round. They therefore concluded that the vinegar was causing vinegar to come out of the already discharged nematocysts.

First, There is no evidence that demonstrates that electrocuted tentacles behave like natural stings. In particular, it seems more likely that natural stings leave little venom behind, whereas electrocuted tentacles are likely to cause abortive firing, or incomplete firing, thus quite possibly leaving some venom behind. If this is the case, then the model does not represent real stings.

Second, their experimental design did not control for venom initially discharged into the membrane or pooled above the membrane, only what came through with each wash. Therefore it may be that some venom was lodged in or above the membrane from the initial electrocution, and was subsequently recovered by the second wash, giving misleading conclusions.

Third, the post-vinegar recovery was of very low venom potency, suggesting that it was diluted, supporting the idea that the venom came from in or above the membrane, not from secondary discharge. In this case, vinegar would be a better solvent than originally realised, and therefore an even better first aid option.

Fourth, and perhaps most importantly, the percentages tell the whole story. The authors estimated that 20-30% of nematocysts fire initially (I estimate 10-20%, but the difference doesn't matter for this argument). So 60% of 20-30% is about 10-15% additional venom load. But even if their hypothesis turns out to be entirely correct, that still leaves the other 70-80% of nematocysts armed and dangerous. It's that 70-80% that you want to disable, not the 10-15%. So if vinegar causes 10-15% more but it also causes 70-80% less, then by using vinegar you're still some 60-70% better off to use vinegar. Sorry my math is probably not so good this time of night (2am), but you get the idea hopefully.

Finally, much of the media quoted one of the authors of the study as saying that they found that vinegar makes stings worse. That's not true -- that's not what they found. They didn't test stings. They tested electrocuted tentacles in a lab. But their incomplete procedures even make what they did find debatable. "

Vinegar is at this moment the best solution for box jelly stings

In severe box jelly fish stings it is rapid Envenomation which is the cause of sudden death. The use of CPR/AED are extremely unlikely to alter the outcome for a severely stung individual on the beach

All victims of box jellyfish stings should receive treatment with Vinegar before being transported rapidly to hospital

There is a box jellyfish anti-venom but do no know if it is available in Thailand or how effective the product is.

http://www.csl.com.au/docs/223/621/Box%20Jellyfish%20PI%20-%20approved%20Dec2009.pdf

[limbos]

This seem to me to be ultimate solution to jellyfish protection! Has anybody tried this?:

http://www.medicaldaily.com/safe-sea-jellyfish-sting-preventer-sunblock-combo-promises-protection-both-stings-and-uv-305002

“It didn’t completely inhibit the stings, but it came pretty darn close,” - Sound good enough for me

This will absolutely not help with box jelly fish stings. P{lease feel free to test this on yourself but don't promote it to other people.

Vinegar is the only advised primary care item to use with box jelly fish stings. As already mentioned plenty of times in this thread, the vinegar doesn't relief the pain but it stops the stingers from firing off more venom into the wounds.

NOTHING ELSE works.

This is not what I read:

Does Safe-Sea® protect swimmers against all types of jellyfish and sea lice?

Yes, Safe-Sea® eliminates stinging cells discharge and prevents skin penetration by the cnidaria sting mechanism. There are 15,000 specimens of jellyfish, coral hydroids and anemones and their toxins content is highly variable, but they share 30 types of stinging cells with same mode of action. Safe-Sea® inactivates the stinging mechanism and is therefore designed to work for all types. Trials have shown it to be effective against toxic jellyfish from different types.

Was Safe-Sea® tested against many types of jellyfish?

Safe-Sea® is the only product which has been tested and proven to be effective against jellyfish stings. This includes clinical tests under double blind conditions in several medical centers against several types of jellyfish. These clinical tests were conducted on Sea Nettle in Stanford Hospital University, Box Jellyfish in Bert Fish Medical Center in Florida, and Rhopilema (toxic Mediterranean jellyfish) in Rambam Hospital, Israel. All tests demonstrated that that Safe-Sea® provides effective protection against jellyfish stings. Other tests conducted by an independent Japanese team indicated that Safe-Sea® provides protection against Blue Bottle, Sea Wasp and Box Jellyfish (clinical test reports can be provided on request). These tests indicate that Safe-Sea® is effective against even the most dangerous jellyfish.

What I have understood from what I read about this is that it greatly reduces the severity of jelly stings in general but it is not specifically teated against the Thai Box jelly variant.

But how do you know that "This will absolutely not help with box jelly fish stings"?? Have you tested that or heard about others that has??

And I don't "promote" it. I just wonder if peoply have tried it because it would be a very good solution if it worked. Wearing a stinger suit or staying out of the water is not imho

Ok, maybe you want to read this article;

"There is NO - ABSOLUTELY NO evidence to show that Safe Sea jellyfish sting protection lotion works against the type of box jellyfish that has killed people in Thailand, South-East Asia, Australia or anywhere. NO PROOF - NONE!

Don't waste your money and risk your life if you think Safe Sea or similar lotions and potions will save you and your children from a lethal box jellyfish sting because they may not. Nidaria the Israeli company that develops/manufactures this product has NEVER tested it on lethal box jellyfish. In fact, one study (2005) published on their website [1] said they should - but over 10 years later they have not.

The species of box jellyfish tested in the study arranged by Nidaria is non-lethal and lives in the Americas. It is not the same as the Thai species. Yes they are 'box jellyfish' but there are many different types - while domestic cats and lions are feline, one will rip your head off. The study also says that Safe Sea lotion only provided 70% protection against this species. What about the other 30%? If the stinger was a killer would you be only 30% dead?

This product that apparently mimics the clownfish's slimy defence against the anemone's stinging cells was developed and is manufactured by the founder and director of Nidaria, Amit Lotan. The 'evidence' provided by Nidaria on their website (Safe Sea Scientific Articles) is 4 papers - one previously referred to here and 3 others all authored by Amit Lotan. This is like Ronald McDonald evaluating the nutritional value of a Happy Meal.

In 2009 when Safe Sea attempted to profit with dangerous false advertising in Thailand, Dr Lisa Gershwin, an eminent international box jellyfish expert, had this to say:

“Physalia utriculus is neutralised by vinegar, whereas the multi-tentacled Physalia here in Australia is activated by it. A clown fish covered with the slime of one anemone will be ready prey for another anemone. Safe Sea does not work as well for Chiropsalmus quadrumanus as it does for Chrysaora quinquecirrha.

There are subtle biochemical differences in species perception and species behaviours that we do not fully understand. Sometimes they are between classes, sometimes they are between sister species. It is possible that the product works better for Chironex and/or Irukandji than it works for the species tested; it is also possible that it does not work at all for one or both; it is also possible that it works somewhere in between. The only way we will know is by credible independent testing. Until then, scientific honesty and duty of care dictate that we assume it could be bad, and we thus avoid the ramifications of a Type II error.”

So what are the facts? The fact is that Safe Sea is NOT sold in Australia - for obvious reasons. The fact is that Nidaria that sells Safe Sea has not tested it fully. The fact is that Safe Sea can NOT be trusted as prevention against potentially lethal jellyfish in the Indo-Pacific region including Thailand. The fact is that the best ways not to get stung by a box jellyfish in Thailand is to swim in the pool or wear a lycra suit in the sea."

For pictures and more links, please visit the original link as listed above.

[Basil B]

In severe box jelly fish stings it is rapid Envenomation which is the cause of sudden death. The use of CPR/AED are extremely unlikely to alter the outcome for a severely stung individual on the beach

All victims of box jellyfish stings should receive treatment with Vinegar before being transported rapidly to hospital

There is a box jellyfish anti-venom but do no know if it is available in Thailand or how effective the product is.

http://www.csl.com.au/docs/223/621/Box%20Jellyfish%20PI%20-%20approved%20Dec2009.pdf

"The use of CPR/AED are extremely unlikely to alter the outcome for a severely stung individual on the beach" Please substantiate...

I read the following http://www.theaustralian.com.au/news/human-hearts-can-withstand-box-jellyfish-sting/story-e6frg6n6-1226522156754 and find you post not only to be inaccurate but to the point of advising people not to attempt CPR when in actual fact it could possibly save someone's life...

CPR can be done by most able people, problem being most people do not know how to do it, as I said before I believe the life of the toxins to be short lived so CPR and the use of AED's can save lives by maintaining circulation of oxygenated blood until such time as getting professional medical care.

[Loeilad]

@Loeilad Strange as it may seem these animals were around long before tourists came on the scene. If you go into there territory which we all do dont think they, the animal life, will make concessions they wont.

Your attitude is that these animals have no right to be there but they do. Dont like it stay out of the water.

WhatI think you better read some of my posts as I have said no such thing EVER!

"If you don't like it stay out of the water" is possibly the most facile comment I've read so far.

You don't like it I don't really care. You have to understand it is their home and it isn't yours. You play by their rules not the other way around. Incidentally the tourist industry is not the be all and end all despite what you think. Take precautions of course and things such as nets may well be useful but at the end of the day you are still a guest in the water.

..an utterly facetious post. If you don't know what you are talking about, why not read up a bit before making such silly comments?

[Loeilad]

Because of research and various warnings from well known Australian researchers regarding this and other products that claim things that are not true in respect to box jelly fish.

As I said before, by all means try it on your self in the very unlikely event you ever get stung by box jelly fish, but please refrain from promoting such insane ideas and false promises that can cause death because of the wrong treatment being delivered.

This can be found on the Thailand box jelly fish blog

"New cream??!! This stuff's been around for years - and it still doesn't work! Safesea was introduced to Thailand in 2008 and exploited the wave of concern regarding the 'discovery' of box jellyfish here. It made false claims then and still does. It has not - still - been proven to work against box jellyfish or man o war/bluebottles and for other species it could be 50-70% effective, is this enough? Once again, why make the claims without the proof? Why not just prove it? Go on Nidaria, you too, do some tests on box jellyfish and bluebottles before making such grand claims about protecting innocent, unsuspecting people against ALL jellyfish and giving them a false sense of security when there is no efficacy, no proof, none."

"please refrain from promoting such insane ideas and false promises that can cause death because of the wrong treatment being delivered" -jeeez, are you actually saying that jelli protection in a sun screen can kill...?

If this gives you, let's say 30% less "damage" from a box jelli sting and more on other jellifish why not use a sunscreen with jellifish protection instead of one without when you need sunscreen anyway?? And stop accusing me of promoting this product, I just asked for people's experiences unlike you who just seems to know it all. So please send me some links that this product has absolutly no effect on box jellies as you claim or keep quit if you have no idea

I'm affraid the problem seems to be you who "doesn't know it all" - you are making claims based on unsubstantiated even discredited information. You need to be much more critical in your "searches" on the subject, rather than jumping on the first site that comes along.

\

[Loeilad]

Wounds from a box jelly fish are very distinct and very easily recognizable.

There is no questioning at all about vinegar being the best treatment, please take the time and go back in this thread, in two posts I gave information on why vinegar is still the best treatment.

AED's have long been illegal to be used in Thailand by laymen. This is slowly changing, Samui airport departures has now an AED machine. This is very recent, this change in attitude/allowing AED's, just a few months old and needs to work its way down the 'food chain' so to speak. Very limited amount of hotels on Samui do actually have an AED at the premises. If they would be used, you might get sued if you use them on a Thai person and they die. Hoepfully that attitude change will continue, for the better.

The first 20 minutes seem to be the important ones when stung by a box jelly, heart failure may happen within minutes and PR is needed. If you survive the first 15-20 minutes, it's indeed very likely that you will survive the incident.

From post # 57:

In case you're referring to research done recently in Australia, here's the answer to that from Dr. Lisa Gershwin, box jelly fish researcher;

"There were several things questionable about the research, in no particular order:

The authors forced nematocyst discharge with an electrical current. The nematocysts fired into a membrane, then venom was collected under the membrane, then vinegar was applied to the tentacles, then they collected venom again from under the membrane. They found that 60% more venom was obtained in the second round. They therefore concluded that the vinegar was causing vinegar to come out of the already discharged nematocysts.

First, There is no evidence that demonstrates that electrocuted tentacles behave like natural stings. In particular, it seems more likely that natural stings leave little venom behind, whereas electrocuted tentacles are likely to cause abortive firing, or incomplete firing, thus quite possibly leaving some venom behind. If this is the case, then the model does not represent real stings.

Second, their experimental design did not control for venom initially discharged into the membrane or pooled above the membrane, only what came through with each wash. Therefore it may be that some venom was lodged in or above the membrane from the initial electrocution, and was subsequently recovered by the second wash, giving misleading conclusions.

Third, the post-vinegar recovery was of very low venom potency, suggesting that it was diluted, supporting the idea that the venom came from in or above the membrane, not from secondary discharge. In this case, vinegar would be a better solvent than originally realised, and therefore an even better first aid option.

Fourth, and perhaps most importantly, the percentages tell the whole story. The authors estimated that 20-30% of nematocysts fire initially (I estimate 10-20%, but the difference doesn't matter for this argument). So 60% of 20-30% is about 10-15% additional venom load. But even if their hypothesis turns out to be entirely correct, that still leaves the other 70-80% of nematocysts armed and dangerous. It's that 70-80% that you want to disable, not the 10-15%. So if vinegar causes 10-15% more but it also causes 70-80% less, then by using vinegar you're still some 60-70% better off to use vinegar. Sorry my math is probably not so good this time of night (2am), but you get the idea hopefully.

Finally, much of the media quoted one of the authors of the study as saying that they found that vinegar makes stings worse. That's not true -- that's not what they found. They didn't test stings. They tested electrocuted tentacles in a lab. But their incomplete procedures even make what they did find debatable. "

Vinegar is at this moment the best solution for box jelly stings

In severe box jelly fish stings it is rapid Envenomation which is the cause of sudden death. The use of CPR/AED are extremely unlikely to alter the outcome for a severely stung individual on the beach

All victims of box jellyfish stings should receive treatment with Vinegar before being transported rapidly to hospital

There is a box jellyfish anti-venom but do no know if it is available in Thailand or how effective the product is.

http://www.csl.com.au/docs/223/621/Box%20Jellyfish%20PI%20-%20approved%20Dec2009.pdf

"There is a box jellyfish anti-venom but do no know if it is available in Thailand or how effective the product is."

This claim is again apparently the result of a “search” rather than “research”

Just finding one web site is not enough to suggest a definitive answer..........a little further “searching” reveals this.....

http://www.abc.net.au/news/2009-06-15/jellyfish-antivenom-likely-ineffective/1714124

"There's never been a case where someone could say that antivenom saved a life," says Isbister.

The situation is at present that there is no effective antivenom.....but there is research going on...

[oncearugge]

In severe box jelly fish stings it is rapid Envenomation which is the cause of sudden death. The use of CPR/AED are extremely unlikely to alter the outcome for a severely stung individual on the beach

All victims of box jellyfish stings should receive treatment with Vinegar before being transported rapidly to hospital

There is a box jellyfish anti-venom but do no know if it is available in Thailand or how effective the product is.

http://www.csl.com.au/docs/223/621/Box%20Jellyfish%20PI%20-%20approved%20Dec2009.pdf

"The use of CPR/AED are extremely unlikely to alter the outcome for a severely stung individual on the beach" Please substantiate...

I read the following http://www.theaustralian.com.au/news/human-hearts-can-withstand-box-jellyfish-sting/story-e6frg6n6-1226522156754 and find you post not only to be inaccurate but to the point of advising people not to attempt CPR when in actual fact it could possibly save someone's life...

CPR can be done by most able people, problem being most people do not know how to do it, as I said before I believe the life of the toxins to be short lived so CPR and the use of AED's can save lives by maintaining circulation of oxygenated blood until such time as getting professional medical care.

That is a C.R.P. link to nothing!

Now tell us two things................

.1 The long term (discharge from hospital) survival rates of those who suffer an out of hospital cardiac arrest

2. The number who have survived a 4+ hour period of CPR following box jellyfish Envenomation

Only peer reviewed articles/ case reports published in respected scientific journals please.

For the record I did NOT encourage anyone not to provide aid to someone in need.

[Basil B]

In severe box jelly fish stings it is rapid Envenomation which is the cause of sudden death. The use of CPR/AED are extremely unlikely to alter the outcome for a severely stung individual on the beach

All victims of box jellyfish stings should receive treatment with Vinegar before being transported rapidly to hospital

There is a box jellyfish anti-venom but do no know if it is available in Thailand or how effective the product is.

http://www.csl.com.au/docs/223/621/Box%20Jellyfish%20PI%20-%20approved%20Dec2009.pdf

"The use of CPR/AED are extremely unlikely to alter the outcome for a severely stung individual on the beach" Please substantiate...

I read the following http://www.theaustralian.com.au/news/human-hearts-can-withstand-box-jellyfish-sting/story-e6frg6n6-1226522156754 and find you post not only to be inaccurate but to the point of advising people not to attempt CPR when in actual fact it could possibly save someone's life...

CPR can be done by most able people, problem being most people do not know how to do it, as I said before I believe the life of the toxins to be short lived so CPR and the use of AED's can save lives by maintaining circulation of oxygenated blood until such time as getting professional medical care.

That is a C.R.P. link to nothing!

Now tell us two things................

.1 The long term (discharge from hospital) survival rates of those who suffer an out of hospital cardiac arrest

2. The number who have survived a 4+ hour period of CPR following box jellyfish Envenomation

Only peer reviewed articles/ case reports published in respected scientific journals please.

For the record I did NOT encourage anyone not to provide aid to someone in need.

1.In this instance we are talking about cardiac arrest following box jellyfish attack, so survival rates would differ from that of say an chain smoking octogenarian who had heart failure and been revived and had another attack after discharge.

2. not sure how many people have survived due the use of CPR, but read the article...

"Now that we know there can be full cell recovery it could mean that if CPR is given until a person is put on a heart/lung machine this could potentially save lives.''

What is proposed is CPR is required until the casualty reaches a facility with a heart/lung machine (life support), hopefully that would be a lot less than 4 hours, and they would remain on life support until the heart was able to function on it's own, and hopefully they would make a full recovery, I do not see any cause for a relapse after being discharged.

One thing for sure they will not survive if you do nothing.

The article does quote from James Cook University I think you will find JCU one of the most respected institutions doing work on box jellyfish.

I think this is the article in question. https://research.jcu.edu.au/bmdt/news-and-updates/a-heart-stopping-sting

Edited October 18, 2015 by Basil B

[oncearugge]

Basil B

Very impressive!

A non medically qualified "researcher" with a Bsc in Zoology mouthing off in what amounts to a press release.

If you cannot produce the evidence/information I requested then just say so.

Does every hospital with an Emergency Department also have a "heart lung machine" ?

Best you stick to subjects you know something about.

[Basil B]

Basil B

Very impressive!

A non medically qualified "researcher" with a Bsc in Zoology mouthing off in what amounts to a press release.

If you cannot produce the evidence/information I requested then just say so.

Does every hospital with an Emergency Department also have a "heart lung machine" ?

Best you stick to subjects you know something about.

And your qualifications???

And have you ever resuscitated anybody??? (I have)

Edited October 18, 2015 by Basil B

[oncearugge]

Basil B

Very impressive!

A non medically qualified "researcher" with a Bsc in Zoology mouthing off in what amounts to a press release.

If you cannot produce the evidence/information I requested then just say so.

Does every hospital with an Emergency Department also have a "heart lung machine" ?

Best you stick to subjects you know something about.

And your qualifications???

/

And have you ever resuscitated anybody??? (I have)

1. you have not produced one piece of the information I requested.

2. you have failed to answer the question about heart/lung machines

3 You have the audacity to ask about my qualifications?

I will answer you 3rd point ......................

. I practice EM within a very large (100+trolley spaces + 6 dedicated resus. rooms) Emergency department.

Whilst very well equipped we do not have a heart/lung machine, so if you are the victim of a box jellyfish sting I suggest an urgent consultation with the Zoologist.

[balo]

I think its worst at night , am I right ? The jelly fish is closer to the beach at night . So really they should put out some warning signs . Innocent tourists do not read any news about this before it's too late.

No balo, you're not right, Many box jelly fish stings and sightings are during the day time, assuming that it's worse during the night time may give you unfortunately a false sense of security.

I understand the risks are there at day time too. Still this is the second death in a row that happened at night time.

[Basil B]

1. you have not produced one piece of the information I requested.

2. you have failed to answer the question about heart/lung machines

3 You have the audacity to ask about my qualifications?

I will answer you 3rd point ......................

. I practice EM within a very large (100+trolley spaces + 6 dedicated resus. rooms) Emergency department.

Whilst very well equipped we do not have a heart/lung machine, so if you are the victim of a box jellyfish sting I suggest an urgent consultation with the Zoologist.

1. I feel I have, read post #165

but just to add to point 1. something like only 50% are resuscitated by CPR, of which probably about 20% are discharged from hospitals alive, but as I pointed out this figure is not a true reflection of the the survival rate for people suffering from venomous stings and bites as opposed to the elderly where the heart is well past its sell by date...

2. maybe heart/lung machines may not be available at many A&E facilities, and more to the point the availability of surgeons on hand as I assume it requires major surgery to hook up, (was quoting from the article), my thoughts have always been the continuation of CPR by automated means as I know from experience CPR can be strenuous and exhausting work, I know of automated ventilators I also have searched for automated cardiac compression machines, and they are available, known as auto Pulse Machines.

I still go back to my own views on the box jellyfish stings and that is the effects are not permanent, maybe the article is wrong in saying it kills the cells of the heart but probably it has an effect on the nervous system causing the heart to fail or malfunction, that's why I advocate the availability of AED's (again as my initial first aid training started some 40 years ago as a member of the SJAB for many years and and later on did a number of First Aid and refresher courses as a Scuba diver including O² provider, but have done no first aid training in the last ten years so I have not had the opportunity to train with AED's but as I understand they are designed to be used by untrained persons if needed, where I was wrong in previous posts is the ability of AED's to provide continuous heart stimulation).

3. And you did not answer my question fully also the word practice has many meanings, I am sorry to say I still feel you are negative to the use of CPR, like as if you were an accountant trying to balance the books of a underfunded geriatric ward.

You may think the survival rate is low for CPR, but I look at it another way, there are many people alive today thanks to CPR, and there would be many more if a lot more people learned CPR and there were more AED's.

Edited October 19, 2015 by Basil B

[limbos]

I think its worst at night , am I right ? The jelly fish is closer to the beach at night . So really they should put out some warning signs . Innocent tourists do not read any news about this before it's too late.

No balo, you're not right, Many box jelly fish stings and sightings are during the day time, assuming that it's worse during the night time may give you unfortunately a false sense of security.

I understand the risks are there at day time too. Still this is the second death in a row that happened at night time.

Of the seven lethal, recorded box jelly fish accidents in Thailand that I know of as of today, those two are also the only two that occurred during the night time.

[limbos]

1. you have not produced one piece of the information I requested.

2. you have failed to answer the question about heart/lung machines

3 You have the audacity to ask about my qualifications?

I will answer you 3rd point ......................

. I practice EM within a very large (100+trolley spaces + 6 dedicated resus. rooms) Emergency department.

Whilst very well equipped we do not have a heart/lung machine, so if you are the victim of a box jellyfish sting I suggest an urgent consultation with the Zoologist.

1. I feel I have, read post #165

but just to add to point 1. something like only 50% are resuscitated by CPR, of which probably about 20% are discharged from hospitals alive, but as I pointed out this figure is not a true reflection of the the survival rate for people suffering from venomous stings and bites as opposed to the elderly where the heart is well past its sell by date...

2. maybe heart/lung machines may not be available at many A&E facilities, and more to the point the availability of surgeons on hand as I assume it requires major surgery to hook up, (was quoting from the article), my thoughts have always been the continuation of CPR by automated means as I know from experience CPR can be strenuous and exhausting work, I know of automated ventilators I also have searched for automated cardiac compression machines, and they are available, known as auto Pulse Machines.

I still go back to my own views on the box jellyfish stings and that is the effects are not permanent, maybe the article is wrong in saying it kills the cells of the heart but probably it has an effect on the nervous system causing the heart to fail or malfunction, that's why I advocate the availability of AED's (again as my initial first aid training started some 40 years ago as a member of the SJAB for many years and and later on did a number of First Aid and refresher courses as a Scuba diver including O² provider, but have done no first aid training in the last ten years so I have not had the opportunity to train with AED's but as I understand they are designed to be used by untrained persons if needed, where I was wrong in previous posts is the ability of AED's to provide continuous heart stimulation).

3. You did not answer my question and the word practice has many meanings, I am sorry to say I still feel you are negative to the use of CPR, like as if you were an accountant trying to balance the books of a underfunded geriatric ward.

You may think the survival rate is low for CPR, but I look at it another way, there are many people alive today thanks to CPR, and there would be many more if a lot more people learned CPR and there were more AED's.

On point one, afaik less than 10% is resuscitated 'in the field' by CPR and the % doubles when an AED is used. Not a very high % at all but better than nothing and you want to give everybody a fighting chance, right?

The more people learn about CPR and AED, the more people will have a chance to survive, fully agree with your last statement.

[Captainmorgan]

This seem to me to be ultimate solution to jellyfish protection! Has anybody tried this?:

http://www.medicaldaily.com/safe-sea-jellyfish-sting-preventer-sunblock-combo-promises-protection-both-stings-and-uv-305002

“It didn’t completely inhibit the stings, but it came pretty darn close,” - Sound good enough for me

This will absolutely not help with box jelly fish stings. P{lease feel free to test this on yourself but don't promote it to other people.

Vinegar is the only advised primary care item to use with box jelly fish stings. As already mentioned plenty of times in this thread, the vinegar doesn't relief the pain but it stops the stingers from firing off more venom into the wounds.

NOTHING ELSE works.

This is not what I read:

Does Safe-Sea® protect swimmers against all types of jellyfish and sea lice?

Yes, Safe-Sea® eliminates stinging cells discharge and prevents skin penetration by the cnidaria sting mechanism. There are 15,000 specimens of jellyfish, coral hydroids and anemones and their toxins content is highly variable, but they share 30 types of stinging cells with same mode of action. Safe-Sea® inactivates the stinging mechanism and is therefore designed to work for all types. Trials have shown it to be effective against toxic jellyfish from different types.

Was Safe-Sea® tested against many types of jellyfish?

Safe-Sea® is the only product which has been tested and proven to be effective against jellyfish stings. This includes clinical tests under double blind conditions in several medical centers against several types of jellyfish. These clinical tests were conducted on Sea Nettle in Stanford Hospital University, Box Jellyfish in Bert Fish Medical Center in Florida, and Rhopilema (toxic Mediterranean jellyfish) in Rambam Hospital, Israel. All tests demonstrated that that Safe-Sea® provides effective protection against jellyfish stings. Other tests conducted by an independent Japanese team indicated that Safe-Sea® provides protection against Blue Bottle, Sea Wasp and Box Jellyfish (clinical test reports can be provided on request). These tests indicate that Safe-Sea® is effective against even the most dangerous jellyfish.

What I have understood from what I read about this is that it greatly reduces the severity of jelly stings in general but it is not specifically teated against the Thai Box jelly variant.

But how do you know that "This will absolutely not help with box jelly fish stings"?? Have you tested that or heard about others that has??

And I don't "promote" it. I just wonder if peoply have tried it because it would be a very good solution if it worked. Wearing a stinger suit or staying out of the water is not imho

Ok, maybe you want to read this article;

"There is NO - ABSOLUTELY NO evidence to show that Safe Sea jellyfish sting protection lotion works against the type of box jellyfish that has killed people in Thailand, South-East Asia, Australia or anywhere. NO PROOF - NONE!

Don't waste your money and risk your life if you think Safe Sea or similar lotions and potions will save you and your children from a lethal box jellyfish sting because they may not. Nidaria the Israeli company that develops/manufactures this product has NEVER tested it on lethal box jellyfish. In fact, one study (2005) published on their website [1] said they should - but over 10 years later they have not.

The species of box jellyfish tested in the study arranged by Nidaria is non-lethal and lives in the Americas. It is not the same as the Thai species. Yes they are 'box jellyfish' but there are many different types - while domestic cats and lions are feline, one will rip your head off. The study also says that Safe Sea lotion only provided 70% protection against this species. What about the other 30%? If the stinger was a killer would you be only 30% dead?

This product that apparently mimics the clownfish's slimy defence against the anemone's stinging cells was developed and is manufactured by the founder and director of Nidaria, Amit Lotan. The 'evidence' provided by Nidaria on their website (Safe Sea Scientific Articles) is 4 papers - one previously referred to here and 3 others all authored by Amit Lotan. This is like Ronald McDonald evaluating the nutritional value of a Happy Meal.

In 2009 when Safe Sea attempted to profit with dangerous false advertising in Thailand, Dr Lisa Gershwin, an eminent international box jellyfish expert, had this to say:

“Physalia utriculus is neutralised by vinegar, whereas the multi-tentacled Physalia here in Australia is activated by it. A clown fish covered with the slime of one anemone will be ready prey for another anemone. Safe Sea does not work as well for Chiropsalmus quadrumanus as it does for Chrysaora quinquecirrha.

There are subtle biochemical differences in species perception and species behaviours that we do not fully understand. Sometimes they are between classes, sometimes they are between sister species. It is possible that the product works better for Chironex and/or Irukandji than it works for the species tested; it is also possible that it does not work at all for one or both; it is also possible that it works somewhere in between. The only way we will know is by credible independent testing. Until then, scientific honesty and duty of care dictate that we assume it could be bad, and we thus avoid the ramifications of a Type II error.”

So what are the facts? The fact is that Safe Sea is NOT sold in Australia - for obvious reasons. The fact is that Nidaria that sells Safe Sea has not tested it fully. The fact is that Safe Sea can NOT be trusted as prevention against potentially lethal jellyfish in the Indo-Pacific region including Thailand. The fact is that the best ways not to get stung by a box jellyfish in Thailand is to swim in the pool or wear a lycra suit in the sea."

For pictures and more links, please visit the original link as listed above.

Maybe it's just me but I am not used to hysterical people yelling I make false claim about products which is not proven when all I do is ask if anybody has any experience with it. What if you actually answered my questions (the sentences in my 3 posts ending with a ?) instead of repeating the same mantra over an over? You know I got you the first time, SAFE SEA SUN CREAM IS NOT PROVEN AGAINST THAI BOX JELLY! So with that out of the way can you now answer me were it is proven that it don't work at all as you claim???

You see, even if you think they should, if you exclude the most extreme places like northern australia in the season, people will not stop swimming in the indian or pacific ocean or wherever else dangerous jelly might live or wear a ridicullus, uncomfortable suit that removes the pleasure of a day at the beach just because there is about 1 in 10 000 000 or so chance of getting badly burned. Just like people are walking to the beach in sandals and not f.ex. military boots even if there is an ever so slight chanse of getting bitten / stung by a dangerous snake, spider, scorpion, centipide etc

And so the reason I think this kind of sun cream is a great product is that it gives you protection for "free". Your gonna need sun cream anyway so why not use one on the beach that gives you some jellyfish protection as a bonus?? Yeeeeeees, I understand it will not give you a 100% protection against all kinds of yellies and it costs a few dollars more, but as I said in my first post, if it gives you let's say 50% protection and damage reduction then I will definatly buy it. It could actually save your life (as opposed to NOT wearing any protection) in the very unlikly event that you get burned by a dangerous jelly!

So therefore I try one last time, has anybody had any experience with this or a similar sun cream product?

[oncearugge]

Captainmorgan

Nice rant but not worth a detailed response.

"Sun creams" do NOT protect against box jellyfish stings

[CharlieH]

Petty bickering posts and some responses have been removed. (regardless of validity of content).

[oncearugge]

1. you have not produced one piece of the information I requested.

2. you have failed to answer the question about heart/lung machines

3 You have the audacity to ask about my qualifications?

I will answer you 3rd point ......................

. I practice EM within a very large (100+trolley spaces + 6 dedicated resus. rooms) Emergency department.

Whilst very well equipped we do not have a heart/lung machine, so if you are the victim of a box jellyfish sting I suggest an urgent consultation with the Zoologist.

1. I feel I have, read post #165

but just to add to point 1. something like only 50% are resuscitated by CPR, of which probably about 20% are discharged from hospitals alive, but as I pointed out this figure is not a true reflection of the the survival rate for people suffering from venomous stings and bites as opposed to the elderly where the heart is well past its sell by date...

2. maybe heart/lung machines may not be available at many A&E facilities, and more to the point the availability of surgeons on hand as I assume it requires major surgery to hook up, (was quoting from the article), my thoughts have always been the continuation of CPR by automated means as I know from experience CPR can be strenuous and exhausting work, I know of automated ventilators I also have searched for automated cardiac compression machines, and they are available, known as auto Pulse Machines.

I still go back to my own views on the box jellyfish stings and that is the effects are not permanent, maybe the article is wrong in saying it kills the cells of the heart but probably it has an effect on the nervous system causing the heart to fail or malfunction, that's why I advocate the availability of AED's (again as my initial first aid training started some 40 years ago as a member of the SJAB for many years and and later on did a number of First Aid and refresher courses as a Scuba diver including O² provider, but have done no first aid training in the last ten years so I have not had the opportunity to train with AED's but as I understand they are designed to be used by untrained persons if needed, where I was wrong in previous posts is the ability of AED's to provide continuous heart stimulation).

3. You did not answer my question and the word practice has many meanings, I am sorry to say I still feel you are negative to the use of CPR, like as if you were an accountant trying to balance the books of a underfunded geriatric ward.

You may think the survival rate is low for CPR, but I look at it another way, there are many people alive today thanks to CPR, and there would be many more if a lot more people learned CPR and there were more AED's.

On point one, afaik less than 10% is resuscitated 'in the field' by CPR and the % doubles when an AED is used. Not a very high % at all but better than nothing and you want to give everybody a fighting chance, right?

The more people learn about CPR and AED, the more people will have a chance to survive, fully agree with your last statement.

I.agree more people should receive First Aid training/instruction.

AED's are only of use if a "shockable" heart rhythm is present.(Ventricular Fibrillation/ Pulseless Ventricular Tachycardia) As these two rhythms herald imminent death delayed use of an AED will not assist.

Any other cardiac rhythm which results in collapse/unconsciousness is nonshockable and use of an AED will not assist.

Only good quality CPR will improve the already very small chance of an out of hospital cardiac arrest victim surviving.

[German Viking]

DO NOT use vinegar on bow jellyfish it makes things even worse !

That is absolutely nonsense, where do you get that ill informed information from?

In case you're referring to research done recently in Australia, here's the answer to that from Dr. Lisa Gershwin, box jelly fish researcher;

"There were several things questionable about the research, in no particular order:

The authors forced nematocyst discharge with an electrical current. The nematocysts fired into a membrane, then venom was collected under the membrane, then vinegar was applied to the tentacles, then they collected venom again from under the membrane. They found that 60% more venom was obtained in the second round. They therefore concluded that the vinegar was causing vinegar to come out of the already discharged nematocysts.

First, There is no evidence that demonstrates that electrocuted tentacles behave like natural stings. In particular, it seems more likely that natural stings leave little venom behind, whereas electrocuted tentacles are likely to cause abortive firing, or incomplete firing, thus quite possibly leaving some venom behind. If this is the case, then the model does not represent real stings.

Second, their experimental design did not control for venom initially discharged into the membrane or pooled above the membrane, only what came through with each wash. Therefore it may be that some venom was lodged in or above the membrane from the initial electrocution, and was subsequently recovered by the second wash, giving misleading conclusions.

Third, the post-vinegar recovery was of very low venom potency, suggesting that it was diluted, supporting the idea that the venom came from in or above the membrane, not from secondary discharge. In this case, vinegar would be a better solvent than originally realised, and therefore an even better first aid option.

Fourth, and perhaps most importantly, the percentages tell the whole story. The authors estimated that 20-30% of nematocysts fire initially (I estimate 10-20%, but the difference doesn't matter for this argument). So 60% of 20-30% is about 10-15% additional venom load. But even if their hypothesis turns out to be entirely correct, that still leaves the other 70-80% of nematocysts armed and dangerous. It's that 70-80% that you want to disable, not the 10-15%. So if vinegar causes 10-15% more but it also causes 70-80% less, then by using vinegar you're still some 60-70% better off to use vinegar. Sorry my math is probably not so good this time of night (2am), but you get the idea hopefully.

Finally, much of the media quoted one of the authors of the study as saying that they found that vinegar makes stings worse. That's not true -- that's not what they found. They didn't test stings. They tested electrocuted tentacles in a lab. But their incomplete procedures even make what they did find debatable. "

Vinegar is at this moment the best solution for box jelly stings

There has been other treads about vinegar and Box Jelly Fish with a number of links to other sites - "limbos" is correct, vinegar is the best solution at the moment...

Anyway I having a general question, there are 2 different kind of vinegars, made of destilled alcohol or made by fermentation which is the better one for the jellyfish treatment!!???

[Basil B]

I would assume White/distilled vinegar as it would contain less impurities... but in an emergency any will do.

Distilled/White vinegar is not white but clear in colour and that is what you see in the photo's of "vinegar stations", most vinegars are brown in colour.

Leave the malt for you Fish'n'Chips...

[limbos]

Malt or white vinegar doesn't make a difference, as long as they have the acidic % of vinegar.

If you put vinegar in vinegar poles but use big 1.5L water bottles, you can also use food colors, so people don't accidentally drink it or the vinegar gets stolen. The food color doesn't affect the usefulness of the vinegar.

Edited October 29, 2015 by limbos

[theoldgit]

Off topic and nonsense posts removed.

[Dr Angel Yanagihara]

Aloha,

I have been researching box jellyfish and other venoms for 18 years. I am a venom biochemist focused on elucidating mechanism of pathogenisis (how venoms kill) and also have developed field ecology techniques to collect many different types of box jellies. I have worked on many species of box jellies including Chironex venom and developed animal models of acute cardiac collapse and Irukandji syndrome in mice and piglets. I have developed specific venom inhibitors that have allowed rescue of lethally injected animals. I was recently invited to visit Koh Samui to consider the situation and whether my DOD funded technologies for cubozoan stings could be useful. I learned a great deal in the 18 days in Thailand. I also had 6 meetings in Bangkok and Chon Buri with government and university folks. I made several lay and scientific presentations. I will be writing research proposals to come back and conduct collaborative work with fisheries folks as well as basic biomedical research on the venom.

I am happy to answer lay questions and to discuss state of the art research questions.

If I can figure out how, I would like to up load jpgs of the power point talks and videos of the movies. I would also like to upload scientific publications which are pertinent to the various questions that have been raised on Thai Visa forum threads.

By way of a big picture comment, and A BIG NOTE OF CAUTION, I would like to stress that while the public often seeks FACTS from the internet, the messy truth is that in areas of active research FACTS are often slippery and evolving best syntheses of rigorous scientific experimental or epidemiological data. Data analysis should be an ego free objective zone. I am also often asked for my "expert" opinion. There is in truth no absolute "expert" and all authorities should be questioned in my opinion. The moment I learn something new and find a mistake, I am happy to be instructed- in this field the big picture objective is improved human health outcomes. Local researchers have mentioned morning glory as a promising approach and I am very curious about that.

My bottom line current thoughts are:

1. Stinger suits should be recommended in all affected areas including Koh Samui for all ocean swimmers. Simple 1 mm thick Australian style full body suits would literally be a life saver. I feel that the bikini should be limited to pools and that stinger suits can be made fashionable.

2. Vinegar poles would be a priority each 100 yards of beach front.

3. There is important work to be done by the Ministry of Health to consider the world wide body of research literature with regard to critically evaluating the current blanket call for ice pack sting site treatment. I was frankly shocked by this ice pack treatment protocol since the American Heart Association and all other literature based clinical care shows improved pain management and outcomes after (normal tap 42-45oC) hot water immersion. This is not my call but I will certainly work to provide the Thai decision makers all recent publications that I think should fairly be considered.

4. Clinical care protocols are needed. I have been working with USSOCOM Dive Medical Officers on this. We have made good progress and I look forward to working further with Mahidol clinical researchers on this topic.

5. I would like to conduct live tentacle assays using Koh Samui box jellies to test the usefulness of my technologies (Sting No More spray and cream) as well as other commercial products and other potential inhibitors.

I would like to ask members to email ( <<<< Email removed as per forum rules >>>> ) photos and locations of any box jellies seen.