Eva

Bites and stings

How to manage unexpected wildlife interactions

Don't let the same dog bite you twice. Chuck Berry

The terms ‘bite’ and ‘sting’ refer to when an animal or plant breaks the skin surface, potentially transferring germs or venom that can result in anything from a minor irritation to a severe medical condition.

We generally use the word ‘bite’ when it occurs with teeth (e.g. a dog bite), and sting when it occurs with another part of the body (e.g. a bee stings with a barbed stinger; a plant stings with tiny hairs on its leaves).

In the case of insect bites and stings, while both hurt, the difference in the two terms refers to whether any toxic venom is transferred. An insect bite occurs when the insect pierces the skin. Often the insect injects anticoagulant saliva so they can feed on your blood. By contrast, an insect sting is when the animal transfers toxic venom into your system, often as a defence mechanism.

While both can result in a pain, itchiness, or even an allergic reaction for some people, the causes are quite different. For an insect bite, our bodies are responding to the potential infection by the breakdown of the skin barrier and potential transfer of infectious agents from the insect (e.g. malaria transferred to humans via mosquito bites). For an insect sting, your body in addition to potential infection is dealing with a foreign toxic substance, that may have severe medical consequences. The same is true for spiders, although they are not if fact insects – a general misconception for many of us!

In the case of snakes, however, the term ‘bite’ can refer to both venomous and non-venomous attacks, however, for practical purposes all snakes bites are treated as venomous until proven otherwise.

And in the plant kingdom, ‘stinging’ plants have tiny needles that break off and lodge into the skin, causing extreme discomfort.

Having said all this, the chance of being bitten by a snake or spider on a bushwalk is relatively low. In Australia there are about 3,000 snake bites per year, of which 200 to 500 receive antivenom; on average one or two will prove fatal. By contrast, spider-related deaths are almost unheard of:although approximately 2000 people are bitten each year by Redback Spiders, there has only been 1 spider-related death since antivenoms for funnel web and redback spiders were developed in 1980s.

To put this in perspective, there were 1290 road crash deaths and fatal road crashes in Australia during only 2016 And in 2015, there were 45,392 deaths attributed to cardiovascular disease in Australia.

While fatal outcomes of bites and stings by Australian wildlife is unlikely, nevertheless, it’s worth having the knowledge and skill set to deal with unexpected situations in the bush because emergency medical help is often delayed.

Although the likelihood of getting bitten, stung or scratched by an animal on a bushwalk by an animal that will envenomate (or similar) is fairly low, there are some simple things that you can do to reduce that risk further. The information here is based on current guidelines from the NSW Health Direct website.

Some general advice for avoiding wildlife bites, scratches and stings, and good for mozzies too!

  • Wear long sleeved shirts and pants and closed-top shoes to cover up your skin and reduce the risk of bites.
  • Follow the Leave No Trace principles and leave wild animals be. Do not touch, corner or startle a wild animals, especially for the sake of a photo.
  • If you notice a wild animal, warn others in the group. If you can, wait for it to move off on it’s own accord or make a wide berth around the animal.
  • Insect repellant is great for preventing insect and leech bites.

DEET is an extremely effective way of avoiding insect bites including mosquito bites, and is particularly important in areas with known mosquito-borne diseases. The DEET (Diethytoluamide) chemical conceals us to insects by stopping the detection Carbon Dioxide, which we emit from our skin, a stimuli for blood feeding 1.

The Department of Medical Entomology at the University of Sydney & Westmead Hospital released the following guidelines for using repellants:

  • DEET repellants = recommended, but in different strengths depending on situation.
  • Plant-based repellents = good, but need to be reapplied regularly.
  • Wrist-band and patch repellents = ineffective.

Always check the label before applying insect repellent for instructions on how to apply and how often to reapply, and test it first on a small patch of skin before applying fully.

More information Some additional resources

Health direct is a government-funded service, providing quality, approved health information:
https://www.healthdirect.gov.au/bites-and-stings

Free app on to help identify and deal with bites and stings: http://www.seqirus.com.au/bites-app

Resources at the Australian Museum website (e.g. spider bites and venoms)

SPECIAL THANKS TO THE FOLLOWING EXPERTS FOR REVIEWING AND CONTRIBUTING MATERIAL TO THIS ARTICLE:

TICKS:
HENRY LYDECKER | PhD Candidate
School of Life and Environmental Sciences | Faculty of Science
THE UNIVERSITY OF SYDNEY

SPIDERS:
FRAN VAN DEN BERG
Citizen Science Officer
National Parks Association of NSW

Bites and Stings – Definitions

Venoms, poisons, infections & allergies

‘Arty’. To me the word's got as much venom associated with it as 'wacky'. Alex Kapranos

Venoms, poisons, infections and allergies all have unique meanings, but are often confused in everyday language. Let’s break them down to understand what they actually mean.

VENOMS and POISONS

According to the Oxford English dictionary:

A venom is a poisonous substance secreted by animals such as snakes, spiders, and scorpions and typically injected into prey or aggressors by biting or stinging.

A poison is a substance that is capable of causing the illness or death of a living organism when introduced or absorbed.

So basically, if you bite it and die, it is poisonous; if it bites you and you die, it is venomous. Venomous creatures actively inject chemical toxins via fangs, spines, stingers, or similar, into their victim. Venom is used by animals either as a defence mechanism, to counter an attack by an often larger animal, or as a way of catching prey. In some cases, the lethality of the venom is absurd: for instance, just a single drop of the inland taipan’s venom can kill about 100 adult humans. Venom is typically stored in specialised glands inside the venomous animal’s body, and in some cases is used to aid digestion of prey.

By comparison, poisonous animals secrete harmful chemicals, but are only transmitted to their victim if the victim eats or touches the poisonous plant or animal. Similar to venomous animals, even extremely small poisonous critters can have an enormous impact. For instance, the posion dart frog only measures 2 inches but has enough skin toxins to kill about 10 adult humans.

Poisonous substances and venom generally work by disrupting some kind of biological function of their prey or victim. Three of the most common types are neurotoxins, hemotoxins and cytotoxins.

  • Neurotoxins affect the nervous system with the main aim of killing by paralysing the heart and/or lungs. Signs and symptoms include suppressed heart function and breathing, as well as vomiting, paralysis, convulsions and muscle cramps. Critters that use neurotoxins include scorpions, paralysis ticks and cobra snakes.
  • Haemotoxin/hemotoxins affect the blood and tissues of the body and has the ability to break down blood cells and body tissues. Signs and symptoms include severe internal bleeding, major organ failure and the seeping of blood from body orifices such as the ears, nose and eyes. Critters that use hemotoxins include vipers and pit vipers.
  • Cytotoxins cause spontaneous death of the body cells and severe damage to body organs. Signs and symptoms include excruciating pain and major swelling of body tissues. Some jellyfish use cytotoxins.

INFECTIONS

Our skin is an extremely effective barrier to infectious agents such as bacteria. However, if the skin is pierced through an injury, scratch or bite, the wound is susceptible to infection. Ordinarily, germs like bacteria and viruses live on our skin without causing trouble but if the skin becomes broken, these germs move into the more sensitive tissues underneath and can start to multiply and spread, leading to an infection. Infected wounds left untreated can spread and quickly become a serious medical condition.

Any animal attack like a bite or a sting where the skin has been broken has the potential to become infected, and must be treated with this in mind. Having said that, if there is any risk at all that the bite is venomous (e.g. an unidentified snake or spider), then treating the patient for venom is the priority, and any infection risks are considered secondary.

Bites from some mammalian species carry the risk of transfer of infectious diseases like tetanus, Hep B from human bites and Australian bat lyssavirus (ABLV) from bats, and appropriate medical follow up must be taken.

ALLERGIES

With any type of bite or sting there is the potential for an allergic reaction. An allergic reaction is the body’s response to an invading substance. Our immune system gets activated when it detects foreign objects, and mobilises resources (including white blood cells) to the area to cope. In some cases, our bodies get this wrong, and overreacts. It can be from something that does not normally upset other people, but often people with allergic reactions don’t know they are allergic until they are affected.

There are two stages to developing an allergy. The first stage is sensitisation, where the allergen is recognised by the immune system and antibodies are made to fight it (even though the allergen is harmless).

The second stage is when the allergic reaction kicks in. Since the immune system retains the memory of the allergen, whenever it has contact with that allergen again even in the tiniest quantity, the body responds. That’s why people with hay fever have coughs, runny nose and flu-like symptoms at pollen season, or the tiniest amount of peanuts in food can affect someone with a peanut allergy.

Allergic reactions can occur after a bite or sting, where the body overreacts to any new substances that have been detected, be that a poisonous substance from a venomous creature or an infectious germ after the skin has been broken.

The main difference between an irritation like small swelling from a mosquito bite and an allergic reaction like hayfever is that an irritation is localised to the affected area. By comparison, an allergic reaction spreads to other parts of the body.

Anaphylaxis is a severe allergic reaction where the patient experiences extreme allergic responses including itching, swelling and shortness of breath. Anaphylaxis must be treated immediately, as it can cause death if untreated.

FUN FACT: Did you know that our cute and cuddly Platypus (Ornithorhynchus anatinus) is armed with venomous spurs?
shutterstock_109281905_1500
Male platypus have a sharp barb located above its rear webbed feet. Used mainly during the mating season, males inject painful venom into their rivals during a fight.

Reports of humans being stung by platypus are rare, but do exist. While not fatal, stings are reported to be extremely painful with the potential to cause permanent disability around the affected area. Interestingly, individuals held in captivity do not produce venom, making it challenging for scientists to collect and reliably test the properties of platypus venom reliability.

So don’t be fooled by it’s cute and cuddly appearance, male platypus are venomous! As with all animals you see on a bushwalk, respect them from a distance and leave no trace.

Bites and Stings – Specific Species

Managing venomous bites

I don't use a pen. I write with a goose quill dipped in venom. Jay Dratler

Venomous bites have the potential to be life threatening and must be taken seriously until proven otherwise, either through a positive ID of the animal being non-venomous, or confirming that the attack was a ‘dry bite’.

Dry bites are bites by venomous animals where no venom was released (i.e. a bite without envenomation). It’s actually quite common in some species. For example, 80% of the time, Australian eastern brown snakes (Pseudonaja textilis) inflict dry bites 1. By comparison taipans inflict dry bites only 5% of the time 2

In practice, determining whether or not the bite was a dry-bite is extremely challenging. That’s why we always treat bites as venomous in the bush just in case.

Read through the following posts for more specific information on venomous critter bites and how to manage them.

Snakes

Dealing with venomous snake bites

Australia has both venomous and non-venomous species of snakes, both of which can lash out and bite, the venomous one injecting venom, the non-venomous potentially puncturing the skin and causing infection. After an Australian snake bite, it common for signs of local damage like bruising or tissue discolouring to be missing, potentially giving the patient and first-aiders a false sense of security. Don’t be fooled! Every snake bite must be considered a medical emergency until resolved, even if the patient presents well.

Getting a positive identification of the snake used to be extremely important in order to administer the correct antivenom, however, the reality is that it is extremely hard to positively identify a snake species in the heat of the moment, and under challenging light conditions. With the advent of polyvalent antivenoms (i.e. antivenoms that work against several species) a positive identification isn’t essential, however, being able to administer a specific antivenom is less likely to cause complications. Having said this, don’t chase after a snake or try to catch or kill it to get a positive identification. Always treat the bite as if the snake was unidentified if the identification is uncertain.

Here, we cover snake species found in the Greater Sydney Region. For other areas of Australia, see this website .

Identification Snakes in the Greater Sydney Region

Generally speaking, we can separate venomous snakes into two groups: those with the fangs at the front of the mouth, and those with fangs at the rear. Pythons are a different kind of snake that does not kill its prey with venom but instead squeezes its prey to death.

FRONT FANGED SNAKES

Highly venomous snakes have hollow fangs that are long, thin and hollow. These fangs act like syringes where they are able to quickly deliver venom in one swift bite. Highly venomous species tend to have front fangs.

The following front fanged species are found in the greater Sydney region:

Common Death Adder (Acanthophis antarcticus)
Family: Front Fanged Venomous
Venom: Extremely venomous

Photo credit: Wolfgang Wuster for http://www.whatsnakeisthat.com.au/category/region/nsw-act/greater-sydney/

Photo credit: Wolfgang Wuster for http://www.whatsnakeisthat.com.au/category/region/nsw-act/greater-sydney/

Golden-Crowned Snake (Cacophis squamulosus)
Family: Front Fanged Venomous
Venom: Mildly venomous

Photo credit: teejaybee via Foter.com / CC BY-NC-ND

Photo credit: teejaybee via Foter.com / CC BY-NC-ND

Eastern Small-Eyed Snake (Cryptophis nigriscens)
Family: Front Fanged Venomous
Venom: Highly venomous

Photo credit: John Wombey for http://www.whatsnakeisthat.com.au/category/region/nsw-act/greater-sydney/

Photo credit: John Wombey for http://www.whatsnakeisthat.com.au/category/region/nsw-act/greater-sydney/

Yellow-Faced Whipsnake (Demansia psammophis)
Family: Front Fanged Venomous
Venom: Mildly venomous

Photo credit: Mark_Green_13 via Foter.com / CC BY-SA

Photo credit: Mark_Green_13 via Foter.com / CC BY-SA

White-Lipped Snake (Drysdalia coronoides)
Family: Front Fanged Venomous
Venom: Mildly venomous

Photo credit: Rémi Bigonneau via Foter.com / CC BY-NC-ND

Photo credit: Rémi Bigonneau via Foter.com / CC BY-NC-ND

Mustard-Bellied Snake (Drysdalia rhodogaster)
Family: Front Fanged Venomous
Venom: Mildly venomous

Photo credit: ASasch via Foter.com / CC BY

Photo credit: ASasch via Foter.com / CC BY

Red-Naped Snake (Furina diadema)
Family Front Fanged Venomous
Venom: Mildly venomous

Photo credit: AlexandreRoux01 via Foter.com / CC BY-NC-SA

Photo credit: AlexandreRoux01 via Foter.com / CC BY-NC-SA

Marsh Snake (Hemiaspis signata)
Family Front Fanged Venomous
Venom: Mildly venomous

Photo credit: Doug Beckers via Foter.com / CC BY-SA

Photo credit: Doug Beckers via Foter.com / CC BY-SA

Broad Headed Snake (Hoplocephalus bungaroides)
Family: Front Fanged Venomous
Venom: Highly venomous

Photo credit: dnatheist via Foter.com / CC BY

Photo credit: dnatheist via Foter.com / CC BY

Tiger Snake (Notechis scutatus)
Family: Front Fanged Venomous
Venom: Extremely venomous

Photo credit: David Nixon for http://www.whatsnakeisthat.com.au/category/region/nsw-act/greater-sydney/

Photo credit: David Nixon for http://www.whatsnakeisthat.com.au/category/region/nsw-act/greater-sydney/

Spectacled Hooded Snake (Parasuta spectabilis)
Family Front Fanged Venomous
Venom: Mildly venomous

Photo credit: Brian Bush for http://www.whatsnakeisthat.com.au/category/region/nsw-act/greater-sydney/

Brian Bush

Red Belly Black Snake (Pseudechis porphyriacus)
Family Front Fanged Venomous
Venom: Highly venomous

Photo credit: Tony Rodd via Foter.com / CC BY-NC-SA

Photo credit: Tony Rodd via Foter.com / CC BY-NC-SA

Eastern Brown Snake (Pseudonaja textilis)
Family Front Fanged Venomous
Venom: Extremely venomous

Photo credit: AlexandreRoux01 via Foter.com / CC BY-NC-SA

Photo credit: AlexandreRoux01 via Foter.com / CC BY-NC-SA

Eastern Bandy Bandy (Vermicella annulata)
Family Front Fanged Venomous
Venom: Mildly venomous

Photo credit: AlexandreRoux01 via Foter.com / CC BY-NC-SA

Photo credit: AlexandreRoux01 via Foter.com / CC BY-NC-SA

REAR FANGED SNAKES

Rear-fanged snakes are less efficient at injecting venom than front fanged snakes as so must bite and hold their prey in order to envenomate them. This group of snakes has a mix of venomous and non-venomous species. In the greater Sydney region there is one mildly venomous and one non-venomous.

Brown Tree Snake (Boiga irregularis)
Family: Solid Toothed & Rear Fanged
Venom: Mildly Venomous

Photo credit: AlexandreRoux01 via Foter.com / CC BY-NC-SA

Photo credit: AlexandreRoux01 via Foter.com / CC BY-NC-SA

Green Tree Snake (Dendrelaphis punctulatus)
Family: Solid Toothed & Rear Fanged
Venom: Non-venomous

Photo credit: petrichor via Foter.com / CC BY-NC-ND

Photo credit: petrichor via Foter.com / CC BY-NC-ND

PYTHONS

Pythons fall into a separate snake family again and are all non-venomous. Pythons do not have fangs, but instead have sharp, backward-curving teeth for grabbing prey.

The two pythons found in the Greater Sydney region are the closely related Carpet and Diamond Python (Morelia spilota).

Carpet Python and Diamond Python (Morelia spilota)
Family: Pythons
Venom: Non-venomous

Photo credit: Doug Beckers via Foter.com / CC BY-SA

Photo credit: Doug Beckers via Foter.com / CC BY-SA

SNAKE LOOK-A-LIKES

Some lizards with very small or no legs look deceptively like snakes. At a distance, these species can be easily confused with snakes, although close up there are clear differences. Unlike snakes, rest assured legless lizards are non-venomous.

According to the ‘What snake is that’ identification website, the key differences to keep an eye out for are:

  • Tongue: Snakes have forked tongues which they use to ‘taste’ the air for scent particles. All species of legless lizards have a fleshy tongue.
  • Eyes: Most species of lizards have moveable eyelids. Snakes have fixed transparent scales that cover their eyes which are known as the brille or spectacle.
  • External ear openings: All species of legless lizards have external ear openings. Snakes do not have ears, and as a result are unable to hear airborne sound using an ear. Snakes are very sensitive to vibrations and actually have some remnant bones of the ear attached to the lower jawbone.

Photo credit: Misenus1 via Foter.com / CC BY-NC-SA

Photo credit: Misenus1 via Foter.com / CC BY-NC-SA

Prevention Preventing snake bites

Here are some great tips to avoid getting surprised by snakes on the track:

  • Snakes do not hear in the same way we do, instead they detect vibrations. By walking heavily, you can warn any concealed snakes of your presence, making them more likely to flee on their own accord. By comparison, if a snake is caught unaware and only detects your presence at the last minute, it’s far more likely to get startled, and lash out aggressively.
  • If you see a snake on the path, do not disturb it. Tell other people in the group that the snake is there, and give it a wide berth. If you can’t get around the snake, back away slowly and change your route plan.
  • Never attempt to touch or move a snake, especially to ascertain if it’s venomous or not. It can be challenging to identify the species of a snake in the heat of the moment, so the best approach is to assume that all snakes are venomous and act accordingly.
  • Keep your actions smooth and calm. Avoid waving arms around or making sudden movements that the snake could interpret as hostile.
  • Avoid walking through long grass where snakes are easily concealed. It’s easy to accidentally startle or step on a snake.
  • If a snake’s head is raised, this could indicate that the animal feels threatened, and it is winding up ready to strike. Take action to reduce the threat to the animal, which most likely means backing away and finding an alternative route.
  • Snakes often bask alongside a log. To avoid startling a snake, step onto rather than over logs.
  • Snakes are ectotherms, that is, they are dependent on external sources of body heat to function. Hence, it’s common to see snakes out sunning themselves first thing in the morning and may be slow to move away from you.

Signs & Symptoms Signs & symptoms of snake bites

The bite site may be puncture marks, bleeding or scratches.

Signs and symptoms of a snake bite include:

  • Headache
  • Impaired vision
  • Nausea
  • Vomiting
  • Diarrhoea
  • Breathing difficulties
  • Drowsiness
  • Faintness
  • Problems speaking or swallowing.

Management How to manage snake bites

St John Ambulance makes the following management recommendations.

THINGS TO DO:

  1. Follow DRSABCD .
  2. Reassure the patient and ask them not to move.
  3. Apply a broad crepe bandage over the bite site as soon as possible.
  4. Apply a pressure bandage (heavy crepe or elasticised roller bandage) starting just above the fingers or toes of the bitten limb, and move upwards on the limb as far as can be reached (include the snake bite). Apply firmly without stopping blood supply to the limb.
  5. Immobilise the bandaged limb with splints.
  6. Ensure the patient does not move.
  7. Write down the time of the bite and when the bandage was applied. Stay with the patient.
  8. Regularly check circulation in fingers or toes.
  9. Manage for shock.
  10. Ensure an ambulance has been called.

THINGS NOT TO DO:

  • DO NOT wash venom off the skin.
  • DO NOT cut the bitten area.
  • DO NOT try to suck venom out of wound.
  • DO NOT use a tourniquet.
  • DO NOT try to catch the snake.

Spiders

Dealing with venomous spiders

Australia has both venomous and non-venomous species of spiders to humans. As with snakes, treat all spider bites as venomous unless proven otherwise.

Identification Spiders in the Greater Sydney Region

DEADLY AND DANGEROUS

Funnel webs have extremely venomous bites. They are among the most deadly spiders in the world, however, fatalities are extremely low since the development of effective and readily available antivenoms.

Mouse spiders are also up there. According to the Australian Museum: “Some mouse spiders have a very toxic venom which is potentially as dangerous as that of the Sydney Funnel-web Spider… Because of their potential toxicity to humans, first aid treatment should be provided as recommended for funnel-web spider envenomation. Fortunately, funnel-web spider antivenom has proven effective in cases of mouse spider bite”.

Redbacks are common across Australian and readily found in urban areas. Although only the female bite is dangerous to humans, more than 250 antivenoms are administered a year over the summer months.

Funnel web spiders (Atracinae)

Male funnel web spider. Photo credit: http://www.spiders.com.au/

Male funnel web spider. Photo credit: http://www.spiders.com.au/


Female funnel web spider. Photo credit: http://www.spiders.com.au/

Female funnel web spider. Photo credit: http://www.spiders.com.au/

Mouse spiders (Missulena)

Male mouse spider. Photo credit: http://www.spiders.com.au/

Male mouse spider. Photo credit: http://www.spiders.com.au/


Female mouse spider. Photo credit: http://www.spiders.com.au/

Female mouse spider. Photo credit: http://www.spiders.com.au/

Redback spider (Latrodectus hasselti)

Redback spider. Photo credit: http://www.spiders.com.au/

Redback spider. Photo credit: http://www.spiders.com.au/

VENOMOUS – PAINFUL BITE

Black house spider (Badumna insignis)

Black House spider. Photo credit: http://www.spiders.com.au/

Black House Spider (Badumna insignis)

LOW RISK SPIDERS

Wolf spiders (Lycosidae)
Wolf spiders rarely bite, especially if left unhandled. They are common around houses, but low risk to humans.

Wolf spider. Photo credit: http://www.spiders.com.au/

Wolf spider. Photo credit: http://www.spiders.com.au/

Trap door spiders (Ctenizidae)

Trap door spider. Photo credit: http://www.spiders.com.au/

Trap door spider. Photo credit: http://www.spiders.com.au/

Garden orb weaving spider (Eriophora transmarina)

Garden orb weaving spider. Photo credit: http://www.spiders.com.au/

Garden orb weaving spider. Photo credit: http://www.spiders.com.au/

St Andrew’s Cross spiders (Argiope)

St Andrew's Cross  spider. Photo credit: http://www.spiders.com.au/

St Andrew’s Cross spider. Photo credit: http://www.spiders.com.au/

Golden orb weaver (Nephila)

Photo credit: BRJ INC. via Foter.com / CC BY-NC-ND

Photo credit: BRJ INC. via Foter.com / CC BY-NC-ND

Huntsman spiders (Sparassidae)

Huntsman spider. Photo credit: http://www.spiders.com.au/

Huntsman spider. Photo credit: http://www.spiders.com.au/

White-tail spiders (Lampona)
A common misconception is that white tailed spiders have a deadly bite and cause skin necrosis. Yet, their venom is non-lethal. In some cases, bacterial infection is the biggest source of danger to people that have been bitten.

White tail spider. Photo credit: http://www.spiders.com.au/

White tail spider. Photo credit: http://www.spiders.com.au/

Prevention Preventing spider bites

The NSW government has this advice for avoiding funnel web and redback spider bites:

  • Keep your garden free of rubble and rubbish where spiders can hide.
  • Wear shoes, gloves and long sleeved shirt when working in the garden.

    Check shoes and households items for spiders.

For bushwalkers, we recommend:

  • Take care if moving rocks or logs.
  • Wear shoes around campsite, especially at dusk and dawn when it’s harder to see.
  • Check shoes and anything else left out for spiders and insects before use.

Signs and Symptoms Signs and symptoms of spider bites

In general, we split Australian spiders into three medically relevant groups and treat accordingly: big black spiders (funnel webs, mouse spiders), redback spiders and all other spiders.

General signs and symptoms of spider bites include:

  • Sharp pain at bite site
  • Profuse sweating
  • Nausea, vomiting and abdominal pain.

Additional signs and symptoms of a Funnel web spider bite:

  • Copious secretion of saliva
  • Muscular twitching and breathing difficulty
  • Small hairs stand on end
  • Numbness around mouth
  • Copious tears
  • Disorientation
  • Fast pulse
  • Markedly increased blood pressure
  • Confusion leading to unconsciousness.

Additional signs and symptoms of a red-back spider bite:

  • Intense local pain which increases and spreads
  • Small hairs stand on end
  • Patchy sweating
  • Headache
  • Muscle weakness or spasms.

Possible signs and symptoms of other spider bites:

  • Burning sensation
  • Swelling
  • Blistering.

Management Management of spider bites

St John Ambulance makes the following management recommendations:

  1. Follow DRSABCD .
  2. Lie the patient down.
  3. Calm and reassure the patient.
  4. Apply management for:
  • Funnel-web / Mouse spider
    • If on a limb, apply a broad crepe bandage over the bite site as soon as possible.
    • Apply a heavy crepe or elasticised roller bandage starting just above the fingers or toes of the bitten limb, and move upwards on the limb as far as can be reached (include the bite). Apply firmly without stopping blood supply to the limb.
    • Immobilise the injured limb with splints and ensure the patient does not move.
    • Ensure an ambulance (000) has been called or emergency beacon activated.
  • Red-back spider
    • Apply an icepack (cold compress) to the bitten area to lessen pain.
    • Seek medical attention if patient develops severe symptoms.
  • Other spider bites
    • Wash with soap and water .
    • Apply ice pack (cold compress) to relieve the pain.
    • Seek medical attention if patient develops severe symptoms.

Ticks

Dealing with tick bites

Ticks are parasites that live off blood of humans and animals. Ticks get to blood by attaching themselves to the skin of their host with sharp mouthparts, piercing the skin and injecting saliva into the area to prevent blood clotting. In the case of the paralysis tick, it’s the transfer of the highly toxic saliva from that can have serious medical implications for the host.

Special thanks to Henry Lydecker for reviewing and contributing to this article:
HENRY LYDECKER | PhD Candidate
School of Life and Environmental Sciences | Faculty of Science
THE UNIVERSITY OF SYDNEY

Identification Identification of ticks in NSW

In Eastern Australia, 95% of tick bites are due to the Paralysis Tick (Ixodes holocyclus), and most tick-borne illnesses are the result of a Paralysis Tick bite.

Photo credit: Ryan Wick via Foter.com / CC BY

Photo credit: Ryan Wick via Foter.com / CC BY

This species may also be referred to as the grass tick, seed tick and bush tick depending upon the development stage: the egg, larvae (around 1mm and light brown in colour when not full of blood), nymph (around 2mm and pale brown) and the adults (4–5mm in length, without blood).

Tick life cycle (S.L. Doggett, Department of Medical Entomology, Westmead Hospital) as described above

Tick life cycle (S.L. Doggett, Department of Medical Entomology, Westmead Hospital) as described above

Prevention Preventing tick bites

Ticks are usually more likely to be found in more humid, less windy, more dense vegetation, more leaf litter, so avoiding these areas can be a way of dodging tick bites.

Unfortunately, bushwalks generally go through these habitats! Long sleeved shirts and pants are key for reducing the likelihood of tick bites, as well as insect repellent containing DEET or Picardin.

In addition the NSW governemnt website suggests:

  • Tuck long pants into socks and long sleeved shirts in pants.
  • Use light coloured clothing so that ticks are easier to spot.
  • Check yourself regularly for ticks. Tick prone areas include back of the head and neck, groin, armpits and back of knees. Get a friend to check areas like your back that are hard to inspect, or use a mirror.
  • After you get home from a trip, put all clothing in a hot dryer for at least 10 minutes to kill any remaining ticks.

Signs & Symptoms Signs & symptoms of ticks

Although tick bites are not uncommon in Australia, there has been very little medical research into tick-borne illnesses or best practice in tick removal to date. Here’s the best of our knowledge so far!

For most people, tick bites cause local swelling, redness and itchiness at the bite site, but generally pose no medical problems as long as the tick is removed quickly.

On rare occasions, people development allergic reactions (and even anaphylaxis) to ticks. While rare, allergic reactions can be serious, so consult your doctor if you have a history of allergic reactions with tick bites, or if you are concerned about possible allergic reactions.

There are two main tick-borne diseases that can occur in Australia, Queensland Tick Typhus and Flinders Island Spotted Fever. Very occasionally, ticks bites may lead to tick paralysis.

Queensland Tick Typhus
Queensland Tick Typhus is is a condition caused by a bacterium Rickettsia australis, and is transmitted by the Tick species Ixodes holocyclus and Ixodes tasmani. A blood test is the clinic confirmation of the condition, and is treated with antibiotics (although fatalities have occurred rarely).

Symptoms include:

  • Rashes
  • Eschars
  • Headaches
  • Fever
  • Flu-like symptoms
  • Lymph node tenderness

Flinders Island Spotted Fever
Flinders Island Spotted Fever a condition associated with the bacterium Rickettsia honei, and is also transmitted by ticks.

Symptoms include 1:

  • Fever
  • Headache
  • Myalgia
  • Transient arthralgia
  • Maculopapular rash
  • Cough (in some cases)

Tick paralysis
Very occasionally, ticks bites may lead to tick paralysis, an extremely rare, but severe conditions. In the few known cases, tick paralysis has been have recorded in the very young, very old, or otherwise immunologically impaired.

Early signs and symptoms of tick paralysis to include:

  • Rashes
  • Headache
  • Fever
  • Influenza like symptoms
  • Tenderness of lymph nodes
  • Unsteady gait
  • Intolerance to bright light
  • Increased weakness of the limbs
  • Partial facial paralysis

PET OWNERS BE CAREFUL: Tick paralysis is serious (often fatal) in dogs. Owners walking their dogs near the bush need to check pets carefully afterwards for ticks.

Lymes disease
Lymes disease is a seroius tick-borne disease that if left untreated, the infection can spread through the bloodstream to the brain and heart.

Several species of ticks in Africa, Asia, Europe, and North America are known to carry and transmit species of Borrelia bacteria that are known to cause Lyme disease in humans.

Australian ticks like the Paralysis tick have been suspected as possible vectors of Lyme disease, but multiple studies have failed to find any Borrelia species bacteria in these ticks. The only known species in the Borrelia genus that occurs in Australia is only found in one species of Australian tick that is only known to bite Echidnas 2. This species of bacteria is not in the same group as those known to cause Lyme disease, so it is unlikely to be a health threat.

There are, however, advocacy groups in Australia (Primarily the Lymes Disease Association of Australia) that acknowledge Lymes Disease (or Lyme-like diseases) to occur in Australia, and advocate for Lymes Disease to diagnosed and treated accordingly.

Many health workers and public health researchers believe that Queensland Tick Typhus and Flinders Island Spotted Fever are the most common tick-related health issues in Australia. It is widely suspected that patients who believe they have Lyme’s disease actually have a subclinical infection of tick typhus (although there is currently no research to support this).

Regardless of the label, tick-borne diseases can be serious. Consult your health professional immediately if you have any concerns following a tick bite.

Tick-induced meat-allergies
A peculiar meat-allergy has also emerged in recent years, affecting people found in coastal Eastern Australia. The tick-induced mammalian meat allergy (MMA) has seen some people bitten by paralysis ticks to develop a severe allergic reaction to meat products and sometimes dairy and gelatine. If you believe you have developed red meat allergy, consult your doctor for referral to a specialist.

TRAVELLING ABROAD?
If you travel abroad, consult local guides for information about ticks and tick-borne diseases that are relevant there. If you fall sick upon returning to Australia, make sure to discuss your travel with your doctor.

Management Management of ticks

The NSW government health website suggests the following for tick removal:

“Ticks should be removed as soon as possible using fine tipped forceps or fine surgical scissors. Hold the tick as close as possible to the surface of the skin and pull with steady pressure. Avoid squeezing the body of the tick during removal. If you are unable to do this, see your doctor to remove the tick. Do not use methylated spirits, nail polish remover, alcohol, petroleum jelly or any other products on ticks prior to removal as it will cause the tick to inject more toxins.
Note: In individuals with a history of allergic reactions to tick bites, ticks should be removed as soon as possible, but only by a doctor and where resuscitation facilities are readily available”.

Photo credit: https://www.cdc.gov/ticks/removing_a_tick.html

Photo credit: https://www.cdc.gov/ticks/removing_a_tick.html

After removal, apply antiseptic cream to the bite area. If tick removal is difficult, or you begin to suffer rash, swelling, signs of infection, muscle weakness in the bite site area or flu like symptoms, seek medical attention urgently.

DO NOT:

  • Do anything to irritate the tick because this makes it harder to completely remove it (e.g. squeezing, rubbing, scratching).
  • Grasp the tick by the body.
  • Apply methylated spirits, kerosene or fingernail polish.
  • Use a lighted match, or cigarette.

NOTE

The Australasian Society of Clinical Immunology and Allergy recommends killing ticks by freezing them of using ether-containing sprays (e.g. Wart-Off Freeze®, Elastoplast Cold Spray®). This method is still in the research and development phase, and while promising, is not currently recommended by the NSW government health website.

A recent literature review published in early 2017 concludes 3:
“The best method is to remove the tick as soon as possible after it is detected, using either fine-tipped tweezers or a reputable commercially produced tick removal tool to pull the tick away from the site of attachment……Other methods of removal, such as freezing, while promising, have not yet been scientifically validated.”

So the conclusion is: stick to tweezers, until other methods are validated.

Other biting, stinging insects

Dealing with other types of biting, stinging insects

Here we run through all the other common insects found in NSW that bite and sting (information based on articles from the Australian museum).

Identification Identification of biting or stinging insects

Bed Bugs (Cimicidae)
Bedbugs are blood feeders and most active at night. Reactions vary from none to severe irritation and localised swelling.

Photo credit: Armed Forces Pest Management Board via Foter.com / CC BY-NC-ND

Photo credit: Armed Forces Pest Management Board via Foter.com / CC BY-NC-ND

Honey bees (Apis mellifera)
Bees sting as a last resort defence mechanism killing themselves in the process as they drive a barbed stinger into flesh. Bee stings generally cause local pain and swelling, but can cause severe allergic reactions in some cases.

Photo credit: Dendroica cerulea via Foter.com / CC BY-NC-SA

Photo credit: Dendroica cerulea via Foter.com / CC BY-NC-SA

European wasps (Vespula germanica)
Unlike bees, wasps do not die upon stinging. Stings generally cause local pain and swelling, but can cause severe allergic reactions in some cases.

Photo credit: epitree via Foter.com / CC BY-NC

Photo credit: epitree via Foter.com / CC BY-NC

Biting and non-biting flies
Within Australia, horse flies or March flies (Family Tabanidae) are the most significant biting flies. House flies (Musca domestica) can also cause problems by carrying millions of bacteria in its gut, mouthparts or feet.

Photo credit: Jacko 999 via Foter.com / CC BY-NC-SA

Photo credit: Jacko 999 via Foter.com / CC BY-NC-SA

Mosquitoes (Culicidae)
Mosquitoes are blood suckers that carry diseases such as malaria and transfer the disease to humans via salivary glands. Malaria is not a major health problem In Australia, but other mosquito-borne diseases are increasing (e.g. Ross River Virus, Dengue and Murray Valley Encephalitis).

Photo credit: Ecuador Megadiverso via Foter.com / CC BY-NC-SA

Photo credit: Ecuador Megadiverso via Foter.com / CC BY-NC-SA

Ants
Myrmecia (the bull ants and jack-jumpers) and Odontomachus ants are aggressive animals with the potential to inflict painful stings. Ants can pose threats to people with allergic reactions.

Photo credit: david_a_l via Foter.com / CC BY-NC-ND

Photo credit: david_a_l via Foter.com / CC BY-NC-ND

Scorpion
Found under logs, rocks and in shallow burrows in earth banks. Can inflict painful sting.

Photo credit: antisense via Foter.com / CC BY-NC-SA

Photo credit: antisense via Foter.com / CC BY-NC-SA

Centipede
Found under logs, rocks and in shallow burrows in earth banks. Can inflict painful sting.

Photo credit: Black_Claw via Foter.com / CC BY

Photo credit: Black_Claw via Foter.com / CC BY

Caterpillar
Australian Lepidoptera (moths and butterflies) have caterpillars with stinging hairs and/or fragile spines which can cause painful stings to people that accidentally touch them.

Photo credit: dhobern via Foter.com / CC BY

Photo credit: dhobern via Foter.com / CC BY

Prevention Preventing other insect bites and stings

In general, with all insect bites, wearing insect repellent, long sleeved clothing and checking shoes before putting them on are good ways to minimise the risk of being bitten by an insect.

Signs and symptoms Signs and symptoms of other insect bites and stings

The NSW Health Direct website lists 6 common signs and symptoms of insect stings:

  1. An intense burning feeling.
  2. Redness around the sting site.
  3. Pain which generally eases after an hour or so.
  4. Swelling around the sting.
  5. In cases of allergic reaction, swelling may be more severe and affect a larger part of the body, for example the whole leg or arm may become swollen.
  6. Allergic reactions may cause further swelling, pain and in some cases blisters will form.

By comparison, an insect bite that leaves a puncture mark only on the skin, generally has the following signs and symptoms:

  • Skin irritation;
  • Inflammation or swelling;
  • A bump or blister around the bite mark.

Skin rashes, itching, stinging sensations, and/or swelling are all common. On rare occasions, patients go into Anaphylactic shock.

Management Management of other insect bites and stings

Itching is a common outcome of insect stings, but scratching the itch can cause more damage by breaking the skin and opening a wound to infection.

The Australian governement health website recommends the following steps to relieve itching:

  • Try not to scratch the area – keep your nails short to prevent breaking the skin if you do scratch.
  • A cool bath or shower may help to soothe the itching – gently pat yourself dry with a clean towel, but do not rub or use the towel to scratch yourself.
  • Avoid perfumed skin care products.
  • Try to wear loose cotton clothing, which can help prevent you overheating and making the itch worse – avoid fabrics which irritate your skin, like wool or scratchy fabrics.
  • An ice pack may relieve the itching but should not be placed directly against the skin – you can make an ice pack by using a bag of frozen peas wrapped in a clean cloth.
  • There are medicines available to ease the symptoms of itching – speak to a pharmacist for further advice and to make sure any medicines you take are suitable for you.
  • If you are in pain, get advice on medicines from a pharmacist, or from a doctor on medicines you can take.

Bee stings
The Australian governement health website recommends the following steps if you are stung by a bee:

  • Do not use tweezers to remove the sting; bees leave behind a sac of venom, and if you try to use tweezers you will release more venom from the sac.
  • If the stinger is still in the skin, gently try to remove it by scraping it carefully from the side with the edge of a firm object, such as a fingernail or credit card.
  • When you have removed the sting, wash the affected area with soap and water and dry the area gently.
  • If the pain is persistent and continues, massage the area around the sting or bite for 10 minutes using an ice-pack. This will only provide temporary pain relief.

Mosquito bites
The Australian government health website recommends to wash the area with soap and water and apply antiseptic. Cold packs may help with local pain and swelling.

Scorpion or centipede
The Australian government health website recommends the following steps if stung by a scorpion or centipede stings:

  • Apply an ice pack to the sting or bite site.
  • Clean the wound with antiseptic or wash with soap and water to help prevent secondary infection.
  • Use a painkiller.

Caterpillar
The Australian government health website recommends to take these steps if stung by a caterpillar:

  • Remove visible caterpillar hairs with tweezers.
  • Apply and remove adhesive tape to the area to remove the finer caterpillar hairs.
  • Do not scratch or rub the area, this may cause the hairs to penetrate deeper into the skin.

Marine Stings

Dealing with stinging marine species

There are a lot of marine creatures that bite or sting, an evolutionary development to defend and hunt underwater. Some deliver venom via spines, tentacles or teeth, while others aren’t venomous but have sophisticated teeth for attacking prey and defending themselves (e.g. sharks).

The most common marine stings are from jellyfish, mainly bluebottles, followed by spiny fish and stingrays. Box jellyfish are the most dangerous, but rare. Likewise blue-ringed octopi and sea snakes pose significant risks, but are attacks are uncommon.

Identification Identification of stinging marine species

We can split marine species into a few groups: animals that are lethal and non-lethal (i.e. those that give a painful bite)

HIGHLY VENOMOUS

  • Box jellyfish (Cubozoa)
    The box jellyfish is the most venomous animal in the world and can cause cardiac arrest within minutes.
    Photo credit: gautsch. via Foter.com / CC BY-SA

    Photo credit: gautsch. via Foter.com / CC BY-SA

  • Blue-ringed octopus (Hapalochlaena)
    The blue-ringed octopus is a small but deadly creature with enough venom to kill 26 humans. Bites are often painless, resulting in victims not being aware that they’ve been bitten until severe symptoms set in. To make matters worse, there is currently no blue-ringed antivenom, putting it high on the list of deadliest marine creatures.
    Photo credit: Angell Williams via Foter.com / CC BY

    Photo credit: Angell Williams via Foter.com / CC BY

  • Sea snakes (Hydrophiinae)
    Although the majority of sea snakes are highly venomous, venom injection is rare and very few human fatalities have been reported. Nevertheless, be wary of sea snakes and manage all bites as though venom has been injected.
    Photo credit: Daniel, Daniel Kwok via Foter.com / CC BY-NC-ND

    Photo credit: Daniel, Daniel Kwok via Foter.com / CC BY-NC-ND

  • Irukandji jellyfish
    Irukandji are small jellyfish with four long tentacles. Their tentacles can be as small as few centimetres long up to 1 metre. Victims report excruciating pain that is delayed starting for 5-120 minutes, but can last for months. Although often hospitalised, fatalities are rare (3 reported over the last 100 years).
  • News.com.au reports the following experiences from a victim:
    “I cannot begin to explain how excruciating the pain is,” jellyfish toxicologist, Professor Jamie Seymour of James Cook University, told news.com.au.
    “I’ve been stung 11 times and each time I’ve ended up in hospital.
    “It’s very mild to start with, then it takes about 15 to 20 minutes to kick in and it’s overall mind-numbing horrific pain.
    “The last time I got stung across the top of my lip, then I got pins and needles in my feet, pain like red hot pokers in my joints and then overwhelming racking body pain and throwing up for 18 hours.”

    Photo Credit: Marc McCormack, Source:News Corp Australia

    Photo Credit: Marc McCormack, Source:News Corp Australia

  • Stonefish (Synanceia)
    Stonefish are highly venomous and can be fatal if not treated. Often, stings are the result of accidentally stepping on the fish as it is well camouflaged against rocks and coral. Amazingly, stonefish are able to stay out of water for up to 24 hours, so it’s possible to get stung by an individual washed up on the beach. Stonefish antivenom is the second-most administered in Australia.
    Photo credit: Bill & Mark Bell via Foter.com / CC BY-NC-SA

    Photo credit: Bill & Mark Bell via Foter.com / CC BY-NC-SA

  • Scorpion fish
    Scorpion fish are found in shallow waters around Sydney and are often seen by divers. They have sharp spines coated in a venomous mucus that stings and a puncture to the chest or abdomen may be fatal.
    Photo credit: Marine Explorer via Foter.com / CC BY-NC-SA

    Photo credit: Marine Explorer via Foter.com / CC BY-NC-SA

VENOMOUS
Here, we list species that tend to give painful to excruciating bites, but are generally non-leathal. However, be warned, without appropriate medical action, each species still has the potential kill (e.g. patient experiences a severe allergic reaction, breathing difficulties, or has small body frame – children at risk).

  • Blue-bottle (Pacific Man-O-War) jellyfish (Physalia physalis)
    Blue bottles are common throughout marine areas of Australia, and an unwelcome guest for beachgoers. They are between 2-15 cm, and more common on exposed ocean beaches rather than protected waters. A sting, while uncomfortable, is not life-threatening, however, for the very young or elderly there may be medical complications. Avoid the temptation to poke or play with washed up bluebottles as stinging cells in the tentacles may still be active.
    Photo credit: Biusch / CC BY-SA 3.0

    Photo credit: Biusch / CC BY-SA 3.0

  • Jimble jellyfish (Cubozoan)
    Although related to the Box jellyfish, the Jimble jellyfish is nowhere near as potent. It is the only Cubozoan that lives in colder Australian waters, and is occasionally present in high densities in Sydney Harbour.
    Photo credit: https://australianmuseum.net.au/uploads/images/3476/jimble_big.jpg

    Photo credit: https://australianmuseum.net.au/uploads/images/3476/jimble_big.jpg

  • Coneshells
    Brightly coloured coneshells are armed with small harpoons that can sting. Although most stings are no worse than a bee sting, in Australia, there are tropical species that have caused human fatalities. Hence, all species must be treated as potentially dangerous.
    Photo credit: richard ling via Foter.com / CC BY-NC-ND

    Photo credit: richard ling via Foter.com / CC BY-NC-ND

  • Catfish
    Catfish are recognised by their distinctive whiskers around their mouth. They also have sharp, bony spines on the edges of the dorsal and pectoral fins with venom that lock into place when they are threatened. Catfish stings are extremely painful at the site of the sting.

    On the east coast of Australia, the best known species is the eel tailed catfish, which occurs in coastal rivers.

    Photo credit: Sylke Rohrlach via Foter.com / CC BY-SA

    Photo credit: Sylke Rohrlach via Foter.com / CC BY-SA

  • Crown-of-Thorns starfish (Acanthaster planci)
    Crown-of-Thorns has a very wide Indo-Pacific distribution, and is increasingly common around Australia. Since the 1960s there have been population outbreaks where overabundance of the starfish put pressure on the coral species they feed on and coral goes into decline. Overpopulation of the starfish is a concern for vulnerable coral with slow regeneration rates.

    This starfish has spines that can perforate human skin causing sharp pain, persistent bleeding, tissue swelling and nausea. Embedded spines need to be removed surgically.

    Photo credit: Misenus1 via Foter.com / CC BY-NC-SA

    Photo credit: Misenus1 via Foter.com / CC BY-NC-SA

  • Stingray (Myliobatoidei)
    Stingrays have stingers on their tails that can cause pain, swelling, muscle cramps from the venom. Although death is rare, is can happen. Most famously, Steve Irwin was killed in 2006 when the stinger penetrated his thorax.

    The Black Stingray is is one of the largest stingrays in Australia, and is found off the coast of Sydney. Although venomous, they are not usually aggressive towards humans. This video beautifully captures how the stingray moves in water: https://www.youtube.com/watch?v=VPfXvWrVK3Y&feature=youtu.be

    Photo credit: Marine Explorer via Foter.com / CC BY-NC-SA

    Photo credit: Marine Explorer via Foter.com / CC BY-NC-SA

Prevention Preventing marine bites and stings

The Australian government has the following recommendations for avoiding marine bites and stings:

  • Swim at patrolled beaches between the red and yellow flags and inside stinger nets if they’re available.
  • Don’t enter the water when the beaches are closed.
  • Wear a full-body lycra suit for extra protection (particularly from tropical stingers during stinger season).
  • Don’t touch marine stingers if they are on the beach – they can still sting you.
  • Enter the water slowly to give marine stingers time to swim away.
  • Ask a lifeguard for help or advice if needed.

Signs and symptoms Signs and symptoms of stings by marine species

After any marine bite or sting, seek medical help immediately if you experience:

  • Difficulty breathing
  • Difficulty remaining conscious
  • Chest pain
  • Swelling around the sting site
  • Vomiting
  • Spasms
  • Shock
  • Severe bleeding

For stingrays, symptoms include intense pain, nausea, weakness, and fainting. For tentacled creates, symptoms are rashes, blisters, headaches, chest pain, muscle pain, sweating and runny nose. For coneshells, reactions include swelling, numbness, blurred vision, and respiratory failure. In rare instances, a person may experience cardiac arrest.

Management management of stinging marine species

Adapted from St John’s Ambulance guidelines.

Pressure immobilisationCold compress (ice pack) Hot water Vinegar
Funnel-web and Mouse spidersbeesBlue-bottle (Pacific Man-O-War) jellyfishBox jellyfish
snakeswasps (European)Bullrout fishIrukandji jellyfish
Blue-ringed octopusantsCatfishJimble jellyfish
coneshellsticksCrown-of-Thorns starfishsea anenomes
sea snakesscorpionsStingraytropical marine stings of unknown origin
centipedesStonefish
Red-backed spidernon-tropical minor jellyfish
all other spiders

Pressure immobilisation

  1. Follow DRSABCD.
  2. Calm patient and keep still.
  3. Apply a pressure immobilisation bandage.
  4. Ensure call for help has been made—triple zero (000) – or emergency beacon activated.

Cold Compress

  1. Follow DRSABCD.
  2. Calm patient.
  3. Apply a cold compress or ice pack directly over the bite site to relieve the pain.
  4. Seek medical aid if necessary.

Hot Water Treatment:

  1. Follow DRSABCD.
  2. Calm patient.
  3. Place patient’s stung limb in hot water (as hot as you, the first aider, can tolerate).
  4. Ensure call for help has been made—triple zero (000) – or emergency beacon activated.

Vinegar Treatment:

  1. Follow DRSABCD.
  2. Calm patient.
  3. Flood stung area with vinegar for at least 30 seconds.
  4. If vinegar not available, flick tentacles off using a stick or gloved fingers.
  5. Ensure call for help has been made—triple zero (000) – or emergency beacon activated.

Infectious bites and scratches

Dealing with infectious bites and scratches

Biologically speaking, if something bites you it's more likely to be female. Desmond Morris<br />

Bites and scratches themselves usually aren’t a major concern in themselves (apart from drop bear bites), however, the potential for infection is the thing to watch out for, especially if the skin is broken.

Prevention Prevention of infectious animal bites and scratches

WebMD make the following suggestions to prevent domestic and wild animal bites.

  • Do not disturb animals, even your family pets, while they are eating, sleeping, or nursing. Animal mothers can be very aggressive when protecting their young.
  • Never leave a young child or baby alone with a pet or wild animal.
    Do not approach or play with unfamiliar or stray pets or wild animals.
  • Teach children to ask permission from a pet’s owner before petting the animal. Do not pet an animal without first letting it sniff you.
  • Don’t run past a dog, because dogs naturally love to chase and catch things.
  • Many animals give a warning sign before they attack. If you have animals in your home, know their warning signs and teach them to your children.
  • Do not try to separate fighting animals. If available, water sprayed from a hose will often break up the fight.
  • If you see a threatening dog:
    • Stay still. Do not run.
    • Do not make direct eye contact with the dog or stare at the dog. Staring at a dog may be interpreted by the dog as a threat and aggression.
    • Don’t scream. If you say anything, speak calmly and firmly.
    • If you fall or are knocked to the ground, curl into a ball with your hands over your head and neck. Protect your face.
    • Notify animal control and, if possible, speak with the dog’s owners.
  • Tell children to report an animal bite to an adult immediately.
  • Do not keep wild animals as pets.
  • Do not touch or tease wild animals.
  • Do not handle sick or injured animals or animals that are acting strangely.
  • Get help from animal control personnel if you need to rescue a trapped or injured animal. If no help is available, wear the heaviest gloves and clothing you have. Do not move quickly when approaching the animal, and talk in a low, gentle voice to reassure the animal.

General Signs and Symptoms General Signs and Symptoms of infectious bites and scratches

Bites can lead to the following injuries: puncture, lacerations, abrasions or scrapes, bruising and swelling.

Infection is the main concern, noted by swelling, redness, tenderness, pain around the wound, discharge, swollen lymph nodes, shivers and/or high temperature.

Management Management of infectious bites and scratches

General bites
General management includes: stemming the flow of blood, and preventing infection. For any bite, tetanus may develop, so get checked by a healthcare professional who may administer a tetanus booster.

For serious bites, the Australian government health website recommends:

  • Carefully wash the body part that has been bitten off with tap water.
  • Place the part in a plastic bag or container which can be securely sealed.
  • Put the bag or container into iced water (do not place directly onto a block of ice) to keep it cool, as it may be possible to reattach the body part with surgery.
  • Go to your local emergency department immediately, taking the bag or container with you.

For minor bites, the Australian government health website recommends the following:

If the wound is still bleeding:

  • Cover it with a clean cloth then apply pressure with the palm of your hand, then keep the pressure on the wound for 15 minutes.
  • Apply pressure directly over the affected area with a pad made from a clean, rolled up piece of material such as a handkerchief or towel which should be dampened with clean water if possible, as this will reduce the amount of blood soaked up by the material.
  • Use a bandage to wrap around the pad or dressing. Do not wrap the bandage too tightly as it may affect the circulation.
  • If the bleeding is very heavy, it may seep through the bandage. You should use a second dressing to cover the first one.
  • If the bleeding continues through both bandages and pads, remove the second bandage only and apply a new one.
  • Do not look at the wound to see if it has stopped bleeding, in case removing the pressure causes it to start bleeding again.

If the wound is not bleeding:

  • Rinse under running water for two minutes. It might be easier for you to rinse your injury with a shower head, if possible. Pat dry with a clean cloth, then cover the wound with a dry, sterile, non-sticky dressing to help prevent infection.
  • Check the area daily for signs of infection such as increasing pain, redness, swelling or yellow discharge.
  • If you have not had a full course of tetanus immunisation or if your boosters are not up to date contact your doctor.
  • If you are in pain, get advice on medicines you can take from a pharmacist or a doctor.

Leech bites
There is currently no research into best practice for leech removal, so beware of websites and blog posts suggesting best methods to remove leeches!

The problem with remedies like adding adding salt, insect repellent, shampoo, vinegar or heating it up with a lighter or match is that these techniques increase the risk of the leech discharging gut contents (including bacteria) into the wound. The result could be localised infection right up to blood poisoning.

To avoid infection, we suggest direct removal of leeches using fingers or a knife edge to slide the leech sideways off the bite-point until the leech is removed entirely from the skin. Since leeches inject an anticoagulant into the wound site to increase the flow of blood, after removal the site is likely to bleed for a while but overall blood loss is not significant.

Post removal, apply wound care first aid to the bite site and monitor for allergic reaction (unlikely, but possible.

Dogs and cats
Bites usually occur if the animal is provoked, scared, unwell or protective of puppies. Treat wounds for infection and check tetanus. Likewise for human bites!

Bat bites
Australian bats carry lyssavirus, which has led to fatalities when passed onto humans. Early signs and symptoms are flu-like. The best prevention is to avoid handling bats, however, if you are accidentally bitten or scratched:

  • Immediately wash the wound thoroughly with soap and water for at least five minutes.
  • Apply an antiseptic solution or alcohol gel after washing.

Stinging plants

Dealing with stinging plants

Leaders grasp nettles. David Ogilvy

We are pretty familiar with insects and animals that bite and sting. The plant world also has a few unfriendly ways of arranging protection, with some making you itchy whilst others can leave you in pain for months. Soft-skinned walkers beware. It seems that Australia can boast that we have the most painful plant in the world, the Stinging Tree. Somehow this makes us a little proud….

Identification of Stinging Plants How to recognise stinging plants

Remember that it’s not just the living trees that sting, it’s dead leaves too. That means that if you spot a stinging plant, beware of leaf litter surrounding the area too.

Stinging trees are generally found in rainforest on the eastern parts of Australia. Australia has four common types: two that are large rainforest trees growing up to 30 to 35 m. The other two, only bushes often between 0.1 to 1m tall. All four species have a similar stinging mechanism but D. moroides (the Gympie Gympie) is generally considered to have the worst sting.

Gympie-gympie
(Dendrocnide moroides)
 
Common
names
stinging bush, gympie stinger,
mulberry-leaved stinger,
gympie gympie, gympie,
stinger or moonlighter
Tree heightaround 2 metres
Leaf sizelarge vaguely heart shaped
leaves (about the size of your
hand)
Link on WikiGympie-gympie

Giant stinging tree
(Dendrocnide excelsa)
 
Common
names
Australian nettle tree, fibrewood, gimpi gimpi, giant
stinging tree, gympie
Tree heightover 30 metres high
Leaf sizeleaves are large and heart shaped with serated edges,
however unlike the D. moroides, the D. excelsa’s leaves join the stalk at the notch between the overlapping lobes
Link on WikiGiant stinging tree
Locationfound in rainforests in NSW and southern QLD

Shiny leaf stinging tree
(Dendrocnide photinophylla)
 
Common
names
fibrewood, small-leaved nettle, mulberry-leaved
stinging tree, and gympie
Tree heightsimilar to the Giant stinging tree, but much narrower, up to 20 metres
Leaf sizeleaves are glossy on the upper surface, long and
narrow shaped (6-12 centimetres long) with wavy
or sometimes toothed margins
Link on WikiShiny leaf stinging tree
Locationfound in rainforests on the east coast of Australia between Sydney to Cooktown

Atherton Tableland stinger
(Dendrocnide cordata)
 
Common
names
gympie, stinger
Tree heightup to 4 metres
Leaf sizeheart shape leaves but with a broad notch at the base
which is inserted the leaf stalk
Locationfound on the Atherton Tablelands

As a general rule, if you are unsure or can’t remember the specific features of stinging trees, keep clear of plants with heart-shaped leaves with saw-toothed margins that look furry.

Other stinging plants are the ground-hugging nettles. They occur in many different environments, but particularly wet, shady areas.

Photo credit: janGlas via Foter.com / CC BY-NC-ND

Photo credit: janGlas via Foter.com / CC BY-NC-ND

The Sting The how, why and what od stinging trees

How do they sting?
The leaves and some branches and fruits of Stinging Tees are covered in tiny hairs, hollow silica needles that range in length from 0.2 to 2 millimeters. They look deceptively soft and furry, yet they are effectively glass hypodermic needles. Do not touch!

Interestingly, it seems that the pain is not just because of the needles but due to the fact they carry a neurotoxin. According to an ABC article “One scientist, Oelrichs, purified the poison and injected himself with it and suffered intense pain. He proved that the toxin, not the silicon hairs, caused the pain. If you have stabbed yourself with the hairs, you can release the neurotoxin from the hairs by heating or cooling your skin, or just touching it. This neurotoxin is very stable. Experiments have been done with hairs that were collected nearly a century ago, and they can still cause pain.” This article goes on to point out two interesting facts. Firstly, that the tree seems to have no effect on most Australian native animals. Secondly, and more interestingly, is that the plant does not seem to do any actual damage to your body. Unlike the venom from a snake or spider that causes damage to your body in many ways, this toxin seems to “just” cause pain.

Signs and symptoms – how bad is the sting?
The sting of Stinging Trees is pretty bad! In fact, after being stung by a stinging plant the pain can recur for more than two months. And it’s not just the living leaves that sting, dead leaves too can cause problems.

“Stinging trees (Gympie-Gympie) are the bane of people in the Australian tropical and sub-tropical coastal areas – especially after disturbances such as cyclones, which trigger the germination of seeds. It becomes quite an issue when children wander into small plants – and are really badly stung.”

Poisonous plants of Australia by Selwyn Everist (1974) has 684 pages – a lot of poisonous plants. At page 515 he says the following about stinging plants: “If the leaves or the twigs make direct contact with the skin, the hollow, silica-tipped hairs penetrate and there is at first a slight itch, followed in a few seconds by a severe prickling effect which quickly becomes intense pain of a complex nature. The pain is described … as composed of a background of tingling on which is superimposed an intermittent stabbing pain with sharp radiations passing in all directions.” He goes on to say the pain lasts for around eight hours (maybe 30 hours). The pain then can continue to recur for more than two months. More recent research cited by the ABC suggests that the “The pain comes immediately after touching the plant, and it gradually increases to a peak after about 20-30 minutes”. On top of this, it seems that some people can be allergic to the sting and suffer life-threatening anaphylactic shock, although deaths are very very rare.

Prevention
So let’s not allow these plants stop us from heading bush. Avoid the need for first aid by learning to spot these plants and giving them the respect they deserve. They are part of the Australian native ecosystem and deserve their space. Oh, and make sure you always have enough toilet paper so there is no risk of grabbing a leaf from one of these trees by mistake.

  • Know how to ID plants
  • Protective clothing: When walking in some areas, body armour could help :), but since the trees generally grow in warmer areas this has limited practical application. Long thick pants, a shirt and a hat can help protect from brushing against the leaves. Wearing thick gardening gloves will also reduce the risk of getting stung if your hands grab a leave or branch. Just be aware through that the clothes and gloves may collect needles whilst you are walking – so be mindful of this when removing and handling the clothing.

Management
Always work through the standard DRSABCD protocol. Avoid anyone else getting stung.

For stinging trees
The federal government healthdirect website suggests that you follow these four points:

  1. The most important thing is that you do not rub the area, as this can break off the hairs and make them very difficult to remove,
  2. Remove visible hairs with tweezers,
  3. Apply and remove adhesive tape or hair removal wax strip to the area to remove the finer hairs, and
  4. Do not scratch or rub the area, this may cause the hairs to penetrate deeper into the skin.

This simple treatment was developed in the 1990’s by Dr.Hugh Spencer of the Australian Tropical Research Foundation (AUSTROP). Although the original recommendation is to use the sugar-based depilatory “Waxeeze”, which is readily available from most pharmacies, any wax strip-based depilatory will work.

The rationale is to remove the hairs without disturbing them. Remove the visible hairs manually and then remove the remaining smaller hairs using wax strips. If the wax isn’t pre-applied to the strips, then first spread it onto cloth or strips. Do not apply wax directly to the skin because it’s likely that the hairs will break, causing immense pain to the patient, and making them hard or impossible to remove.

The use of pain relieving medication may also help reduce the signs and symptoms.

In 2013, AUSTROP published their updated protocol to deal with stinging trees via a blog post. They have had positive that applying a dilute solution of hydrochloric acid soaked in a cloth on the affected area will help neutralise the proteins. This is reported to be very painful for around 5-10 minutes but “the pain and after-sensitivity is completely gone in about 12 hours after treatment (as opposed to waiting for 3-6 months!)”. Although this method has been the subject of several student studies, the research base for it is very limited, and we strongly suggest that you speak with your doctor before trying this or before adding any hydrochloric acid to your first aid kit.