Stings, marine creatures
Introduction
In the seas around the UK, there are only a few types of sea creatures that sting and they are generally quite rare.
The five main types of stinging sea creatures found in UK waters are described below.
- Weever fish: a small fish, sandy in colour, that usually lies buried in the sand on the seabed. Weever fish have poisonous spines on their back and gills that can sting people, usually on the feet or hands.
- Stingrays: flat, circular or diamond-shaped fish that have a sharp, serrated barb underneath their tail. As with weever fish, most people who are stung by a stingray are stung on their lower legs, ankles and feet after accidentally stepping on one in shallow water.
- Sea urchins: small, round sea creatures with a bony shell that is covered in spines. They are usually found in the shallows, on rocks and in seaweed. The spines of sea urchins are sharp and hard and can cause puncture wounds. Between the spines, small organs contain poison that is released as a defence mechanism.
- Jellyfish: mushroom-shaped creatures that often float near the surface and have long, thin tentacles on the underside of their bodies. The tentacles are covered with small poisonous sacs called nematocysts, which if touched produce a nasty sting. In recent years, during the warmer months, large groups of jellyfish have become increasingly common in the seas around Europe.
- Portuguese man-of-war: a large, poisonous jellyfish-like creature (although it is not a jellyfish) with a large purple-blue, gas-filled bladder and tentacles that hang below the water. They are usually found in tropical waters but in some rare cases they have been spotted in UK waters or washed up on beaches. The sting can be painful but rarely causes death.
Signs and symptoms
The visual signs and symptoms will vary between each type of sting. Weever fish and sea urchins usually sting your foot and will often leave spines in the wound.
Stingrays can leave a large, jagged cut or puncture wound on your skin, and jellyfish and Portuguese men-of-war will often leave raised blisters on the skin in the shape of their own tentacles.
All stings are painful and cause swelling, inflammation or raised areas of skin (welts) and nausea. You are also likely to have other symptoms, depending on what has stung you.
Read more about the symptoms of sea creature stings.
When to seek medical help
It's best to get medical assistance for any type of sting you get in the sea as it will need to be treated and any spines will have to be removed.
If you are in the UK and have been stung, go to the nearest A&E department of your nearest hospital or dial 999 to request an ambulance if you are stung by a stingray, or if you've been stung by any marine creature and you have:
- severe pain that lasts for more than an hour
- chest pain and breathing problems
- fits or seizures
- been stung on a delicate part of your body, such as your face or genitals
Read more about how stings in the sea are treated, both at home and in hospital.
Avoiding stings in the sea
It is rare to be stung in the sea in the UK, but there are precautions you can take to avoid stings.
These include:
- observing any warning signs that are on the beach
- not touching or handling any stinging sea creatures
- wearing protective clothing, such as a wetsuit or waterproof footwear
- scuffing your feet as you walk in shallow water to warn any sea creatures that you are approaching
Read more about how to prevent being stung in the sea.
Healthcare abroad
If you are travelling abroad, it is a good idea to familiarise yourself with animals and plants that can cause injury in the countries you are visiting.
It's also important that you have the right travel insurance for the country or countries you're visiting. Make sure your insurance policy covers any specific activities that you plan to do, like water sports or scuba diving.
When travelling in Europe, a valid European Health Insurance Card (EHIC) will entitle you to free or reduced-cost medical care. However, the EHIC will not cover you for everything that travel insurance covers, such as emergency travel back to the UK.
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Symptoms
If you or someone else has been stung in the sea, get help from someone who has been trained in first aid, such as a lifeguard.
Further medical assistance may also be required if the symptoms of a sting are very severe or painful.
After being stung, some people may have an allergic reaction, known as anaphylaxis or anaphylactic shock, which can sometimes be fatal. Any adverse allergic reaction should be treated as a medical emergency. Dial 999 to request an ambulance.
Read more about how sea creature stings are treated.
Weever fish
A sting from a weever fish can cause the following:
- severe pain for the first two hours
- itching
- swelling (inflammation)
- numbness
- nausea or vomiting
- headache
- abdominal cramps
- tremors (shaking)
A person who has a more serious reaction to a weever fish sting may also experience:
- an abnormal heart rhythm (arrhythmia)
- shortness of breath
- weakness
- paralysis (an inability to move the affected area)
- seizures (fits)
- a drop in blood pressure
- episodes of unconsciousness
In very severe cases people have died, although this is rare.
If you or someone else has been stung by a weever fish, seek medical assistance immediately. Any spines that are left in the foot will need to be carefully removed.
Sea urchins
A puncture wound from a sea urchin can be painful and cause inflammation (swelling) and redness around the affected area. If you have been stung by a sea urchin, and you have puncture wounds in several places, you may experience more severe symptoms including:
- tiredness
- weakness
- aching muscles
- shock
- respiratory failure
- paralysis
In very rare cases, severe injuries from sea urchins have been known to cause death.
You should seek immediate medical attention if the symptoms include:
- breathing problems
- chest pain
- signs of infection, such as increased redness and swelling in the affected area and a high temperature (fever) of 38C (100.4F) or above
Medical assistance is also required if there are spines in or near a joint, as they may need to be surgically removed.
Stingrays
The hard, sharp barb of a stingray can leave a jagged cut or puncture wound in the flesh. The venom produced by a stingray's sting can also cause the breakdown of tissue and severe pain that can last for up to 48 hours.
Other symptoms of a stingray sting may include:
- swelling (inflammation) of the affected area
- skin irritation
- bleeding from the wound
- sweating
- low blood pressure (hypotension)
- feeling faint, weak and dizzy
- nausea or vomiting
- diarrhoea
- headache
- shortness of breath
- seizures (fits)
- muscle cramps
Deaths from stingray injuries are rare, although there have been cases where people have died following a puncture wound to the heart or abdomen.
Always seek immediate medical assistance if you or someone you know has been stung by a stingray. Alert a lifeguard if there is one nearby, before dialling 999 to request an ambulance.
A stingray sting should be dealt with at the A&E department of the nearest hospital.
Jellyfish
If you are stung by a jellyfish, you will immediately feel severe pain, an itchy rash and welts (raised, circular areas on the skin where the tentacles have touched you.
Other symptoms may include:
- nausea or vomiting
- diarrhoea
- abdominal pain
- muscle spasms
- numbness or tingling
- swollen lymph nodes, which are the small nodules that are found in several areas around the body, including in the groin and armpit
In rare cases, a serious reaction to a jellyfish sting can result in breathing difficulties, coma or even death. If you or someone you know has been stung by a jellyfish, seek immediate medical assistance by dialling 999 if they:
- are having problems breathing or swallowing
- have chest pain
- have severe pain at the site of the sting
- are very young or elderly
- have been stung on a large area of their body
- have been stung on their face or genitals
- have severe pain, itchiness or swelling around the sting
Portuguese man-of-war
Someone who has been stung by a Portuguese man-of-war may have the following symptoms:
- a red line with small, white lesions
- blisters and welts (raised areas of skin), in severe cases
A Portuguese man-of-war can sometimes cause a severe allergic reaction, although deaths as a result of a sting are rare. If someone is stung by a Portuguese man-of-war, seek medical attention if:
- The pain is severe and lasts for more than an hour.
- The rash gets worse.
- There are signs of infection, such as increased redness and swelling in the affected area and a high temperature (fever) of 38C (100.4F) or above.
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Treatment
Treatment for stings in the sea will vary depending on what has stung you and, in some cases, how severe your reaction is.
It is possible to treat some stings yourself with first aid. However, if the symptoms are more serious, such as severe pain, swelling or difficulty breathing, dial 999 and ask for an ambulance to come immediately.
Read more about the symptoms of sea creature stings, including information about when to go to hospital.
Weever fish
If you are stung by a weever fish, it's important to get first aid and medical attention immediately.
To control the pain, the affected area should be immersed in hot water (as hot as can be tolerated) for between 30 and 90 minutes. This can be repeated if necessary. When the area is numb, be careful not to burn it in the water.
Any large spines should be carefully removed from the wound using tweezers – avoid touching the spines with your bare hands. Clean the wound using soap and water, before rinsing it with fresh water. Do not cover the wound.
If there is a severe allergic reaction (anaphylaxis), you will need to go to hospital immediately.
Aftercare
If there is itching, hydrocortisone cream can be applied two to three times a day. However, this should be stopped immediately if there are any signs of infection.
If the skin is red and badly inflamed, a topical antibiotic cream or ointment should be applied three times a day.
Pain and inflammation can be treated with painkillers, such as paracetamol and ibuprofen.
If an infection develops, antibiotics may be prescribed. Take them for a minimum of five days after the signs of infection have disappeared.
Sea urchins
Sea urchin puncture wounds and stings are treated in a similar way to a weever fish sting. If there are signs that you or someone you are with have had a severe allergic reaction (anaphylaxis), dial 999 to request an ambulance.
Immerse the affected area in hot water (as hot as can be tolerated) for between 30 to 90 minutes.
Any large spines should be carefully removed from the wound using tweezers. The pedicellariae (small venomous organs) can be removed by putting a small amount of shaving cream on the affected area and using a razor blade to gently scrape them out.
Scrub the wound using soap and water, before rinsing it with fresh water. Do not close the wound with tape.
Aftercare
Pain and swelling can be treated with painkillers, such as paracetamol and ibuprofen.
If the skin is red and badly inflamed, topical antibiotic cream or ointment should be applied three times a day.
Stingrays
Alert a lifeguard and dial 999 to request an ambulance if you are stung by a stingray.
There is no antidote to stingray venom. However, the pain from a sting can be relieved by:
- placing the affected area in hot water (as hot as can be tolerated) for between 30 to 90 minutes
- using pain-relieving medication that is given intravenously (directly through a vein)
- using pain-numbing medication
Once the wound has been cleaned and the sting has been removed (if necessary), the doctor will be able to look for any further damage. A tetanus booster may be needed if it is more than five years since your last tetanus injection.
After being stung by a stingray, you will usually be given antibiotics because there is a high risk that the wound will have been contaminated by bacteria in the sting and the seawater, which could lead to an infection.
Initially, the wound will be left open before being closed with stitches after about 48 hours if it has not become infected. In rare cases, surgery may be needed if the sting affects the tendons or blood vessels.
Jellyfish
You can treat most jellyfish stings yourself. However, dial 999 to request an ambulance if there are severe symptoms, such as difficulty breathing, chest pain or if a large or sensitive area of the body (face, genitals) has been stung.
If someone has been stung by a jellyfish, remove any remaining tentacles with tweezers or a clean stick (wear gloves if they are available).
The affected area should be soaked in vinegar for between 15 to 30 minutes to prevent further toxins from being released. If vinegar is not available, rinse the area with alcohol or seawater (not fresh cold or hot water). Do not rub the area or apply ice. You should also ignore any advice that you may have heard about using urine because it is unlikely to help and in most cases it may make the situation worse.
Apply shaving cream to the affected area and use a razor blade or credit card to remove any nematocysts (small poisonous sacs) that are stuck to the skin.
Aftercare
After a jellyfish sting, any pain and swelling can be treated with painkillers, such as paracetamol and ibuprofen.
Portuguese man-of-war
If you have been stung by a Portuguese man-of-war, the treatment is similar to a jellyfish sting (see above).
However, don't use vinegar or alcohol to wash the affected area because it can make the pain worse (unlike with jellyfish stings).
The pain caused by most Portuguese man-of-war stings will disappear within 15 to 20 minutes, but find immediate medical attention if the pain is still there after an hour or if the area becomes infected.
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Prevention
If you are planning to go in the sea, there are steps you can take to avoid being stung and to ensure that you have easy access to medical care.
For example, you can:
- Observe warning signs on the beach: authorities will often put up warning signs when there have been sightings of groups of jellyfish or Portuguese men-of-war in an area.
- Swim near a lifeguard: if you are stung by a sea creature, you will often need immediate first aid or, in severe cases, a means of contacting an ambulance.
- Avoid touching or handling stinging sea creatures: don't ever touch jellyfish or a Portuguese man-of-war that has been washed up on the beach because even dead tentacles can sting.
- Wear protective clothing, such as a wetsuit or waterproof footwear: weever fish, stingrays and sea urchins are often found in shallow water and rubber-soled shoes or sandals will protect your feet, and a wetsuit will help protect against jellyfish stings when you are in deeper water.
- Scuff your feet when walking in shallow water: this will help disturb and scare off any stinging sea creatures that are in your path.
- Take care when walking in rocky areas or near seaweed: this is often where sea urchins are found.
First aid training and kit
If you spend a considerable amount of time in the sea, it is a good idea to get some basic first aid training and to carry a basic first aid kit with you. The kit should contain useful items, such as a pair of gloves, tweezers, a saline (salt) solution, painkillers and vinegar.
If you have a known allergy to insect stings, it's important to carry appropriate medication with you, such as an adrenaline injection kit. Make sure that the people you are with are aware of your allergy and know how to administer the medication in case you are unable to do so yourself.
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