Divers Alert Network Asia-Pacific, Ashburton, Melbourne, VIC 3147, Australia.
J Travel Med. 2011 Jul-Aug;18(4):275-81. doi: 10.1111/j.1708-8305.2011.00531.x. Epub 2011 Jun 15.
Jellyfish are a common cause of injury throughout the world, with fatalities and severe systemic events not uncommon after tropical stings. The internet is a recent innovation to gain information on real-time health issues of travel destinations, including Southeast Asia.
We applied the model of internet-based retrospective health data aggregation, through the Divers Alert Network Asia-Pacific (DAN AP), together with more conventional methods of literature and media searches, to document the health significance, and clinical spectrum, of box jellyfish stings in Malaysia for the period January 1, 2000 to July 30, 2010.
Three fatalities, consistent with chirodropid envenomation, were identified for the period-all tourists to Malaysia. Non-fatal chirodropid stings were also documented. During 2010, seven cases consistent with moderately severe Irukandji syndrome were reported to DAN and two representative cases are discussed here. Photographs of chirodropid (multi-tentacled), carybdeid (four-tentacled) box jellyfish, and of severe sting lesions were also submitted to DAN during this period.
This study suggests that the frequency and severity of jellyfish stings affecting tourists in Southeast Asia have been significantly underestimated. Severe and fatal cases of chirodropid-type stings occur in coastal waters off Peninsular Malaysia and Sabah, Borneo. Indeed, the first Malaysian cases consistent with Irukandji-like syndrome are reported here. Reports to DAN, a provider of emergency advice to divers, offer one method to address the historic lack of formalized reporting mechanisms for such events, for photo-documentation of the possible culprit species and treatment advice. The application of marine stinger prevention and treatment principles throughout the region may help reduce the incidence and severity of such stings. Meanwhile travelers and their medical advisors should be aware of the hazards of these stings throughout the Asia-Pacific.
世界各地的水母蜇伤都很常见，在热带蜇伤后，并非罕见致命和严重的全身事件。互联网是获取有关旅行目的地实时健康问题信息的最新创新，包括东南亚。
我们通过 Divers Alert Network Asia-Pacific (DAN AP) 应用了基于互联网的回顾性健康数据聚合模型，以及文献和媒体搜索等更传统的方法，记录了 2000 年 1 月 1 日至 2010 年 7 月 30 日期间马来西亚箱形水母蜇伤的健康意义和临床范围。
在此期间，确定了三例死亡病例，均与 chirodropid 中毒有关，均为马来西亚游客。还记录了非致命性的 chirodropid 蜇伤病例。2010 年，有七例符合中度严重的 Irukandji 综合征的病例报告给 DAN，这里讨论两个代表性病例。在此期间，还向 DAN 提交了 chirodropid（多触手）、carybdeid（四触手）箱形水母和严重蜇伤的照片。
本研究表明，影响东南亚游客的水母蜇伤频率和严重程度被严重低估了。马来西亚半岛和沙巴、婆罗洲沿海水域发生了严重的 chirodropid 型蜇伤病例。事实上，这里报告了首例符合 Irukandji 样综合征的马来西亚病例。向 DAN 报告提供了一种方法，可以解决此类事件历史上缺乏正式报告机制的问题，用于可能的罪魁祸首物种的照片记录和治疗建议。在整个地区应用海洋蜇伤预防和治疗原则可能有助于降低此类蜇伤的发生率和严重程度。同时，旅行者及其医疗顾问应注意整个亚太地区的这些蜇伤危害。
