Clinical characteristics of jellyfish stings in Japan

Abstract

Aim: Jellyfish known as "habu-kurage" (Chironex yamaguchii) inhabit the waters surrounding Okinawa and Amami, Japan, and jellyfish stings are limited to areas outside the Japanese main island. However, the shifts promoted by global warming and increasingly intensive interactions with people have led to concerns regarding the possibility of increased jellyfish stings on the main island of Japan. Similar concerns are being raised all over the world. However, studies examining clinical characteristics of jellyfish stings have been limited to Australia, the USA, Europe, and SouthEast Asia. Thus, this study aimed to examine for the first time the clinical characteristics of jellyfish stings in Japan. Methods: We undertook retrospective questionnaire surveys from January 2013 to December 2017 to determine patient characteristics, treatment, and clinical outcomes. We compared patient characteristics between tourists and non-tourists. The primary end-point of the present study was to clarify the clinical characteristics of jellyfish stings. Results: Over the 5-year study period, 204 patients were identified from eight hospitals based on the basic questionnaire, and 35 patients with moderate-to-severe jellyfish stings were also identified. All patients recovered well, including five patients with severe jellyfish stings. Antivenom was not given. The time intervals from the occurrence of jellyfish stings to hospital arrival significantly differed between tourists and non-tourists (P = 0.049), and all tourists visited the emergency department (P = 0.009). Conclusions: Approximately 40 cases of jellyfish stings occurred annually in Japan between 2013 and 2017. Patients recovered well without the use of antivenom.

Clinical characteristics of stonefish “Oni‐daruma‐okoze” envenomation in Japan

“…5 This suggests that there is an unmet need for public health interventions and appropriate prehospital management in Japan. Unlike in our current examination of jellyfish stings in Japan, 8 in the current study, there were no significant differences observed between tourist and non-tourist groups with regard to baseline characteristics. A possible reason for this result could be that, owing to the severe pain caused by the stonefish venom verrucotoxin, patients (tourists and nontourists) tended to promptly visit the emergency department.…”

“…11 The basic questionnaire was distributed in February 2019 and collected by March 2019. 8 The advanced questionnaire 1 was distributed to two hospitals that had treated patients with severe stonefish envenomation, as stated in the basic questionnaire. The advanced questionnaire 1 was distributed in May 2019 and collected by July 2019.…”

“…Due to changes promoted by global warming and increasing tourism, concerns regarding the potential for stonefish envenomation as well as jellyfish stings on the main island of Japan are increasing. [6][7][8] However, few studies of stonefish envenomation have been reported in Japan, 9,10 and studies comprehensively examining the clinical characteristics are limited. Therefore, physicians in the emergency department have limited information with regard to stonefish envenomation.…”

Marine Envenomation

“…Epidemiology: Jellyfish appear in large numbers in swimming areas, particularly inlets and beaches where waves are subdued. Several jellyfish sting cases have been reported in the literature [10][11][12] and recently, Hifumi et al comprehensively described the clinical characteristics of jellyfish stings in Japan [13]. One urban emergency department in Hawaii experiences approximately 20 jellyfish sting cases annually [14].…”

“…Diagnosis: No definite diagnostic criteria exist. Diagnosis of jellyfish stings is based on either the patient's history or positive identification of the responsible jellyfish presented by the patient [13]. Severe stings result in systemic envenomation, which may result in Irukandji syndrome and/or anaphylaxis, and most often require hospital admission [15].…”