Thank you for your efforts to improve public safety and
understanding of marine stingers with the article about treating jellyfish stings in your December issue. Based on research
conducted in my lab at the University of Hawaii, I would like
to call your attention to three minor issues with the article:
Clean the area with vinegar or seawater – never freshwater.
We found that while vinegar is a good first response in that
it inhibits cnidae (capsules that contain the venom) discharge,
seawater does nothing to inhibit undischarged cnidae and only
spreads these microscopic capsules over a greater surface area.
These are like ticking time bombs that eventually do fire, thus
increasing the potential surface area of skin affected by stinging.
Cover the site with a hydrocortisone cream and bandage. Any
site pressure such as applying bandages (or scraping or rubbing) increases cnidae discharge and thus venom load.
Use a hot pack, water immersion, or hot-water bottle filled
with the hottest tap water (about 120 F) inside a thick towel,
and cover the affected area for about 20 minutes. We found that
108 F to 113 F hot water or hot pack application for 45 minutes ( 20 minutes is not sufficient for some stingers) irreversibly
inhibits the venom that has already been injected at the site.
Thus, evidence-based work indicates that the best first-aid
management among commonly available approaches is vinegar rinse followed by hot water immersion.
Angel Yanagihara is an Associate Research Professor at the
University of Hawaii specializing in mechanisms of pathogenesis
of life-threatening cubozoa (box jellyfish).
AYE, AYE “We
took the last boat
ride of the season
on Portage Lakes
with our 2 1/2-year-
old grandson Dean
aboard our Boston
Whaler,” says Bill
and Joan Hall
of Canton, Ohio.
“Getting the next
boating is lots
GOING HOME “Looking aft at Mahone Bay, Nova Scotia, on our
way to winter storage aboard our Seaswirl 2905 Power Wagon,”
says Barry Rofihe of Nova Scotia. “We have a five-month season
here and will be back in the water in May.”
I had a home on the Caribbean Sea and dove almost
every day for about 40 years. I encountered almost everything, including box jellyfish. In those days, we didn’t have
full-body wet suits. On a night dive, a box jellyfish got
caught between my bare leg and my leg knife sheath, and
I went through three days of real problems. I tried the
local wives tale remedies, which just made things worse.
A doctor at the dive center told me to use Adolph’s meat
tenderizer and explained that the tenderizer kills the stinging protein molecules. I made a paste of freshwater and
tenderizer and applied it to the wound. The results and
recovery started almost immediately. It seemed to work for
all kinds of stings, and we always had a bottle of tenderizer
available. ROBERT FOERST CLARK
ANGEL YANAGIHARA RESPONDS: The supposition that the
enzymes in meat tenderizer can enter the skin and selectively
destroy venom proteins deep in the tissue is not supported by
research efforts. They are rather weak enzymes and work slowly as
well as nonspecifically – that is, there would be no selectivity for
jellyfish protein over human protein.
That said, meat tenderizers also contain high levels of sugars
and sea salt. It may be that after three days, the inflammation
was lessened by the application of the salty paste, much like an
Epsom salt soak.
It is important for layfolks to understand that personal experience can form the basis of an anecdotal case report but is quite
different from evidence-based, statistically designed, rigorous