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 On a recent "Miller's Run" on singles in a
big South-Easter, from Miller's Point to Fish Hoek, about 20 minutes into the
paddle, my paddling partner Gavin Gottschalk and I were stung by bluebottles.
Severe
Stings
He was stung severely with a bluebottle
tentacle wrapped around his calf, and, within seconds, apart from the intense
pain of the sting itself, he noticed a sensation of swelling at the back of his
throat. Gavin is a dermatologist and I
am an ENT specialist, so we both understood the implications of this
symptom. Severe allergic reactions can
proceed rapidly to anaphylaxis where the throat and voice box may become so
swollen that the airway becomes blocked off and the sufferer literally chokes
to death. Gavin had been stung once before as a child which must have
sensitized his immune system and this second sting had initiated an allergic
reaction.
Explosive
Tracheotomy?
At this point we were about 1.5 km off
shore doing a downwind run in big swell and we were both naturally quite
worried about what might happen to Gavin.
Anywhere else, even without medical equipment, I could probably have
helped by performing a tracheotomy should the worst happen, but out here all I
could think of using was my hand held flare to blast a hole in his
trachea. Not a method I've seen
described and not something I was ever looking forward to trying out. It
sounds dramatic, but this was what was going through my mind...
Fortunately, his throat swelling seemed to
stabilize and his breathing remained clear and we decided to press on to Fish
Hoek, to my car and cellphone, rather than turning left towards Simonstown with
the difficulties of the wind and swell hitting us side-on. Fortunately he didn't develop an asthma attack,
which can happen in these cases, and fortunately he wasn't stung again. When we reached the beach I had a look at
Gavin's throat with a torch and noted that his uvula (the part of the soft
palate which hangs down at the back of the throat) was still quite swollen. In addition, his lymph nodes in the groin,
draining the sting site were significantly swollen, but everything settled down
over the next half an hour and we didn't need to get him to hospital. One of
the treatments for anaphylaxis is an adrenaline injection, but perhaps the huge
amount of natural adrenaline flowing around his body from doing his first
Miller's run helped to prevent a more serious reaction.
Bluebottle
Research
We were prompted to do a bit of research on
bluebottles and found out that allergic reactions are well described. It might
be prudent for paddlers known to have an allergy or asthma to avoid paddling
when bluebottles are around and to carry an adrenaline syringe in a kit
form. They are available from
pharmacies, usually for people with bee sting allergy.
Bluebottles are the common name for the genus Physalia. They are also called Portuguese Men o'
War. There are 2 common species, the
larger Physalia physalis, common in
the Atlantic, especially in the Carribean but also
world-wide, and the smaller single-tentacled Physalia utriculus, common in the Indian and Pacific. Deaths have
been reported after stings from physalis but
it is utriculus that is usually
responsible for stings of beach-goers in Australia,
New Zealand, the Pacific Islands
and South Africa. Here is a picture of the scary-looking Physalis.
 The Bluebottle (Physalia physalis) also known as the Portuguese Man o'War
It has a sail, filled with Nitrogen and
Carbon dioxide, which may reflect left or right. This determines the direction it is pushed by
the wind, sailing at 45 degrees to the wind and 90 degrees to the other group,
so that either group may escape being washed ashore. Interestingly, it is not a single organism,
but a colony of 4 (the float, the tentacles, the digestive polyps and the
reproductive polyps). Tentacles may be 3
to 10 meters in length and have muscles which contract to fish, grab prey,
usually small fish and crustaceans and drag them within reach of the digestive
polyps. There are millions of stinging cells, called nematocysts, along the
tentacle. They are among the most
complex intracellular structures known. Each is a hollow sphere turned in at
one point to form a hollow containing a thread with barbs. This shoots outward
when triggered to inject a poison of phenols and proteins through a pore at the
tip.
 
Intense
Pain
Intense pain may be experienced for several
hours and swollen lymph nodes and blisters may develop. Muscle aches and respiratory problems may
occur. First aid is to remove the tentacle
by washing it off or using tweezers or a gloved hand. Ice packs and local anesthetic spray will
help with pain, and hot water (above 45 degrees C) will render the poison
inactive. Rubbing the area, or using
vinegar or urine is not recommended as this may stimulate further stings to be
released. Histamine is released and this
may precipitate an asthma attack and cause lymph node swelling. Some of the visible response and certainly
the airway problems may be allergic in nature.
Avoid
Getting Stung
The last question of relevance to paddlers
is how to avoid getting stung in the first place. Of course, not getting onto the water is an
option, as is wearing long sleeve vests, leggings, gloves and water shoes. Bluebottle tentacles are typically picked up
by the paddle blade and swung onto the body with the next stroke, or they are
washed into the boat when "swamped". I
recommend pausing in the paddle stroke when one is spotted to allow the
bluebottle to slide past, and putting the blade in ahead of the float so as to
avoid the trailing tentacles. Getting
the tentacle off when it is wrapped around you is quite difficult while
paddling, but wait until you can brace on one side and try to wash it off on
the other. Easier said than done!
More
Information
Further information at the following
websites
http://animaldiversity.ummz.umich.edu/site/accounts/information/Physalia_physalis.html
http://amonline.net.au/factsheets/bluebottle.htm
http://en.wikipedia.org/wiki/Portuguese_Man_o'_War
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A google search of stingoes results in a bunch of websites that recommend it. I've been carrying a tube of the gel in my PFD but I have no idea whether it really works.
The last time I was stung (before I bought the Stingoes), I scooped a bluebottle onto my neck. A few minutes later I scooped another one on the other side of my neck. The lymph glands on both sides immediately swelled up & I was in agony for about thirty minutes. It happened at Batsato Rock, about 15km from Fish Hoek at the furthest point of our paddle. After half an hour the pain gradually receded. Nasty little swines.
Note that the stings do NOT penetrate the relatively thick skin off your finger tips and it's possible to pick the tendrils off yourself without getting stung further. It's important to get the tendrils off asap.