Dermatotoxicity of 2 nematocyst preparations of the jellyfish Rhopilema nomadica

Toxicological risks on the human health of populations living around the Mediterranean Sea linked to the invasion of non-indigenous marine species from the Red Sea: A review

The Mediterranean region is, by far, a prime travel destination, having hosted more than 330 million tourists in 2016, mostly for seaside holidays. A greatly increased influx of thermophilic Red Sea species, introduced through the Suez Canal in a process referred to as Lessepsian invasion (in honor of Ferdinand de Lesseps who instigated the building of the Suez Canal), have raised awareness among scientists, medical personnel, and the public, of health risks caused by some venomous and poisonous marine species. The main species of concern are the poisonous Lagocephalus sceleratus, and the venomous Plotosus lineatus, Siganus luridus, Siganus rivulatus, Pterois miles, Synancea verrucosa, Rhopilema nomadica, Macrorhynchia philippina and Diadema setosum. Recognizing that the main factors that drive the introduction and dispersal of Red Sea biota in the Mediterranean, i.e., Suez Canal enlargements and warming seawater, are set to increase, and international tourist arrivals are forecasted to increase as well, to 500 million in 2030, an increase in intoxications and envenomations by alien marine species is to be expected and prepared for.

Pediatric jellyfish envenomation in the Mediterranean Sea

BACKGROUND

Several species of jellyfish native to the western Indian Ocean have entered the Mediterranean Sea through the Suez Canal. Since the late 1980s, each summer Rhopilema nomadica forms swarms as long as 100 km in the southeastern Levant and since the millennium aggregations of additional nonnative jellyfish have been sighted. The aim of this study was to evaluate children seen in the emergency department after jellyfish envenomations and to establish patterns of toxicity associated with this organism.

METHODS

A retrospective chart review was performed of all children presenting after jellyfish envenomations to the pediatric emergency department during the jellyfish swarming seasons (June-August) between 2010 and 2015. Extracted data included age, location of envenomation, pain scores, local and systemic manifestations, treatment provided in the emergency department and hospital, and disposition.

RESULTS

Forty-one patients fulfilled the inclusion criteria; their ages ranged from 1 to 16 years and the median age was 9.4 years. Clinical manifestations were evident in all patients. Pain, present in 100% of patients, and an erythematous, whip-like, linear rash present in 87.8%, were the most common manifestations. The majority of 'burns' associated with jellyfish stings were first and second degree. The upper limb was affected in 34% and the lower limb was affected in 61% of cases. One patient suffered a sting to the abdomen and three patients suffered a sting to the face. Treatment in the emergency department included pain control, with nonsteroidal anti-inflammatory drugs and opiates, and antihistamines and topical corticosteroids in some cases. Nearly 49% of patients were seen during the summer of 2015 alone and seven patients in this group needed hospitalization. Reasons for hospitalization included systemic symptoms such as fever, chills, tachycardia, and muscle spasms. Two patients developed severe cellulitis, one patient had an anaphylactic reaction, and one was admitted to the ICU after suffering an anaphylactic reaction to a sting sustained while surfing.

CONCLUSION

The prevalence of the jellyfish swarms and the severity of clinical manifestations because of their envenomations suggest that it should be considered as a health hazard in the Mediterranean Sea. We call for public health authorities in affected countries to initiate a health hazards database, familiarize medical and healthcare staff with the clinical syndromes, train medical and healthcare staff` in appropriate treatment, and initiate and continue public awareness campaigns.

Mediterranean jellyfish venoms: a review on scyphomedusae

The production of natural toxins is an interesting aspect, which characterizes the physiology and the ecology of a number of marine species that use them for defence/offence purposes. Cnidarians are of particular concern from this point of view; their venoms are contained in specialized structures--the nematocysts--which, after mechanical or chemical stimulation, inject the venom in the prey or in the attacker. Cnidarian stinging is a serious health problem for humans in the zones where extremely venomous jellyfish or anemones are common, such as in temperate and tropical oceanic waters and particularly along several Pacific coasts, and severe cases of envenomation, including also lethal cases mainly induced by cubomedusae, were reported. On the contrary, in the Mediterranean region the problem of jellyfish stings is quite modest, even though they can have anyhow an impact on public health and be of importance from the ecological and economic point of view owing to the implications on ecosystems and on some human activities such as tourism, bathing and fishing. This paper reviews the knowledge about the various aspects related to the occurrence and the stinging of the Mediterranean scyphozoan jellyfish as well as the activity of their venoms.

Epidemiology of jellyfish stings reported to summer health centres in the Salento peninsula (Italy)

BACKGROUND

The presence of jellyfish along coasts constitutes a potentially serious public health problem because of the toxic effects of contact with them.

OBJECTIVE

To determine the epidemiology of jellyfish stings in the Province of Lecce, Italy, in 2007.

METHODS

The study involved the gathering and processing of data on patients seeking medical treatment at summer first aid centres and hospitals along the coast of Salento following contact with jellyfish.

RESULTS

In 2007, 446 bathers sought medical assistance following contact with jellyfish. The spatial distribution indicates a greater frequency of stings sustained along the Adriatic coast, while the time analysis shows patterns related to wind direction. Most of the injuries were seen in persons aged between 1 and 10 years and in females. In 24% of cases, injuries were sustained to several parts of the body, while single injuries were mainly to the lower limbs (33%). In 4.9% of cases, there were complications, including one case of anaphylactic shock.

CONCLUSION

In the light of the significant level of medical assistance provided, there is a need to identify suitable strategies that will guarantee the best response in terms of both prevention and treatment.

Biologically active polypeptides in the venom of the jellyfish Rhopilema nomadica

A tropical jellyfish, Rhopilema nomadica (Scyphozoa, Rhizostomeae) has recently invaded the eastern Mediterranean. Its painful stings have been the bane of bathers and fishermen from Egypt to Turkey. This paper reports on the presence of haemolytic activity and alpha-chymotrypsin-like serine protease activity in the venom of the R. nomadica nematocysts. In addition, the presence of phospholipase A2 activity, which has been described previously, is confirmed. Some properties of these activities are defined.