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Irukandji Syndrome Case Series From Australia's Tropical Northern Territory

Nickson, C., Waugh, E., Jacups, Susan P. and Currie, Bart J. (2009). Irukandji Syndrome Case Series From Australia's Tropical Northern Territory. Annals of Emergency Medicine,54(3):395-403.

Document type: Journal Article

IRMA ID 79264104xPUB22
Title Irukandji Syndrome Case Series From Australia's Tropical Northern Territory
Author Nickson, C.
Waugh, E.
Jacups, Susan P.
Currie, Bart J.
Journal Name Annals of Emergency Medicine
Publication Date 2009
Volume Number 54
Issue Number 3
ISSN 1097-6760   (check CDU catalogue open catalogue search in new window)
Start Page 395
End Page 403
Total Pages 9
Place of Publication US
Publisher Mosby
HERDC Category C1 - Journal Article (DEST)
Abstract Study objective
We describe Irukandji syndrome (a painful hypercatecholaminergic condition caused by jellyfish envenoming) in Australia's Northern Territory.

We collected prospectively a standardized data set on patients presenting to health facilities in the Northern Territory. Additional cases were identified retrospectively. Data collected included demographic, geographic, seasonal, and environmental features, as well as sting details, clinical manifestations, investigations, management, and outcomes.

From 1990 to 2007, Irukandji syndrome affected 87 people. Age ranged from 1 to 51 years (64% male victims; 41% children [63% indigenous]). Activities associated with stings included snorkeling or scuba diving (35%) and swimming (29%). Stings commonly occurred in water greater than 2 m deep (63%), with fine weather (73%) and still or light breeze (70%). Seasonal variation was bimodal; peaks in May and October corresponded to prevailing offshore winds in the Darwin and Gove areas, respectively. Pain was severe (65%), with rapid onset (<30 minutes in 79%). Sting lesions (visible in 63%) were mild, and nematocysts (detected in 7 cases) had variable morphology. Systemic features were common, including hypertension and ECG abnormalities. Severe complications included troponin-level increases (2 cases) and cardiomyopathy with ventricular tachycardia (1 case), but no fatalities. Management included vinegar as first aid (66%), parenteral opioids (70%) (range 2 to 82.5 mg morphine equivalents in adults), and magnesium sulfate (3 cases). Hospital admission (49%) and aeromedical retrieval (16%) were commonplace.

Irukandji syndrome in the Northern Territory was clinically consistent with previous studies but had distinct seasonal, geographic, and environmental features. Indigenous children in remote coastal communities are at risk, and there is room for improvement in prevention and management.

Keywords Irukandji
Northern Territory
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Created: Mon, 01 Mar 2010, 23:38:31 CST