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Marine antivenoms.

Bart J Currie1

  • 1Tropical Medicine and International Health Unit, Menzies School of Health Research, Darwin, Northern Territory, Australia. bart@menzies.edu.au

Journal of Toxicology. Clinical Toxicology
|June 17, 2003
PubMed
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Marine animal venoms pose significant risks, with limited antivenoms available. Rapid administration of antivenom for box jellyfish (Chironex fleckeri) stings may be crucial for survival due to cardiotoxicity.

Area of Science:

  • Marine toxicology
  • Venomous marine animals
  • Antivenom research

Background:

  • Marine animals exhibit diverse and complex venoms, leading to fatalities from sea snakes, jellyfish, venomous fish, cone snails, and blue-ringed octopus.
  • Ingestion of toxins from shellfish, pufferfish (Fugu), and ciguatoxin-containing fish can also be fatal.
  • Antivenoms are scarce, generally only available for specific sea snakes, the Australian box jellyfish (Chironex fleckeri), and stonefish.

Purpose of the Study:

  • To review the challenges in characterizing marine animal toxins and the efficacy of available antivenoms.
  • To highlight the critical need for early antivenom administration in cases of rapid-onset cardiotoxicity, such as from Chironex fleckeri stings.
  • To reassess the administration protocols for stonefish antivenom and its potential efficacy against other venomous fish stings.

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Main Methods:

  • Literature review of marine envenomation cases and antivenom efficacy studies.
  • Analysis of clinical presentations and fatality timelines associated with marine stings.
  • Examination of anecdotal evidence and scientific studies on antivenom effectiveness.

Main Results:

  • Characterizing toxins from Chironex fleckeri venom remains challenging, with conflicting studies on antivenom efficacy.
  • Most Chironex fleckeri stings cause localized pain, but fatalities exhibit rapid cardiotoxicity (5-20 minutes).
  • Stonefish antivenom is anecdotally effective for pain relief, but its efficacy against other venomous fish stings and optimal administration route require further investigation.

Conclusions:

  • Early and potentially high-dose antivenom administration is critical for life-saving intervention in severe Chironex fleckeri envenomation.
  • Further research is needed to confirm the efficacy of stonefish antivenom for various venomous fish stings and to optimize its delivery.
  • The limited availability and uncertain efficacy of antivenoms underscore the need for advancements in marine toxicology and treatment strategies.