On April 3, 2008, around 10 am, an 11-year-old Swedish female died after being stung by jellyfish on Klong Dao Beach, Koh Lanta.19 She and three other girls (similar ages) were paddling and playing in water 1 m deep, about 20 m from the beach. The girls screamed, attracting the attention of hotel staff, who ran into the water to assist. The girl was pulled from the water but was blue and pulseless some 4 minutes postenvenomation despite CPR and application of vinegar and a locally obtained salve. The others received minor stings but survived, one requiring hospitalization, the other two treated at the beach.

A 7-year-old male was stung on the left forearm, left thigh, and trunk by an unknown jellyfish while wading at Pattaya INNO-406 cost Beach, the exact date unstated.20 He developed contact dermatitis and acute renal failure with hemoglobinuria with renal biopsy showing acute tubular necrosis. Supportive treatments improved both dermatitis and CP-868596 cell line renal function. On December

27, 2007, in Koh Mak, a 6-year-old male, his mother and father were all stung by a jellyfish, 3 m from a beach restaurant.20 Another young female from eastern Europe also received a painful sting. They were treated immediately with a local “potion” which stopped the pain “in seconds” and left no scars. The next day, December 28, 2007, a 46-year-old male was stung by over 2 m of tentacle at Koh Mak.21 A woman at a nearby beach restaurant used a (possibly the same) “wonderful” local potion, leaving “no skin marks. On December 30, 2007, at a sandy beach also on Koh Mak, a 4-year-old male wading in 30 cm of water where others were swimming and snorkeling, received a large sting.22 Within seconds he became unconscious, apnoeic, and cyanosed. Two minutes after dousing with about 1.5 L of vinegar, he spontaneously regained consciousness. He spent 3 days in Trat SSR128129E hospital but has permanent scarring over his legs (Figure

2). His parents received minor stings while rescuing him. Subsequent anecdotal evidence revealed that another boy almost drowned in deep water nearby after a minor sting the year before.22 On April 18, 2008, at about 5 pm, a 47-year-old male received a sting in 1 m of water fronting the Marriott Hua Hin (200 km SW of Bangkok), in the western Gulf of Thailand.21 The victim’s wife saw the jellyfish (described as a “box jellyfish” 20–30 cm in diameter with 3–4 finger-like tentacles, 15–20 cm long) as a wave dumped it on her husband’s forearm. He had received several previous jellyfish stings in Thailand (see incident December 28, 2007, above), although this was more severe. The skin marks were similar to this previous sting, although the jellyfish in Koh Mak looked “younger” (cleaner and clearer) than this one that had a brownish–bluish bell. This time, the victim was taking “heavy treatment for allergy” which possibly mitigated the initial impact but had no effect on the skin damage. Topical cortisone was applied, seemingly helping reduce the severe skin pain.