YOU ARE NOW CONNECTED TO THE TOXLINE (1981 FORWARD, NON-ROYALTY) FILE. ==BEE STINGS, JELLYFISH== 4 AUTHOR Fenner PJ AUTHOR Williamson JA AUTHOR Burnett JW AUTHOR Rifkin J TITLE First aid treatment of jellyfish stings in Australia. Response to a newly differentiated species [see comments] SOURCE Med J Aust; VOL 158, ISS 7, 1993, P498-501 ABSTRACT Vinegar has been shown to inhibit neomatocyst discharge in Chironex fleckeri, the deadly north Australian box-jellyfish, and application of vinegar has become accepted first aid, not only for box-jellyfish stings, but also for stings by other Australian jellyfish. However, in a newly differentiated species of Physalia in Australian waters, which causes severe envenomation, vinegar was found to cause discharge in up to 30% of neomatocysts. In treating these stings, the use of vinegar is not recommended as it may increase envenomation. Stings from the single-tentacled Physalia utriculus (the "bluebottle") are not severe, tentacles with unfired nematocysts rarely adhere to the victim's skin and vinegar dousing is not required. Vinegar treatment is therefore an unnecessary step in the first aid management of any Physalia sting but remains an essential first aid treatment for all cubozoan (box) jellyfish tested to date. 7 AUTHOR Exton DR AUTHOR Fenner PJ AUTHOR Williamson JA TITLE Cold packs: effective topical analgesia in the treatment of painful stings by Physalia and other jellyfish. SOURCE Med J Aust; VOL 151, ISS 11-12, 1989, P625-6 ABSTRACT A study has shown that, when applied to Physalia ("bluebottle") jellyfish stings, cold packs are effective as topical analgesia in the relief of mild-to-moderate skin pain. The application of ice also has been shown to be effective for topical analgesia in a number of other jellyfish stings, including by Cyanea ("hair jellyfish"), Tamoya sp. ("Moreton Bay stinger" or "fire jelly") and Carybdea rastoni ("jimble") as well as by Physalia. In the current state of knowledge, cold packs or ice are recommended as the first-aid treatment for jellyfish stings with local skin pain. 2 AUTHOR Bernstein JA AUTHOR Kagen SL AUTHOR Bernstein DI AUTHOR Bernstein IL TITLE Rapid venom immunotherapy is safe for routine use in the treatment of patients with Hymenoptera anaphylaxis. SOURCE Ann Allergy; VOL 73, ISS 5, 1994, P423-8 ABSTRACT BACKGROUND: Rapid venom immunotherapy regimens have been developed to provide safe protection to individuals who have experienced Hymenoptera anaphylaxis by administering greater than 50 micrograms of venom over two to three hours on treatment day 1. A rapid venom immunotherapy protocol which consisted of administration of a cumulative dose of 58.55 micrograms of each venom on treatment day 1 followed by an accelerated build-up over 3 weeks to a final maintenance dose of 100 micrograms per venom was developed by our group in 1984. OBJECTIVE: We report our 10-year cumulative experience with this rapid venom immunotherapy regimen. METHODS: Seventy-seven venom-allergic patients received a cumulative dose of 58.55 micrograms per venom on treatment day 1 in an ambulatory care setting. Rapid venom immunotherapy was assessed for safety. A cost analysis was performed to compare rapid venom immunotherapy to a modified rush immunotherapy regimen. RESULTS: Four patients (5.2%), experienced mild systemic reactions consisting of diffuse urticaria on day 1. Treatment was otherwise well tolerated. Resting events occurred in 21 patients, a mean number of 12 months (range: 3 days to 48 months) after treatment, without systemic reactions. CONCLUSIONS: This experience confirms that rapid venom immunotherapy is safe to administer in an ambulatory setting and should be considered especially for patients during the stinging insect season when rapid protection is required. 11 AUTHOR Fenner PJ AUTHOR Williamson J AUTHOR Callanan VI AUTHOR Audley I TITLE Further understanding of, and a new treatment for, "Irukandji" (Carukia barnesi) stings. SOURCE Med J Aust; VOL 145, ISS 11-12, 1986, P569, 572-4 ABSTRACT A brief analysis is presented of the large recorded numbers of swimmers who have been stung by the "Irukandji" (Carukia barnesi) jellyfish during the 1985-1986 summer season in north Queensland, and the results are discussed. Many of the victims may suffer from symptoms of overstimulation of the sympathetic system, and hypertension is shown to be another complication of this syndrome. This hypertension seems to respond well to intravenously-administered phentolamine, an alpha-adrenergic receptor blocking drug. Phentolamine also reduces the excessive shaking and sweating that appears to be part of the "Irukandji syndrome". Diazepam relieves the anxiety which is part of the syndrome, but antihistamine agents and hydrocortisone seem to have no beneficial effect.