A Most Unfortunate Encounter with a Cubozoa Cubomedusae

Sept 15, 2017

It is HOT, living at 12 degrees N of the equator during September. We are only 120 miles away, which would be 1.5-2 hours by car, or 24 hours by sailboat, if one could get there as the bird flies.  The sun is intense, and if there is little to no wind, then there is not much one can do for relief. The only “natural” way we can cool off is by jumping in the water.  We will stay in there until we finally get goosebumps and actually feel chilled.  This is no great burden, given the abundance of things to look at 20 feet below through the clear water.

After a long day of driving around the North side of the island, in a vehicle without a/c, through dusty, arid terrain, it only was natural to jump in the water as soon as we returned to Uno Mas. The interior of the boat was pushing 100 degrees. The sun was almost down, so what a beautiful way to observe a sunset.  Unfortunately, a Box Jellyfish decided to do the same thing, at the exact same time, and in the exact same location as Angie.  It must have been a bit miffed that someone was poaching on its sunset observation. At first, she thought it was just another jellyfish particle, floating in the water, after the rest of it had been eaten by a fish.  It is pretty common to feel little stings, here and there, that always leave little welts. One gets used to it unless you get a hit on the face.  Those are rather annoying.

Well, Angie’s original assumption of a little left over fish dinner was wrong.  The first “hit” on the shoulder didn’t hurt just a tad, but a WHOLE LOT more. Then there was another whopper of an impact on her hip, and finally  a less violent one on her ankle, all down the left side of her body.  Holy mackerel did it hurt.   So, of course, she had to look around and see WHAT was going on.  A short distance away, a large box jellyfish was enjoying the sunset view, about a foot below the water.  That was not good and the pain was excruciating, so she hightailed it back to the boat, trying to remember what she had read about the box jellies and how lethal they could be. Bonaire has its own bred, so that was what the assumption was as to the culprit.

Bonaire Box Jellyfish Photo from "Reef Creatures" Identification Books
Bonaire Box Jellyfish
Photo from “Reef Creature Identification” Book Below

After getting the snorkeling gear off, and yelling for Mark, the process began.  Everyone knows, the first thing you do is douse it with vinegar, straight up, and NOT pee on it, which everyone thinks you are supposed to do. (At least guys do.  They are always willing to do that for the sake of saving someone’s life.)  Fortunately, Angie cleans with vinegar and keeps a spray bottle handy.  Mark emptied the diluted concoction out and filled it with 100%.  The way the areas were burning and stinging, they were going to need full strength.   While Angie constantly applied it to help “repress unfired stinging nemocysts” (from the Reef Creature Identification Book),  Mark pulled out the onboard medical book geared towards a cruising lifestyle.  Angie remembered something in there about jellyfish stings.  In there, they suggested repressing the nemocysts with rubbing alcohol, then shaving the areas to lop off any left over particles, and then applying lidocaine.   Angie cleans with rubbing alcohol as well, so Mark once again, dumped the diluted solution and refilled with full strength.  The vinegar did not seem to help stop anything, so there was high hopes that the alcohol would start some kind of relief.  After a half an hour of constant dousing,  nothing changed, so we decided to shave the areas.  Nope, nothing changed after that either, so it was back to dousing with alternates of vinegar and alcohol.

After Angie got shaved, she started feeling jellyfish hits on the bottoms of her feet, the palms of her hands, and in unmentionable areas.  She thought the shaving and subsequent rinse had left jellyfish bits that you could not see on the deck where we were standing and where she was sitting.  The secondary pains were just as potent, feeling like a thousand hot needles intermittently searing into you.  At least those pains came and went and were not constant like the initial ones.

After a while,  we tried using Unburn Gel for sunburns on the spots, since it was the only thing we could think of that had lidocaine.  Nope, that only offered relief the instant it was applied.  The hot pokers sprung back to life within seconds.

By this time, it was way past sundown. Angie had to get out of the wet swimsuit because it was putting a lot of pressure against her chest and was getting really uncomfortable.  The secondary “hits” kept “firing” and then new ones started inside her nose, and above her eyebrows.  She knew she didn’t pick her nose during the whole process, so Angie slowly realized the venom were “traveling” throughout her body on the inside and not from the outside.  Mark never got any type of sting from standing or kneeling on the deck where the washdown was happening.  Once the new “spikes” started on her tongue and at the back of her throat, we decided to get the Epipen in case her throat swelled shut.  We also decided at that point that Mark should call the local diver medical hotline from our satellite phone.  Having the hits traveling throughout her body was unnerving to Angie, and she thought it could possibly get serious.

The hotline guy was very helpful. He said the Bonaire Banded Box Jellyfish was actually less potent, so that was a good thing.  He also said that the venom would go throughout the nervous system, explaining all of the additional sensations.  However, after 2 hours, it should die down.  As long as Angie did not start feeling nauseous or have a tight feeling in her chest, then she should survive.  Well, the tight feeling had already happened, but wasn’t getting any worse. It could have been from trying to quell a panic attack.  If she started getting nauseous then we needed to get to the hospital quickly.  It would take some doing, but we could probably be there within 10 minutes if we had to walk from the dinghy dock, which was most likely. We do not see very many taxis running around the island. Mark checked to see what an ambulance would cost, just in case.

After about 3 hours of constant application of vinegar and alcohol, the secondary “hits”  subsided, so Angie thought that was a good sign that things were turning around.  However, the original impact points kept firing every few seconds throughout the night.   It was masochistic, but the only relief was to smack the areas that “fired.”  Thinking that was a stupid thing to be doing all night, Angie then started trying out all of the other topical creams and gels we had in our medical kits, thinking SOMETHING would have to help.  Every one did,  for just an instant, upon initial application. Nothing lasted longer than that.  Applying the alcohol also helped for just that initial contact as well.  This was better than smacking herself, at least.  Then,  trying to figure out how to get some sleep, she tried to keep pressure on all of the spots by laying on her side, with kitchen towels wrapped into balls to create pressure points.  Surprisingly, that helped for a bit and provided a marginal amount of relief.  The shoulder was difficult because the pain wrapped around the top and then down the side. The pain was not constant, but then the “firing” started again, every few seconds, to the point it would take her breath away.  Next, she tried soaking the towels in alcohol and maintain the constant pressure.  That helped for a bit as well.

When the intermittent hot pokers started up, yet again, Angie found that squeezing her fist would help stop and distract the pain at the shoulder at least.  After a while, she found a small nerf football that we keep handy (for plugging an unfortunate hole in the hull in an emergency) and used it to constantly squeeze.  This helped a bit with the shoulder zaps.  The hip pains eventually dissipated with the constant pressure and alcohol soaked towel, and the ankle hit eventually felt like any other jellyfish sting (burning and annoying).  She was finally able to get some sleep.

Upon waking,  the initial hit points felt like burns and only the shoulder would “fire” intermittently, but at  much less intensity.  It was bearable.

Upon hearing from the hotline that the Bonaire Box Jellyfish was less of a threat, the anxiety level decreased. It should not be lethal.  It didn’t dawn on Angie, until reading its description  for the umpteenth time, of being  2.5 inches long, and the tentacles being reddish brown and white, that we had identified the wrong assailant.  The body was close to 8-10 inches long, and the tentacles were transparent with pinkish dots on them, which could very well be seen as reddish brown, but the white parts on the tentacles definitely were not present.  What she really got entangled with was a Sea Wasp box jelly, a much more lethal cousin which carries enough venom to kill 60 men. One of the deadliest animals in world based on quantity of venom and speed of kill.

Sea Wasp Box Jellyfish Photo from "Reef Creatures" Identification Book
Sea Wasp Box Jellyfish
Photo from “Reef Creature Identification” Book Below

Angie thinks the already heavy antibiotics and allergy meds she is on for the sinus infection probably toned down the severity of the reaction, along with getting the vinegar and alcohol on it quickly.  We are now in the process of trying to locate a higher potency lidocaine topical gel in case we have another, and hopefully less memorable, incident.

Now, when she goes into the water, Angie is constantly checking the water line, looking for another jellyfish, which has taken away from her joy of observing what is happening below.  A few days later, she saw a very small Siphonophore-like jelly, only about 4 inches long, swimming by. It was regarded with much respect.  She also now wears t-shirts and yoga shorts, at least covering the main torso, much to the tan line’s dismay.  She cannot seem to get away from that tank top and shorts tan.

Angie's Bibles
Angie’s Bibles

Lessons Learned:  Know your enemy well, or at least know where to look in your reference books. “Googling” it would not have helped since we do not have internet at the boat. (Score: 1 –  Angie’s Book Collection, 0  – Internet).

Face your fears  (Jump back in the water, get back on that motorcycle, or climb up that mast).

Always look up and be aware of your surroundings (on land as well as in the water).

another sunset Bon 1

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