German tourist dies from box jellyfish attack on Samui

[cumgranosalum]

Im interested concerned about your products..can you direct me to some peer reviews that I can access over the net for free?

[Dr Angel Yanagihara]

@cumgranosalum

This technology is based on and an extension of previously reported venom inhibition studies

https://www.academia.edu/4176442/Cubozoan_Venom-Induced_Cardiovascular_Collapse_Is_Caused_by_Hyperkalemia_and_Prevented_by_Zinc_Gluconate_in_Mice

The patent filings have been made (2012-2015) with all the pertinent data fully disclosed. Because of IP issues, US and international patent filings had to proceed "enabling" publications. That said the manuscript with the data specific to these products is now in press with a publication date near Jan 1, 2016. If you are a clinician please let me know and I can share this with you through non-public domain means.

The products are composed of all OTC allowed "soap" or "cosmetic category"FDA monograph Generally Recognized as Safe (GRAS) ingredients. FTC compliance only requires disclosure of components that are present above a certain percentage. Because of market place realities of copy-cat rip off in the global market place the full ingredient lists and composition is only disclosed to clinical collaborators.

[Dr Angel Yanagihara]

Here is another link to the paper if the academia edu link is not free from your area

https://angel-yanagihara-photo.smugmug.com/Various/

I have also tried to attach a pdf

Yanagihara_and_Shohet_2012_PLOS_ONE-libre copy.pdf

[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.

* Update on Item 3. Recent correspondence with key decision makers related to the Thai cases indicates that in cases of near death instability, the priority is CPR O2 ABC full stop (not ice or heat). For non-life threatening stings however, soon to be published studies also apparently concur with the majority of literature that heat or hot water application is the most effective management again when the victim is not unstable.

Given the danger in Koh Samui waters, it would seem that avoidance and stinger suits would be extremely valuble