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Monday, March 27, 2017

Ka`u News Briefs Monday, March 27, 2017

Ope`ape: The Hawaiian Bat is the subject of the talk at Kilauea visitor Center 
Auditorium in Hawai`i Volcanoes National Park  on Tuesday at 7 p.m. 
See story below. Photo from HVNP

One of more than 30 species of box jellyfish, Chironex 
fleckeri.  Photo by Robert Hartwick/Courtesy of UH
THE BEST JELLYFISH STING TREATMENTS are as counter-intuitive as the stings are harmful. Reputable medical websites repeatedly mimic each other and unwittingly disseminate unproven remedies – such as rinsing with sea water, or applying ice or scraping the tentacles off the victim’s skin with a credit card. It’s vinegar, not sea water; plucking, not scraping; and heat, not cold that are helpful, according to a new study by University of Hawai`i researchers. They found that many “remedies,” readily available to anyone who Googles “how to treat a jellyfish sting,” will only exacerbate an already serious problem.
     Angela Yanagihara, assistant research professor at UH Mānoa Pacific Biosciences Research Center and John A. Burns School of Medicine, told University of Hawai`i: “We put those methods to the test in the lab and found they actually make stings much, much worse.”
    Box jellies are among the deadliest animals in the oceans, responsible for more deaths every year than sharks. Even mild stings cause severe pain and can leave horrible scars. The stings are caused by tiny capsules called cnidae, which contain a coiled tubule and venom. Upon contact with a victim, the tubule is discharged in a harpoon-like fashion, either entangling or piercing the skin of the animal it contacts.
Dr. Angela Yanagihara collects Hawaiian box jellyfish
at 3 a.m. Photo courtesy of UH
    Yanagihara, aided by Christie Wilcox, a postdoctoral fellow at JABSOM, looked at the best ways to respond to stings from two box jelly species, the Hawaiian box jelly Alatina and the largest box jelly in the world, the Australian box jelly Chironex fleckeri.
     They examined how different ways of removing tentacles—rinsing with vinegar or seawater, scraping with a credit card or simply plucking them off—affected the amount of venom injected during a sting using a human tissue model designed by Yanagihara. They also looked at whether treating with ice packs or hot packs lessens damage from the venom.
     The team found that some of the most commonly recommended actions, including rinsing with seawater, scraping the tentacles and applying ice, dramatically increased the severity of the stings.
     “Less than one percent of stinging cells on a tentacle actually fire when you’re first stung,” explained Wilcox. “So anything you do that moves the tentacles, or the unfired 99 percent of stinging cell capsules around, has the potential to increase the amount of venom injected into you by many fold.”
     The team found that rinsing with vinegar—which irreversibly prevents the unfired stinging cells from firing—or even simply plucking tentacles off with tweezers led to less venom injection. And after the sting, applying heat actively decreased venom activity.
     Applying ice not only didn’t help with stings from Hawaiian box jelly, it enhanced the venom’s activity to make stings cause more than twice the damage.
     Yanagihara explained: “Heat not ice will act as a “treatment” by inactivating venom already in the skin. These venoms are all highly heat sensitive. Safe hot water 110-115 degrees F (43-45 degrees C) applied for 45 minutes massively inactivated the venom already injected.

Jelly fish at the Sting No More laboratory. Photo from stingnomore.com
   “Authoritative web articles are constantly bombarding the public with invalidated and frankly bad advice for how to treat a jelly sting,” commented Yanagihara, “I really worry that emergency responders and public health decision makers might rely on these unscientific articles. It’s not too strong to point out that in some cases, ignorance can cost lives.”
     For those who can find it, the team found the best way to treat a jelly sting was the combination of Sting No More™ Spray and Cream, a venom-inhibiting product duo developed by Yanagihara with Hawaiʻi Community Foundation, National Institutes of Health and Department of Defense funding.
     In response to a comment posted to the UH News website, Yahagihara wrote: “Vinegar is not a “remedy” or “treatment”; it does not enter the skin or effect venom already in the body. While this has gotten muddled in the popular lay press and on-line, the purpose of vinegar has always been to accomplish part one of a two part first aid approach which is to prevent additional stinging by
Vinegar doesn't cure the sting but it prevents the cells from
continuing to sting. Image from www.perfscience.com
undischarged cnidae left on the skin after tentacle contact. Anytime a jellyfish tentacle contacts human skin thousands of undischarged cnidae (stinging cell capsules) are left on the skin. These are microscopic and invisible to the naked eye but can be seen under the microscope after taking a sticky tape lift. Vinegar causes the collagen capsule to swell preventing the structural apparatus from firing. Sea water – while sounding innocuous, is not a good choice to remove cnidae. It is not effective in washing the cnidae off of the skin. It simply moves the sticky stinging capsules around without inactivating these “time bomb” venom injecting capsules. Later they will fire increasing the over all area of the sting.
     “It’s all too easy to find bad advice on treating jelly stings on the internet,” said Wilcox. But she also noted that such bad advice isn’t solely the fault of the sites that provide it. “Even in the peer-reviewed literature, there are a lot of examples of recommendations that are made in passing in discussion sections without any direct evidence to back them up, and then those just keep getting repeated and cited over and over even though they’re not based on rigorous, empirical scientific evidence.”
Sting No More was developed in cooperation
with University of Hawai`i.
    The team expects these statistically powered findings will prompt online medical sites, government agencies, and the broader medical community to re-evaluate the advice they provide on treating jelly stings. International collaborators and colleagues have joined in this effort and are conducting similar studies around the world using this Yanagihara-Wilcox sting model to test locally prevalent jellyfish species in a similar push to develop evidence-based medical practices.
     Sting No More™ (Alatalab Solutions, LLC) was developed under a Department of Defense grant that aimed to rapidly and effectively treat stings in U.S. Special Operations Command combat divers. With the intention of supporting the development of technologies and therapies of benefit to people, the funding required a commercialization plan for resulting products. All testing of the new commercial product, in the current study was performed under an approved University of Hawaiʻi Conflict of Interest plan. This product demonstrates the strongly pro-innovation culture at UH dedicated to bringing to the public sector technologies that have been developed with federal and state research dollars.

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A NO VOTE FOR JUDGE NEIL GORSUCH in his confirmation for U.S. Supreme Court Justice is promised by Hawai`i Senator Mazie Hirono. She is a member of the Senate Judiciary Committee and explained her opposition today:  
     “The real focus and the real heart of this decision lies in the struggles that working families, women, differently-abled, people of color, the LGBTQ community, immigrants, students, seniors, and our native peoples face every day,” Senator Hirono said. “These are the everyday Americans who will be impacted by the decisions a Justice Gorsuch would make.
Hawaiian bat.
Photo by Corrina Pinzari /USGS
      “The central question for me in looking at Judge Gorsuch and his record, in listening carefully through three days of hearings is whether he would be a Justice for all, or only a Justice for some. I do not believe Judge Gorsuch meets this test. 
     “I will oppose his nomination, and I will oppose it every step of the way. I urge my colleagues to do the same. This is simply too important for the future of America and its values.”    
    Hirono discussed her decision to oppose Judge Gorsuch with CNN’s Wolf Blitzer.

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Hawaiian Hoary Bats, Tue, Mar 28, 7 p.m., Kīlauea Visitor Center Auditorium in Hawai`i Volcanoes National Park. USGS bat biologist and researcher Corinna Pinzari reveals recent research into bat biology, monitoring and ecology and examines ‘ōpe‘ape‘a’s current status and distribution.  ‘Ōpe‘ape‘a (Hawaiian hoary bats) are the only true native terrestrial mammals in Hawai‘i. Free; park entrance feed apply.

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