Cnidarian invertebrates distinguished by their cube-shaped medusae
Chironex fleckeri or sea wasp is cause of most deaths
Largely restricted to the Indo-Pacific Ocean/Australian waters but various species can be found widely
83% occur in < 1m of water.
Most stings are benign (requiring local treatment only), recent data suggests fatality rate is much lower than the 20% previously reported.
Morbidity and Mortality are dose- and time-dependent, which explains why majority of deaths have been children.
Morbidity and Mortality are dose- and time-dependent, which explains why majority of deaths have been children.
Has about 15 tentacles (measure up to 3m in length) that contain millions of "stinging cells" called nematocysts.
Contact with the tentacles cause rapid onset of pruritic/burning
Thought to affect sodium/potassium/calcium channels
Rhabodmyolysis can occur from sustained muscle contractions caused by myotoxins in venom.
Cardiovascular collapse can occur d/t dysrhythmia (from hyperkalemia) and osmotic dysregulation of endothelial and cardiac tissues from pore-forming toxins within the venom.
Chironex fleckeri venom causes cell membranes to become porous allowing K+ influx/hyperkalemia
Box jellyfish envenomation
Toxins
Fire coral envenomation
Ciguatera
Crown-of-Thorns starfish envenomation
Scombroid
Stonefish envenomation
Tetrodotoxin 