Vinegar makes box jellyfish stings worse

Original story by Brendan Trembath, ABC News

Box jellyfish stings, which can be deadly, could be made worse by applying vinegar, Australian researchers have found.

Pouring vinegar on the welts caused by the sting of the jellyfish has been the recommended first aid treatment for decades.

But researchers from James Cook University and Cairns hospital in far north Queensland have found that vinegar promotes the discharge of box jellyfish venom.

Box jellyfish are the most venomous creatures on the planet, and Associate Professor Jamie Seymour from the Australian Institute of Tropical Health and Medicine at James Cook University says she is in awe of them.

“No venomous animal on the planet kills quicker than this thing, so they are reasonably impressive, from that point of view,” he said.

People badly stung by box jellyfish have died within minutes.

The Australian Resuscitation Council (ARC) is a voluntary coordinating body that represents all major groups involved in the teaching and practice of resuscitation as part of first aid treatment.

The ARC recommends treating stings with vinegar to inhibit the injection of venom.

Meanwhile, the Queensland Poisons Information Centre advises on its website says to not use vinegar to treat stings from Bluebottles (Physalia sp), however does currently say to use vinegar on box jellyfish (Chironex fleckeri) and Irukandji stings (Carukia barnesi jellyfish).

However, Associate Professor Seymour says the research has now called that advice into question.

“You can increase the venom load in your victim by 50 per cent,” he said.

“That’s a big amount, and that’s enough to make the difference, we think, between someone surviving and somebody dying.”

He says first responders would be better off relying on the fundamentals of first aid.

“If the person’s not breathing on the beach, breathe for them,” he said.

“Otherwise leave them alone and they’ll probably come out of it.”

He says organisations that deal will this sort of emergency medicine, such as the ARC, now need to look at the research findings.

“That’s the interesting one – we now have evidence that shows that vinegar increases the venom load in the victim,” he said.

“There is no evidence that shows the application of vinegar decreases the amount of venom in the victim.

“What now is up to the ARC, is for them to review the data that we’ve published, which has already obviously been peer reviewed, and for them to make a decision as to what should go on.

“We would expect that the protocols would change.”

[Stinging balls] that have already fired off – and it might only be 20 or 30 per cent – you apply vinegar to them and it increases the venom coming out of those by 60 per cent, and that’s the kicker.

Associate Professor Jamie Seymour

However, he says it is not known how long that might take.

The first documented case of using vinegar to treat box jellyfish stings was in the Philippines just over a century ago.

“Vinegar was first used, from what I can gather, in 1908 in Manilla where a then-medical officer in the army saw a couple of kids jump off a wharf, they got stung, and he put vinegar on them,” Associate Professor Seymour said.

“We have absolutely no idea why, but he did.”

He says in the 1980s researchers investigated what vinegar did and found evidence of its effectiveness.

“What those studies with vinegar showed was that if you apply vinegar to those tentacles when they’re on the body, that those stinging balls that haven’t gone off become completely and totally inactive, which is really good,” he said.

“The problem was nobody looked at what the vinegar did to the ones that have already fired off.

“That’s what our research has shown: that of the ones that have already fired off – and it might only be 20 or 30 per cent – you apply vinegar to them and it increases the venom coming out of those by 60 per cent, and that’s the kicker.”

The research has been published in the journal of Diving and Hyperbaric Medicine.