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Fatal envenomation by jellyfish causing Irukandji syndrome

Peter J Fenner and John C Hadok
Med J Aust 2002; 177 (7): 362-363.

The Irukandji syndrome was named in 1952.1 It is the set of severe systemic symptoms that occur some 30 minutes after some jellyfish stings.2,3 The only species so far identified as causing the syndrome is Carukia barnesi, a small carybdeid box jellyfish occurring in the Cairns area (latitude, 16o44'S; longitude, 145o40'E), north Queensland.3 The bell of this tiny jellyfish is just 12 mm in diameter in mature specimens. The original description of the Irukandji syndrome is (paraphrased): the severe systemic symptoms developing 30 minutes or so after a mild skin sting from Carukia barnesi. Severe low back pain; excruciating muscle cramps in all four limbs, the abdomen and chest; sweating, anxiety, restlessness, nausea, vomiting, headache and palpitations occur.2,3

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  • Peter J Fenner1
  • John C Hadok2

  • 1 PO Box 3080, North Mackay, QLD.
  • 2 Emergency Department, Mackay Base Hospital, Mackay, QLD.

Correspondence: pjfenner@ozemail.com.au

Acknowledgements: 

We thank Dr M Lewin and Dr Shiranth de Silva for providing clinical information about the patient, and Dr Simone Harrison for help in preparing this article. Research to date on Irukandji has been funded by Australian Rotary Health Foundation, Lions International, CRC Reef Research and the Thyne-Reid Education Trust No.1.

  • 1. Flecker H. "Irukandji" sting to north Queensland bathers without production of wheals but with severe general symptoms. Med J Aust 1952; 1: 89-91.
  • 2. Barnes JH. Cause and effect in Irukandji stingings. Med J Aust 1964; 1: 897-904.
  • 3. Fenner PJ, Williamson J, Callanan VI, Audley I. Further understanding of, and a new treatment for, "Irukandji" (Carukia barnesi) stings. Med J Aust 1986; 145: 569-574.
  • 4. Fenner P, Williamson J, Burnett J, et al. The "Irukandji syndrome" and acute pulmonary oedema. Med J Aust 1988; 149: 150-156.
  • 5. Fenner PJ, Harrison SL. Irukandji and Chironex fleckeri jellyfish envenomation in tropical Australia. Wilderness Environ Med 2000; 11: 233-240.
  • 6. Roberts G. Tiny harbinger of death lurking in our seas. Sydney Morning Herald April 20, 2002: 1.
  • 7. Fenner PJ, Carney I. The Irukandji syndrome: a devastating syndrome caused by a north Australian jellyfish. Aust Fam Phys 1999; 28: 1131-1137.
  • 8. Australian Resuscitation Council. Envenomation -- jellyfish stings. ARC policy 8.9.6. Melbourne: Royal College of Surgeons, March 2001.
  • 9. Tibballs J, Hawdon G, Winkel KD, et al. The in vivo cardiovascular effects of Irukandji (Carukia barnesi) venom [abstract]. In: Proceedings of the International Society of Toxinology XIIIth World Congress on Animal, Plant and Microbial Toxins. September 2000, Paris France. The Society, 2000: 276.

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