Pathogenesis (development of disease)
Urticaria (hives) secondary to jellyfish sting is characterized by edema (water retention) of the dermis (skin), which is an expression of an increase in vascular permeability.Mediators (messengers) are released primarily from mast cells (cells of the body’s defense system that have stored certain messengers, including histamine and heparin).
One can distinguish an immunological from a non-immunological pathomechanism.
The venom of the cube jellyfish (Cubomedusae; synonym: sea wasp) contains cytolysins that damage cell walls and thus lead to cell death. This particularly affects erythrocytes (red blood cells) in large quantities (= hemolysis), which leads to a rapid increase in the serum potassium concentration. The consequence of hyperkalemia (excess potassium) is asystole – i.e. complete cessation of electrical and mechanical cardiac action for more than 2 seconds – and thus death.
The poison of the Portuguese galleon (Physalia physalis) is physaliatoxin. This consists of enzymes (e.g., elastase, endonucleases, collagenases, an AMPase, and a nonspecific amino acid ester hydrolase), among others, and has neurotoxic (nerve-damaging), hemolytic, and cytolytic (cell-dissolving) effects.
Etiology (causes)
Geographic distribution of jellyfish
| Jellyfish species | Geographical distribution | Season |
| Hair or nettle jellyfish(yellow hair jellyfish; colloquially “fire jellyfish”)Fire jellyfish in the North Sea and Baltic Sea (luminous jellyfish (Pelagia noctiluca), the yellow hair jellyfish (Cyanea capillata), compass jellyfish (Chrysaora hysoscella)) | North and Baltic Sea | The fire jellyfish is driven into the Baltic Sea especially in late summer, by wind and current. |
| Fire and luminous jellyfish (Mediterranean jellyfish). | Mediterranean Sea | Luminous jellyfish in swarms, especially in midsummer |
| Fire jellyfish/yellow hair jellyfish (Cyanea capillata) | Atlantic, English Channel, and North and Baltic Seas. | |
| Foxglove jellyfish (Linuche unguiculata) | Tropical and subtropical western Atlantic, especially around the West Indies and the Bahamas | |
| Compass jellyfish (Chrysaora hysoscella | Atlantic Ocean, Mediterranean Sea, North Sea and Kattegat | |
| Luminous jellyfish (Pelagia noctiluca) | Mediterranean Sea and in the tropical Atlantic Ocean | |
| Portuguese galley (Physalia physalis; English Man-o-War). | Pacific Ocean, but also off the Canary Islands and off Portugal (western Mediterranean); Caribbean (coast of Cuba); occasionally off the Spanish Balearic Islands of Mallorca and Formentera, Spanish Atlantic coast, Atlantic coast of Florida | |
| Cube jellyfish (Cubomedusae; synonym: sea wasp; English box jellyfish). | Worldwide; mostly in tropical and subtropical waters of Indian Ocean, Pacific Ocean, and Atlantic-West Indo-Pacific (Papua New Guinea, Solomon Islands, Borneo, Malaysia, Philippines) | Summer months (November to June) |