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  1. Cnidarians (Jellyfish, Corals and Anemones)
  2. Biomedical Database
  3. Clinical entry: Carukia sp. (Irukanji syndrome)

Clinic: Carukia sp. (Irukanji syndrome)

Examine for venom effects

Autopharmacological and allergic effects

  • Nausea, vomiting, abdominal pain, diarrhoea,
  • urtitcaria, angio-oedema,
  • bronchospasm,
  • arterial hypotension, shock (cause: systemic allergic reactions).

Local Effects

  • Minimal local erythema,“goose pimples” (see 'Morphological characteristics'),

  • Transient small blisters, localised sweating, local pain may be so mild that the victim does not initially notice it.

Neurological effects

  • Cramping abdominal pain, back pain, limb pain (nature of the pain: in waves, pain gradually increasing to a maximum that lasts up to 15 min, after a break, the cycle re-commences),
  • Vomiting
  • Piloerection, priapism.
  • Tachycardia, cardiac arrhythmias, arterial hypertension (diastolic 130–140 mmHg!), 
  • with consecutive headache, intracranial bleeding (very rarely), pulmonary oedema, peripheral cyanosis (peripheral vasoconstriction), oliguria (decreased blood supply to the kidneys), fear of death. Cardiac arrest.

Time course

  • Signs and symptoms appearing with a delay of 5 to 120 minutes (average 25 to 40 minutes).
  • Persisting for up to 24 h to 72 h or more.

Species-specific envenoming pattern

The assessment of the envenoming pattern is based on the data from publication in which the identification of the snakes is clearly specified and in accordance with accepted criteria.

  

Auto-
pharma-
cological
and
allergic
effects1

 Local effects2 Autonomic and neuromuscular
nervous system effects3		 Cardiac effects4
Carukia barnesiA       ? 
Other species carybdeid jellyfishthat
may cause Irukandji syndromeB		       ? 
for comparison
Chironex sp.      ?  
Chiropsalmus sp.      ?  
for comparison
Physalia physalis        
Physalia utriculus        

Carukia sp. and other carybdeid jellyfish

The 'Irukanji syndrome'

AThe 'Irukandji syndrome' was first defined in patients envenomned by Carukia barnesi.

BOther carybdeid jellyfish species may also cause 'Irukandji syndrome' (Gershwin et al. 2013: “Table 1.2 Summary of ecology and syndrome characteristics of species known or believed to cause Irukandji syndrome”; Tibballs et al. 2012; Debate: Little et al. 2006, Gershwin 2006, Fenner 2006):
Alatina mordens, Carukia shinju, Carybdea alata, Carybdea rastonii, Carybdea xaymacana, Malo maxima, Malo kingi, Alatina mordens, Gerongia rifkinae, and Morbakka fenneri

1Autopharmacological and allergic effects

Anaphylactic reactions, in particular anaphylactic shock, may be difficult to distinguish in differential diagnostic terms from systemic toxic effects (Tibballs 2006; Tibballs et al. 2011). 

2Local effects

Minimal local erythema,“goose pimples”, possibly transient small blisters, localised sweating, local pain may be so mild that the victim does not initially notice the sting or underestimates it (Barnes 1964, Fenner et al. 1986a, 1986b, 1988, Flecker 1952). 

3Autonomic and neuromuscular nervous system effects

Clinical features of the syndrome resemble those of an adrenal medullary or catecholamine excess, such as seen in cases of phaeochromocytoma. 
Neuromuscular and autonomic nervous system dysfunction (Burnett et al. 1998, Winkel et al. 2005, Winter et al. 2008).
“The pharmacological basis of the Irukandji syndrome has long been the subject of speculation. Some clinical features of the syndrome resemble those of an adrenal medullary or catecholamine excess, such as seen in cases of phaeochromocytoma and scorpion or funnel-web spider envenomation.
Irukandji‑associated muscle pain and cramps result from combined autonomic (catecholamine‑mediated), neurotoxic (ion‑channel mediated), and possibly direct muscular and inflammatory mechanisms, rather than a single isolated pathway” (Winkel et al. 2005).
Findings in mice are consistent with the hypotheses of a toxin induced stress cardiomyopathy from sustained catecholaminergic activity (Seymour et al. 2020)
Signs and symptoms appearing with a delay of 5 to 120 minutes (average 25 to 40 minutes) (Carrette et al. 2012): cramping abdominal pain, back pain, limb pain (nature of the pain: in waves, pain gradually increasing to a maximum that lasts up to 15 min, after a break, the cycle re-commences); vomiting; tachycardia, cardiac arrhythmias, arterial hypertension (diastolic 130–140 mmHg), pulmonary oedema, headache, piloerection, peripheral cyanosis (peripheral vasoconstriction), oliguria (decreased blood supply to the kidneys), fear of death.
These symptoms of envenoming can persist for up to 24 h to 72 h and more (until complete resolution) (Carette et al. 2012).
Cardiovascular effects from sustained catecholaminergic activity
(Burnett et al. 1998,Tiong 2009, Winkel et al. 2005, Winter et al. 2008)

4Cardiac effects

Cardiac and pulmonary effects are most likely predominately secondary to autonomic nervous system effects (see neurological effects above).

Case fatality rate

One definite death reported (Carrette et al. 2012).

Species-specific publications: see ‘References’ at the end of the file. 

Clinical management

See also Clinical Management: cnidarians

for advice on diagnosis (clinical, laboratory) and treatment (supportive).

First Aid Measures for Jellyfish stings

The Cochrane review of 2023 came to the following conclusion (McGee et al. 2023):

“For people with symptoms and signs of jellyfish stings, and their first responders or treating clinicians, treatment will depend on the species of jellyfish, as the stings from different species produce symptoms of varying severity. However, we cannot be certain which is the best treatment for any species of jellyfish. Although our evidence was very uncertain, the data from the included studies evaluating heat application after non-box jellyfish stings in Australia and Hawaii are consistent with the ARC 2010 guideline, which suggests starting treatment with heat after stings in non-tropical Australia. We have found no evidence to refute heat application for non-box jellyfish stings in non-tropical Australia. For box jellyfish envenomation, the evidence is more limited, but both the ARC 2010 and ILSF 2000 guidelines recommend the application of vinegar to inactivate the nematocyst. Our review did not find sufficient evidence to support these recommendations, but the recommendations are consistent with evidence from in vitro studies (Yanagihara 2017)”. 

The review of Cunha et al. (2022) came by and large to the same conclusions: The first aid and treatment recommendation are based on individual cases and cases series and expert opinion.
Pek et al. 2025 conclude in their systematic review “There were very few studies and a significant risk of bias and heterogeneity, leading to very low-quality evidence on first aid treatment for jellyfish stings.”
Yanagihara et al. (2025) published additional experimental observations.

The current uncertainty of recommendations is also reflected in the accompanying document ‘Research on Jellyfish Stings’ of the 2025 version of the ANZCOR Guidelines ‘Guideline 9.4.5 - First Aid Management of Marine Envenomation’

The ANZCOR Guidelines emphasize:
“The most important part of first aid for a potentially fatal jellyfish sting is to watch for cardiac arrest, treat with CPR (Refer to ANZCOR Guideline 8) if this occurs, and expedite transfer to definitive care including antivenom.”

Due to the high regional diversity of jellyfish, the unpredictable dynamics caused by global warming and the uncertainty of the evidence base for the various recommendations, we refer to regional/national guidelines. We recommend to follow-up developments of the evidence carefully.

systemic supportive treatment

A general understanding of emergency medicine is required, or can be found in emergency medicine guidelines, e.g. ABCDE approach, WHO-ICRC Basic Emergency Care.

Obey Carukia sp. and other carybdeid jellyfish (Irukanji syndrome) - specific features

see 'Species-specific envenoming pattern above'. 

Key issues

Laboratory and physical investigations

  • Skin scrapings to confirm the culprit (Huynh et al. 2003). Scrapings are not recommended outside of a specific research project with appropriate patient consent (Government of Western Australian Country Health Service: Irukandji Syndrome Management Guideline)
  • Cardiac enzymes, Troponin
  • ECG (Tachycardia, arrhythmia; T-wave inversion and ST segment depression)
  • Chest-X-ray (pulmonary oedema)
  • Echocardiogram (cardiomyopathy)
  • CT brain (intra-cranial haemorrhage secondary to the sudden rise in blood pressure)

Supportive treatment is lifesaving

Cardiocascular failure 

  • Cardiovascular management

ABCDE-approch is lifesaving as supportive treatment. 

Respiratory failure

  • Airway management
  • Breathing: Oxygen ⇨ assisted ventilation ⇨ mechanical ventilation

ABCDE-approch is lifesaving as supportive treatment.

Current treatment shedule for the 'Irukanji syndrome'.

Note: 
The evidence base for treating "Irukandji syndrome" is largely anecdotal. It was developed in Australia and employed for the treatment of a number of patients.

“Clinical management includes parenteral analgesia, antihypertensive therapy, oxygen and mechanical ventilation.” (Tibballs et al. 2012)

Pain

Opiates
It is necessary to make provision for the treatment of adverse reactions (respiratory depression) (Fenner et al. 1986 a,b, 1988, Little and Mulcahy 1998).

See Government of Western Australian Country Health Service: Irukandji Syndrome Management Guideline.

Clonidine
“Judicious dosing of clonidine can safely and effectively reduce opioid requirements.” (Isman et al. 2022; Little and Somerville 2016).
See Government of Western Australian Country Health Service: Irukandji Syndrome Management Guideline.

Magnesium

“Our study did not demonstrate a benefit in the use of magnesium in the treatment of Irukandji syndrome. As such the current use of magnesium needs to be reconsidered until there is good evidence to support its use.“ (McCullagh et al. 2012, Rathbone et al. 2013,
“There is no clear evidence to support the use or recommend against the use of MgSO4 in IS. The reporting of recrudescence of symptoms with reduction of dose does suggest a dose response relationship. A multi-agency RCT using standardised diagnostic definitions and treatment regimens is needed to establish whether MgSO4 has a role in managing this debilitating syndrome“ (Rathborne et al. 2017).
See Government of Western Australian Country Health Service: Irukandji Syndrome Management Guideline.

Arterial hypertension
Phentolamine (Fenner et al. 1986 a,b, 1988,Martin and Audley 1990).
Note: Phentolamine has been used, but may not be available in emergency departments. An agent with a shorter half-life may be preferable (glyceryl trinitrate) given the potential for cardiovascular collapse. Caution should be exercised to avoid life-threatening hypotension as cases of echocardiographically proven cardiac dysfuncton have occured (Bailey et al. 2003).
See Government of Western Australian Country Health Service: Irukandji Syndrome Management Guideline.

Pulmonary oedema
In the usual manner with a loop diuretic (furosemide) i.v., morphine i.v. and sublingual nitrate. However, it must be remembered that there may be a poor response (see above, 'Neurological effects'). In that case endotracheal intubation and artificial respiration (IPPV) will be necessary (Bailey et al. 2003, Fenner et al. 1986 a,b, 1988).
See Government of Western Australian Country Health Service: Irukandji Syndrome Management Guideline

Specific treatment (antivenoms)

No antivenom available.
See Government of Western Australian Country Health Service: Irukandji Syndrome Management Guideline. 

References

Reviews

  • D'Ambra I, Lauritano C. A Review of Toxins from Cnidaria. Mar Drugs. 2020 Oct 6;18(10):507. PMID: 33036158; PMCID: PMC7600780. https://doi.org/10.3390/md18100507 

  • Carrette TJ, Underwood AH, Seymour JE. Irukandji syndrome: a widely misunderstood and poorly researched tropical marine envenoming. Diving Hyperb Med. 2012 Dec;42(4):214-23. PMID: 23258458.

  • Cegolon L, Heymann WC, Lange JH, Mastrangelo G. Jellyfish stings and their management: a review. Mar Drugs. 2013 Feb 22;11(2):523-50. PMID: 23434796; PMCID: PMC3640396. https://doi.org/10.3390/md11020523

  • Cunha SA, Dinis-Oliveira RJ. Raising Awareness on the Clinical and Forensic Aspects of Jellyfish Stings: A Worldwide Increasing Threat. Int J Environ Res Public Health. 2022 Jul 10;19(14):8430. PMID: 35886286; PMCID: PMC9324653. https://doi.org/10.3390/ijerph19148430

  • McGee RG, Webster AC, Lewis SR, Welsford M. Interventions for the symptoms and signs resulting from jellyfish stings. Cochrane Database Syst Rev. 2023 Jun 5;6(6):CD009688. PMID: 37272501; PMCID: PMC10240560. https://doi.org/10.1002/14651858.CD009688.pub3 

  • Pek JH, Lim SH, Ong GY, Djarv T, Douma M, Welsford M, Charlton NP. First Aid Treatment of Jellyfish Stings: A Systematic Review. Cureus. 2025 May 17;17(5):e84289. PMID: 40525026; PMCID: PMC12169498. https://doi.org/10.7759/cureus.84289 

  • Reis MB, Zoccal KF, Gardinassi LG, Faccioli LH. Scorpion envenomation and inflammation: Beyond neurotoxic effects. Toxicon. 2019 Sep;167:174-179. Epub 2019 Jun 20. PMID: 31228480. https://doi.org/10.1016/j.toxicon.2019.06.219 

  • Ryan RYM, Seymour J, Loukas A, Lopez JA, Ikonomopoulou MP, Miles JJ. Immunological Responses to Envenomation. Front Immunol. 2021 May 10;12:661082. PMID: 34040609; PMCID: PMC8141633. https://doi.org/10.3389/fimmu.2021.661082

  • Tibbals J. Australian venomous jellyfish, envenomation syndromes, toxins and therapy. Toxicon. 2006 Dec 1;48(7):830-59. Epub 2006 Jul 15. PMID: 16928389. https://doi.org/10.1016/j.toxicon.2006.07.020

  • Tibballs J, Li R, Tibballs HA, Gershwin LA, Winkel KD. Australian carybdeid jellyfish causing "Irukandji syndrome". Toxicon. 2012 May;59(6):617-25. Epub 2012 Feb 14. PMID: 22361384. https://doi.org/10.1016/j.toxicon.2012.01.006

  • Tibballs J, Yanagihara AA, Turner HC, Winkel K. Immunological and toxinological responses to jellyfish stings. Inflamm Allergy Drug Targets. 2011 Oct;10(5):438-46. PMID: 21824077; PMCID: PMC3773479. https://doi.org/10.2174/187152811797200650
  • Ward NT, Darracq MA, Tomaszewski C, Clark RF. Evidence-based treatment of jellyfish stings in North America and Hawaii. Ann Emerg Med. 2012 Oct;60(4):399-414. Epub 2012 Jun 6. PMID: 22677532. https://doi.org/10.1016/j.annemergmed.2012.04.010

Original publications

Carukia barnesi

  • Bailey PM, Little M, Jelinek GA, Wilce JA. Jellyfish envenoming syndromes: unknown toxic mechanisms and unproven therapies. Med J Aust. 2003 Jan 6;178(1):34-7. doi: 10.5694/j.1326-5377.2003.tb05040.x. PMID: 12492389. https://doi.org/10.5694/j.1326-5377.2003.tb05040.x

  • BARNES JH. CAUSE AND EFFECT IN IRUKANDJI STINGINGS. Med J Aust. 1964 Jun 13;1:897-904. PMID: 14172390. https://doi.org/10.5694/j.1326-5377.1964.tb114424.x

  • Burnett JW, Weinrich D, Williamson JA, Fenner PJ, Lutz LL, Bloom DA.Autonomic neurotoxicity of jellyfish and marine animal venoms. Clin Auton Res. 1998 Apr;8(2):125-30. PMID: 9613803. https://doi.org/10.1007/bf02267823

  • Doshi D, Foëx BA, Nataly Y. BET 2: role of vinegar in Irukandji syndrome. Emerg Med J. 2015 Dec;32(12):970-1. PMID: 26598636. https://doi.org/10.1136/emermed-2014-204985.2 

  • Fenner, P., D. Rogers, J. Williamson (1986a) Box jellyfish antivenom and “Irukandji” stings.Med. J. Aust. 144: 665-666

  • Fenner, P. J., J. Williamson, V. I. Callanan, I. Audley (1986b) Further understanding of, and a new treatment for, “Irukandji” (Carukia barnesi) stings. Med. J. Aust. 145: 569-574 https://doi.org/10.5694/j.1326-5377.1986.tb139500.x

  • Fenner PJ, Williamson JA, Burnett JW, Colquhoun DM, Godfrey S, Gunawardane K, Murtha W. The "Irukandji syndrome" and acute pulmonary oedema. Med J Aust. 1988 Aug 1;149(3):150-6. PMID: 2899834. https://doi.org/10.5694/j.1326-5377.1988.tb120544.x

  • FLECKER H. Irukandji sting to North Queensland bathers without production of weals but with severe general symptoms. Med J Aust. 1952 Jul 19;2(3):89-91. PMID: 14956317. https://doi.org/10.5694/j.1326-5377.1952.tb100081.x 

  • Huynh TT, Seymour J, Pereira P, Mulcahy R, Cullen P, Carrette T, Little M. Severity of Irukandji syndrome and nematocyst identification from skin scrapings. Med J Aust. 2003 Jan 6;178(1):38-41. PMID: 12492390. https://doi.org/10.5694/j.1326-5377.2003.tb05041.x 

  • Isman A, Seymour J, Little M. Use of clonidine in the treatment of Irukandji syndrome: A 4-year retrospective cohort study on safety, efficacy and clinical utility. Emerg Med Australas. 2022 Aug;34(4):504-508. Epub 2022 May 31. PMID: 35638940. https://doi.org/10.1111/1742-6723.14017 

  • Little M, Mulcahy RF. A year's experience of Irukandji envenomation in far north Queensland. Med J Aust. 1998 Dec 7-21;169(11-12):638-41. PMID: 9887916. https://doi.org/10.5694/j.1326-5377.1998.tb123443.x 

  • Little M, Somerville A. Clonidine to treat Irukandji syndrome. Emerg Med Australas. 2016 Dec;28(6):756-757. Epub 2016 Sep 22. PMID: 27659905. https://doi.org/10.1111/1742-6723.12675

  • McCullagh N, Pereira P, Cullen P, Mulcahy R, Bonin R, Little M, Gray S, Seymour J. Randomised trial of magnesium in the treatment of Irukandji syndrome. Emerg Med Australas. 2012 Oct;24(5):560-5. Epub 2012 Sep 11. PMID: 23039299. https://doi.org/10.1111/j.1742-6723.2012.01602.x

  • Rathbone J, Quinn J, Rashford S. Response to 'Randomised trial of magnesium in the treatment of Irukandji syndrome'. Emerg Med Australas. 2013 Feb;25(1):97-8. PMID: 23379465. https://doi.org/10.1111/1742-6723.12026

  • Rathbone J, Franklin R, Gibbs C, Williams D. Review article: Role of magnesium sulphate in the management of Irukandji syndrome: A systematic review. Emerg Med Australas. 2017 Feb;29(1):9-17. Epub 2016 Oct 17. PMID: 27748058. https://doi.org/10.1111/1742-6723.12694

  • Seymour J, Saggiomo S, Lam W, Pereira P, Little M. Non-invasive assessment of the cardiac effects of Chironex fleckeri and Carukia barnesi venoms in mice, using pulse wave doppler. Toxicon. 2020 Oct 15;185:15-25. Epub 2020 Jun 29. PMID: 32615183. https://doi.org/10.1016/j.toxicon.2020.06.018

  • Tiong K. Irukandji syndrome, catecholamines, and mid-ventricular stress cardiomyopathy. Eur J Echocardiogr. 2009 Mar;10(2):334-6. Epub 2008 Sep 17. PMID: 18801721. https://doi.org/10.1093/ejechocard/jen246 

  • Winkel KD, Tibballs J, Molenaar P, Lambert G, Coles P, Ross-Smith M, Wiltshire C, Fenner PJ, Gershwin LA, Hawdon GM, Wright CE, Angus JA. Cardiovascular actions of the venom from the Irukandji (Carukia barnesi) jellyfish: effects in human, rat and guinea-pig tissues in vitro and in pigs in vitro. Clin Exp Pharmacol Physiol. 2005 Sep;32(9):777-88. PMID: 16173936. https://doi.org/10.1111/j.1440-1681.2005.04258.x

  • Winter KL, Isbister GK, Schneider JJ, Konstantakopoulos N, Seymour JE, Hodgson WC. An examination of the cardiovascular effects of an 'Irukandji' jellyfish, Alatina nr mordens. Toxicol Lett. 2008 Jul 10;179(3):118-23. Epub 2008 May 2. PMID: 18547753. https://doi.org/10.1016/j.toxlet.2008.04.011

Other species carybdeid jellyfish that may cause Irukandji syndrome

  • Gershwin LA, Richardson AJ, Winkel KD, Fenner PJ, Lippmann J, Hore R, Avila-Soria G, Brewer D, Kloser RJ, Steven A, Condie S. Biology and ecology of Irukandji jellyfish (Cnidaria: Cubozoa). Adv Mar Biol. 2013;66:1-85. PMID: 24182899. https://doi.org/10.1016/b978-0-12-408096-6.00001-8
    Tibballs J, Li R, Tibballs HA, Gershwin LA, Winkel KD. Australian carybdeid jellyfish causing "Irukandji syndrome". Toxicon. 2012 May;59(6):617-25. Epub 2012 Feb 14. PMID: 22361384. https://doi.org/10.1016/j.toxicon.2012.01.006

Debate

  • Little M, Pereira P, Carrette T, Seymour J. Jellyfish responsible for Irukandji syndrome. QJM. 2006 Jun;99(6):425-7. Epub 2006 May 10. PMID: 16687419. https://doi.org/10.1093/qjmed/hcl057
    Gershwin L. Jellyfish responsible for Irukandji syndrome. QJM. 2006 Nov;99(11):801-2; author reply 803-4. Epub 2006 Oct 12. PMID: 17038417. https://doi.org/10.1093/qjmed/hcl105
    Fenner PJ. Jellyfish responsible for Irukandji syndrome. QJM. 2006 Nov;99(11):802-3; author reply 803-4. Epub 2006 Oct 12. PMID: 17038415.  https://doi.org/10.1093/qjmed/hcl104

Images of tentacle prints

  • Cunha SA, Dinis-Oliveira RJ. Raising Awareness on the Clinical and Forensic Aspects of Jellyfish Stings: A Worldwide Increasing Threat. Int J Environ Res Public Health. 2022 Jul 10;19(14):8430. PMID: 35886286; PMCID: PMC9324653. https://doi.org/10.3390/ijerph19148430

Internet links providing specific information

Internet links providing general clinical guidance 

  • WHO ABCDE Approach. https://cdn.who.int/media/docs/default-source/integrated-health-services-(ihs)/csy/bec-quick-cards/becp-edu29-pdf-en-finl.pdf?sfvrsn=2532d61b_2

  • WHO-ICRC Basic Emergency Care: approach to the acutely ill and injured. https://www.who.int/publications-detail-redirect/basic-emergency-care-approach-to-the-acutely-ill-and-injured. https://cdn.who.int/media/docs/default-source/integrated-health-services-(ihs)/csy/bec-quick-cards/becp-edu29-pdf-en-finl.pdf?sfvrsn=2532d61b_2

Species-specific evidence

Studies

Australia

  • Huynh et al. (2003)
    (1) A retrospective case series of 128 patients, identified from Cairns Base Hospital emergency department records with discharge diagnoses of marine stings between 1 July 2001 and 30 June 2002. 
    (2) A prospective study of skin scrapings from 50 patients presenting with marine stings from the same period.
  • Little and Mulcahy (1998)
    Retrospective chart review of patients (n=62) who had at least two symptoms or signs of Irukandji envenomation as described by Flecker (1952) and Barnes (1964). The charts have been extracted from the databases of the only two emergency departments in 1996 in Cairns where all patients who are presenting are registered.
  • Nickson et al (2009)
    87 patients (70 prospectiv, 17 retrospective). Inclusion criteria : « consistent with Irukanji syndrome based on Burnett J, Currie B, Fenner P, et al. Cubozoans (“box jellyfish”). In: Williamson JA, Fenner PJ, Burnett JW, et al., eds.

Case reports

Australia

  • Barnes (1964)
    6 jellyfish stings. Identification: 'print' of the jellyfish body, clinical picture 3/6; self-stinging experiments 3/6.
  • Dawson (2003)
    1 fatal case
  • Fenner and Hadok (2002)
    Jellyfish sting. Identification: clinical picture ("Irukandji syndrome").
  • Fenner et al. (1986a)
    2 jellyfish stings. Identification: 'print' of the jellyfish body, clinical picture.
  • Fenner et al. (1986b)
    3 jellyfish stings. Identification: 'print' of the jellyfish body, clinical picture.
  • Fenner et al. (1988)
    3 jellyfish stings. Identification: 'print' of the jellyfish body, clinical picture; retrospectively via antibody detection with ELISA (1/3).
  • Flecker (1952)
  • Little M, Mulcahy RF, Wenck DJ. Life-threatening cardiac failure in a healthy young female with Irukandji syndrome.Anaesth Intensive Care. 2001Apr;29(2):178-80. PMID: 11314837. https://doi.org/10.1177/0310057x0102900212
  • Martin and Audley (1990)
    1 jellyfish sting. Identification: typical 'print' of the jellyfish body,clinical picture.
  • Pereira et al. (2010)
    1 sting. Definite death reported; Identification: nematocysts.
  • Tiong (2008)

Malaysia

  • Lippmann et al. (2011)

Thailand

  • Fenner and Lippmann (2009)
  • Thaikruea (2020)

Torres Strait

  • McIver et al. (2011)

USA (Florida)

  • Grady and Burnett (2003)

References

  • BARNES JH. CAUSE AND EFFECT IN IRUKANDJI STINGINGS. Med J Aust. 1964 Jun 13;1:897-904. PMID: 14172390. https://doi.org/10.5694/j.1326-5377.1964.tb114424.x
  • Dawson AH. Fatal envenomation by jellyfish causing Irukandji syndrome. Med J Aust. 2003 Feb 3;178(3):139; author reply 139-40. PMID: 12776732. https://doi.org/10.5694/j.1326-5377.2003.tb05109.x
  • Fenner PJ, Hadok JC. Fatal envenomation by jellyfish causing Irukandji syndrome. Med J Aust. 2002 Oct 7;177(7):362-3. PMID: 12358578. https://doi.org/10.5694/j.1326-5377.2002.tb04838.x
  • Fenner PJ, Lippmann J. Severe Irukandji-like jellyfish stings in Thai waters. Diving Hyperb Med. 2009Sep;39(3):175-7. PMID: 22753247.
  • Fenner, P., D. Rogers, J. Williamson (1986a) Box jellyfish antivenom and “Irukandji” stings.Med. J. Aust. 144: 665-666
  • Fenner, P. J., J. Williamson, V. I. Callanan, I. Audley (1986b) Further understanding of, and a new treatment for, “Irukandji” (Carukia barnesi) stings. Med. J. Aust. 145: 569-574 https://doi.org/10.5694/j.1326-5377.1986.tb139500.x
  • Fenner PJ, Williamson JA, Burnett JW, Colquhoun DM, Godfrey S, Gunawardane K, Murtha W. The "Irukandji syndrome" and acute pulmonary oedema. Med J Aust. 1988 Aug 1;149(3):150-6. PMID: 2899834. https://doi.org/10.5694/j.1326-5377.1988.tb120544.x 
  • FLECKER H. Irukandji sting to North Queensland bathers without production of weals but with severe general symptoms. Med J Aust. 1952 Jul 19;2(3):89-91. PMID: 14956317. https://doi.org/10.5694/j.1326-5377.1952.tb100081.x
  • Grady JD, Burnett JW. Irukandji-like syndrome in South Florida divers.Ann Emerg Med. 2003 Dec;42(6):763-6. PMID: 14634600. https://doi.org/10.1016/s0196-0644(03)00513-4
  • Huynh TT, Seymour J, Pereira P, Mulcahy R, Cullen P, Carrette T, Little M. Severity of Irukandji syndrome and nematocyst identification from skin scrapings. Med J Aust. 2003 Jan 6;178(1):38-41. PMID: 12492390. https://doi.org/10.5694/j.1326-5377.2003.tb05041.x 
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