Just when you thought it was safe to go back to the beach . . .

August 6, 2010, 5:52 pm

MailOnline (U.K.) reports today that an unusually high number of seaside bathers in Britain have been stung by the venomous lesser weever fish (Echiichthys vipera). This unpleasant creature burrows in the sand around shallow beach areas. Its sharp dorsal fins — seen projecting upward in the picture — contain a toxin consisting of serotonin, epinephrine, histamine, and several enzymes.   Stings cause immediate extreme pain that increases over 30-60 minutes and then gradually resolves over the next 24 hours.  Treatment involves wound care, debridement, and analgesics. The role of prophylaxis with a tetanus booster and initial antibiotics has not been studied, but some experts do not recommend either.

The recent spell of hot weather in Britain may be responsible for the increased incidence of these encounters.

Pain control can often be achieved by immersing the involved area for 30-60 minutes in hot water — 104 degrees fahrenheit or as hot as the patient can tolerate without causing scalding.  This will denature the venom.  As a rule of thumb, there are two general types of marine envenomations.  Puncture wounds caused by spines usually respond to hot water immersion.  These include injuries caused by scorpion fish, lion fish, stone fish, and stingrays. Surface stings — such as those caused by jellyfish — are relieved by application of vinegar.  The alternative treatment — urinating on the wound — is sometimes gymnastically and psychologically difficult, and has never been properly studied.

We haven’t posted the classic “jellyfish” clip from the sitcom Friends in a while, but those who haven’t seen it before are in for a treat:

3 Comments:

  1. precordialthump Says:

    Another great post Leon,

    But that Weaverfish looks pretty puny to my antipodean eyes…

    BTW, what do you think of the ‘denaturation hypothesis’ of hot water treatment of fish spine stings? I think a neuromodulation effect is more likely as the pain generally comes back if if the stung body-part is taken out of the hot water. Denaturation should be irreversible. just another mystery to ponder…

    Cheers,
    Chris

  2. Neuroskeptic Says:

    Nasty, but at least we don’t have stonefish in this country…

  3. Leon Says:

    Thanks for the comments!

    Neuroskeptic — The weever has another major advantage of the stonefish — it is an ingredient in the delicious Provencal fish stew bouillabaisse: http://tinyurl.com/cbtrkk Just be sure that the dorsal and gill fins have been removed.

    precordialthump: You are correct — the fact that pain from marine stings tends to return immediately upon removing the affected area from hot water seems somewhat inconsistent with the deanuration hypothesis. The best discussion of this I know is David Muirhead’s article “Applying pain theory in fish spine envenomation” (S Pacific Underwater Med Soc J 2002;32:150): http://tinyurl.com/24798eu Muirhead suggests that Gate Control and other modern theories of pain better explain the phenomenon of hot water analgesia in these stings.