Feb 15, 2004 Table of Contents

Please note: This information was current at the time of publication. But medical information is always changing, and some information given here may be out of date. For regularly updated information on a variety of health topics, please visit familydoctor.org, the AAFP patient education Web site.

Information from Your Family Doctor

Sea Creature Injuries and Fish Poisoning

Am Fam Physician. 2004 Feb 15;69(4):893-894.

How do I treat jellyfish stings?

Take off any visible tentacles. Use gloves or a towel so that you do not get more stings. Jellyfish tentacles keep stinging even if they are not attached to the jellyfish and even if the jellyfish is dead. The tentacles are the long stringy parts that hang down under the jellyfish body.

Put salt water or vinegar on the area for 30 minutes or until the pain stops. Do not use fresh water. That will make the tentacles sting again and give you more pain. Ice packs are good for easing the pain.

See a doctor if the pain lasts for more than one hour, if you feel faint, or if you have trouble breathing.

How do I treat a sea urchin sting?

Soak the stinging area in hot water to ease the pain. Have a doctor see if the sea urchin's spine has to be surgically removed. Do not try to take the spine out by yourself. The spines break easily, and you are not likely to be able to remove all of the spines that are in your skin.

How do I treat a stingray injury?

Put direct pressure on the injury to control heavy bleeding. Call an ambulance. If there is only a little bleeding, soak the area in hot water to help ease the pain. Be sure to see a doctor for follow-up care. Your tetanus shot will have to be updated.

What is fish poisoning?

There are two kinds of fish poisoning.

  • Ciguatera (say this: seeg-wha-terra) poisoning happens when you eat reef fish that have eaten a poisonous food. This poison, a toxin, does not go away when the fish is cooked.

  • Scombroid poisoning can happen if a fish was not properly cooled after it was caught. A substance like histamine builds up in some fish when they get too warm. If you eat them, you react to the histamine that is released in your body.

Who gets fish poisoning?

Anyone who eats fish can get ciguatera or scombroid poisoning. Fish poisoning is more common in Hawaii, Florida, New York, Washington, and Connecticut.

How can I tell I have ciguatera or scombroid poisoning?

The symptoms of ciguatera poisoning are nausea, vomiting, diarrhea, dizziness, and numbness. You may notice a change in your ability to feel cold. You will think something feels hot when it really is cold.

The symptoms of scombroid poisoning are similar to other allergic reactions, such as flushing, nausea, vomiting, hives, and difficulty breathing.

There are no blood or lab tests for these poisonings.

How is fish poisoning treated?

Ciguatera poisoning is treated with medicines that help ease your symptoms. There is no medicine that will cure the poisoning. The symptoms go away over time.

Scombroid poisoning is treated like other allergic reactions with medicine that blocks the histamine in your blood. If you get scombroid poisoning, it does not mean you are allergic to fish.

How long can I expect to be sick?

The symptoms of ciguatera poisoning last for one to two weeks. How long they last depends on the amount of toxin you have in your body. The symptoms can come back any time you eat an affected fish.

The symptoms of scombroid poisoning last six to eight hours after you eat the toxin. The symptoms can come back any time you eat fish that has not been refrigerated properly.

How can I prevent fish poisoning?

To avoid ciguatera poisoning, don't eat the fish that often carry the ciguatera toxin. This includes amberjack, grouper, snapper, sturgeon, king mackerel, barracuda, and moray eel.

The poison is more concentrated in the internal organs, like the liver, so you should never eat them.

To avoid scombroid poisoning, don't eat any fish that has not been refrigerated properly.

Where can I get more information?

Your doctor.

E Medicine: Instant Access to the Minds of Medicine

Web site address: http://www.emedicine.com

Divers Alert Network

Web site address: http://www.diversalertnetwork.org

Telephone: 1-800-446-2671


This handout is provided to you by your family doctor and the American Academy of Family Physicians. Other health-related information is available from the AAFP online at http://familydoctor.org.

This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.

Copyright © 2004 by the American Academy of Family Physicians.
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