Most Canadians are ill-prepared to deal with bites/ stings in tropical climates. Here are the three most common.

SCORPIONS

There are 1,600 species of scorpions which all have a poisonous stinger at the back of their bodies and two grasping pincers at the front. Most are about 2.5 cm long. They are found in deserts, subtropical and tropical areas, as well as on all major land masses except Greenland and Antarctica. They are nocturnal creatures that hide in cracks or under rocks. Their stingers contain venom that is toxic to arthropods, vertebrates and humans. Twenty-five species from the family Buthidae produce lethal venom. This neurotoxin causes convulsions, paralysis and cardiac irregularities, requiring an antivenom to save lives. Most stings simply cause local effects, with local pain, swelling and discolouration lasting from minutes to several days. Treatment. Clean and apply cool compress. If you’re having a hard time swallowing, go to Emergency. Symptoms may include breathing difficulties, muscle twitching, unusual movements of the head, neck and eyes, drooling, sweating, nausea, vomiting, high blood pressure, rapid, irregular heartbeat, restlessness and excitability. This requires ICU admission for supportive treatment and perhaps anti-venom administration. Older adults and children are more at risk for adverse effects. Very few deaths have been reported in the US, fewer in Canada.

PUFFERFISH (BLOWFISH)

Blowfish can consume water to turn themselves into a ball several times their size to avoid being eaten. Tetrodotoxin is 1,200 times more deadly than cyanide and one fish has enough toxin to kill 30 humans. There is no antidote to this poison. There are 120 species worldwide, varying in size from 2.3 cm to more than 30 cm in length. None have scales, but are covered in rough spiny skin. You should Google all the different sizes, colours and features these fish have. People in Japan eat these fish once the liver, ovaries and skin containing the poison tetrodotoxin have been removed. You are more likely to come across these nasty creatures walking along the shore or in the water. If you step on one, seek medical help immediately. Pufferfish may be confused with porcupine fish which have longer spines and are less dangerous, although both can be painful and feel like a bad bee sting. Even dead fish can release the toxin, so be careful to wear protection for your hands if you touch them. With pufferfish, you initially have numbness, then a very bad sense of pain. This is followed by nausea, vomiting, and severe dizziness. You need to get help immediately, as these symptoms progress to trembling, wobbly walking, blue-tinged coloured gums, dilated pupils, muscle tremors and seizures. The next stage is difficulty breathing, inability to walk, complete paralysis, then coma. Treatment. Remove any spines with tweezers, thoroughly clean with soap and water, then soak in hot water (45 degrees) for 20 minutes. Seek help right away. With MILD exposure, you may only get redness, swelling and itching that lasts a few hours. With MODERATE exposure, you get numbness and tingling, dizziness, nausea and difficulty breathing. Seek medical attention. SEVERE exposure from eating or extensive touching can lead to cardiac arrest, respiratory failure and even death. EARLY TREATMENT IS ESSENTIAL, as you may need a ventilator and medications to manage hypotension, reverse muscle weakness, and prevent seizures.

JELLYFISH STINGS

There are five different types of jellyfish in the Gulf of Mexico. They have stingers (nematocysts) that contain venom which they inject into your skin. The most dangerous are box jellyfish, most often found near Australia, the Philippines, the Indian Ocean and central Pacific Ocean. Stings are extremely painful, creating rashes and welts on the skin. Severe reactions may be difficulty breathing, and, rarely, coma and death. Treatment. Apply vinegar for at least 30 seconds. Use sea water if vinegar is not available. This may prevent the venom from being released from the stingers. Remove any stingers that you see with tweezers. Do not scrape the skin. Soak in hot water to decrease pain. Alternatively, treat with ice packs, depending on the type of jellyfish. Avoid alcohol, soda water, and fresh water since it could massively discharge nematocyst venom. Also avoid bandaging. Call an ambulance right away if you have trouble breathing, swollen tongue or lips, feel unwell, nausea or vomiting, dizziness, muscle spasms or a sting in the eye or mouth. Observe if there are any purple flags on the beach — they are warnings to NOT GO SWIMMING! Be aware of local emergency services. Although there are very few lethal results from these injuries, it is important to be aware of possibilities.

Enjoy your holiday! Dr. Vicki Holmes is a Saskatoon retired family physician who has a special interest in Palliative Care and Women’s Health. She is passionate about sharing medical information with the public! (Vicki’s Photo: Memories by Mandy)

-Joanne Paulson