Box Jellyfish Sting : Symptoms, First Aid, Complication, And Treatment


Box Jellyfish Sting

Jellyfish Sting

Jellyfish species are capable of causing severe injury and death. Chironex fleckeri, or the Australian box jellyfish, is the most dangerous.

It can be as heavy as 4 pounds and have dozens of tentacles reaching up to 10 feet. Each tentacle is covered in button-like structures loaded with thousands upon thousands of poisonous “darts.”

Box jellyfish is the only one able to see with 24 eyes. They are skilled predators because they prefer to swim over drifting.

They are in tropical waters near Australia, Thailand, and the Philippines. However, also near Hawaii, Florida, and Puerto Rico. Experts believe that box jellyfish can be responsible for as many as 40 deaths per year.

Box Jellyfish Sting Symptoms

Box jellyfish stings can be extremely painful. Although some symptoms may appear for hours or weeks, the most serious ones are immediate. These include:

  • The skin is prone to red whip-shaped lesions called “wheels”.
  • Burning and blistering
  • Grave abdominal pain
  • Chest pain
  • Shock
  • Chills or fever
  • Muscle spasms
  • Sweating
  • Nausea or vomiting

If the sting proves fatal, it is often due to cardiac arrest. Experts believe the poison directly affects the heart.

First aid

Box jellyfish sting symptoms and first aid

Do not touch or compress the sting. Avoid rinsing the area in freshwater, alcohol, or with ice packs. These substances can make the sting more severe and cause to release of more toxicities.

Contrary to common belief, you shouldn’t use urine to treat box jellyfish stings. It can make the symptoms worse, similar to vinegar.

Box jellyfish Sting Complications

Box jellyfish stings may cause immediate or delayed reactions that can last several days or weeks. These complications can include:

Irukandji Syndrome

Box jellyfish sting complications

The sting of Carukia Barnes primarily causes this condition. Still, it can also be due to other box jellyfish from the same Carybdea family, such as Alaina Mordens, Malo maxima, and Carybdea alata. It can speed up the heartbeat and raise blood pressure.

Uncontrolled bleeding, fluid buildup in the lungs, and even heart failure can all result from a sudden, sometimes extreme, rise in blood pressure. You may also experience a local reaction if you are stung by Carukia or similar jellyfish. It can take up to 20-30 minutes for the more severe symptoms to appear in Irukandji Syndrome.

The sting of Chironex is not the cause of Irukandji Syndrome. Chironex fleckeri and other jellyfish can cause heart rhythm problems and eventually death. They may also result in excessive potassium production and never-ending muscular spasms. If severe, the lethal reaction is often immediate.

Delayed Allergic Reaction

Some stings may cause an allergic reaction lasting up to a week. It can lead to a rash, blisters, or other skin irritations. You can get topical and oral treatment from your healthcare provider to treat the condition.



The tentacles of box jellyfish can cause permanent scarring. These include keloids which raise scar tissue areas.

The skin may change in color or be lichenified, which is when the skin becomes thicker and more leathery. Some areas may even die.


You can reduce the chances of getting stung by box jellyfishes by taking these steps:

  • Avoid areas where jellyfish are prevalent.
  • Wear a waterproof swimsuit and waterproof shoes.
  • Watch out for jellyfish in your area. Sometimes they can swarm.
  • Water shoes recommended for walking on the shoreline or near the water.
  • Do not touch jellyfish present on the shore. The tentacles can still be deadly.
  • Swimming near a lifeguard is advisable as they can provide first aid and dispatch an
    ambulance if needed.

Box Jellyfish Sting Treatment

A box jellyfish sting requires prompt medical attention. Immediately come out of the water and get first aid and other lifesaving measures.

Next, follow these steps:

  1. Get out of the water, or help the person affected to get out of it.
  2. Rinse the acid-burned region for at least 30 seconds. Vinegar is a common choice for toxicologists in North America. It is better first to use acetic acid in the Indo-Pacific region as vinegar can worsen the symptoms.
  3. Use tweezers to remove any nematocysts or tentacles from your body.
  4. Contact emergency medical personnel. You can monitor pulse and observe breathing patterns. If the person stops breathing or shows signs of cardiac arrest, you can start CPR. You can continue to resuscitate the patient or use other equipment to administer oxygen.

After being treated by medical professionals, the victim of the box jellyfish bite may be given pain medication and antivenom. The patient will continue treatment for breathing problems, including intubation and ventilator.

Box Jellyfish Sting Antivenom

Box jellyfish sting antivenom and treatment

Since the 1970s, an intravenous antivenom has been available for Chironex-fleckeri stings. However, its effectiveness has not yet been determined.

Research has shown that magnesium sulfate can add to venom during administration. Doctors may even use heat to relieve the sting. Researchers have also discovered a medication that blocks venom and reduces pain and scarring.

Give the medicine within 15 minutes of the first sting. It is currently only available as an injectable drug.

Is a Box Jellyfish Sting Deadly?


According to the Emergency Care Institute of New South Wales, the sting can be fatal if it affects more than 10% of the skin, particularly in children. The sting can lead to cardiac arrest in a few minutes. It is not known how many deaths result from a box jellyfish bite.

One study estimates that there are tens of thousands of deaths each year


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