Venomous fish stings (ichthyoacanthotoxicoses).
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Although fish venoms exert a cardiovascular effect, the presence of adrenergic substances was not previously demonstrated. Chromatographic analysis with electrochemical detection showed the presence of substances co-migrating with norepinephrine, dopamine and tryptophan. Serotonin, which was thought to be implicated in the intense pain following fish envenomation, was not detected. Norepinephrine was identified as a component of the stonefish Synanceia verrucosa venom by gas chromatography-mass spectrometry.
We report the purification of a lethal fraction of Weever fish venom using preparative electrophoresis. It was found to be composed of four identical subunits with an overall mol. wt of approximately 324,000. A 20 g mouse was killed instantly by an i.v. injection of 2 micrograms.
Venom from the olive sea snake, Aipysurus laevis, was injected into three species of prey fish, Chromis nitida, Dascyllus aruanus and Istiblennius meleagris. Their behaviour and ventilatory patterns were observed for 48 hr. Six progressive stages of envenomation, involving impairment of the locomotory and ventilatory systems, were identified. There were significant interspecific differences in time taken to reach various stages. In nature, the action of the venom not only would facilitate subduing the prey, but recovering it if it escaped.
From January 1979 through March 1988, our regional poison center, located many hundreds of miles from the nearest coastal salt water, documented 23 cases of envenomation by "Lionfish" (members of genus Pterois). All cases involved specimens which were maintained in the homes of amateur aquarists. A study of patient epidemiology showed the following: patient's sex 91.3% male, 8.7% female; patients ages ranged from 17 to 50 years with an average age for males of 29.8 years and 35 years for females; the site of the envenomation accident was always in the home; the only part of the body envenomated was the hand or finger; and all of the patients were symptomatic. Symptoms noted included sharp pain, swelling, redness, bleeding, nausea, numbness, joint pain, anxiety, headache, disorientation, and dizziness. One patient had a complication of cellulitis. Treatment provided included immersion of the effected area in hot water at 40 C for 60 to 90 min, analgesics, tetanus toxoid, and antibiotics. There were no deaths noted and treatment proved effective in all cases. This paper also discusses the natural history, clinical effects, and current treatment for envenomations from these beautiful but dangerous venomous fish, which can cause poisoning exposures that are likely to be encountered by poison centers anywhere in the world.
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As more people travel to the oceans for sport diving and other marine related activities, the incidence of marine envenomations has risen. This article is designed to give the emergency physician an overview of varying marine envenomations, their clinical presentation, and recommended treatment. Part 1 of this article addresses general wound management and vertebrate envenomations. Part 2 will concentrate on invertebrate envenomations.
As man takes increasing advantage of the waters of the world for recreational, commercial and scientific purposes, the hazards of human contact with inhabitants must be appreciated. Many invertebrate and vertebrate animal species have developed natural defense mechanisms, some of which involve envenomation, with a few species posing the threat of serious injury or death. This paper discusses the more common and more serious marine envenomations encountered worldwide, including toxicology of the associated venoms and a discussion of current treatment recommendations.
The expansion of marine fisheries into tropical waters, which is now occurring, will increase the risks of widespread poisonings because of the abundance of biotoxins in warm-water organisms. However, toxic marine organisms are not only a health hazard but also a possible source of new pharmaceutical products.A classification of marine intoxicants is given in this paper with special reference to the oral biotoxins which will be of primary concern in the expansion of warm-water fisheries. The biotoxins are both invertebrate (e.g., molluscs, arthropods) and vertebrate (mostly fishes) in origin. Biotoxications of vertebrate origin may be caused by the muscles, the gonads or the blood of certain fishes or by special poison glands not equipped with traumagenic devices. (Venomous fishes, having poison glands and traumagenic spines, etc., are of no direct concern as oral intoxicants.)The ichthyosarcotoxic fishes, in which the flesh is poisonous, appear to constitute the most significant health hazard. A list of fishes reported as causing ciguatera poisoning (one of the most serious and widespread forms of ichthyosarcotoxism) is included in this paper.
Incidence of snake bites, scorpion and venomous fish stings are established in French Guiana (a South American French territory). About 75 snake bites per 100,000 population, 90 scorpion stings and 125 fish stings are recorded in a year by official sanitary services. Authors give geographical and ecological variations, and risks, of venomous animal accidents. Severity of snake bites and medical cost are emphasized. Necrosis and/or bleedings follow 5% of cases and hospital lethality reaches 2.2%.
Stingose, an aqueous solution of 20% aluminum sulphate and 1.1% surfactant, has been developed as a wide-acting and effective first-aid treatment designed to counteract the venoms of insects, bees, marine stingers and stinging plants. Rapid application to prevent further systemic abosorption is necessary. As virtually all characterized insect, marine, and spiked-fish venoms contain a protein component, it is proposed that the Al3+ ion in Stingose interacts with proteins and long-chain polysaccharide components to denature and inactivate the venoms. It is also proposed that an osmotic fluid movement towards the high ionic strength solution could account for part of the action of the product. In an extensive field trial which involved 1003 cases, the over-all success of first-aid treatment with Stingose in 997 cases and partial success in six cases was extremely high. Further work is to be undertaken to study the range of envenomations against which Stingose is active.
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