An investigation of injury jellyfish in the International Triathlon, Cha-am District, Phetchaburi Province, Thailand, 19th March 2016

Abstract

Backgrounds: Bureau of Epidemiology got notification from officers of the Marine and Coastal Resources Research and Development Center (MCRC), Upper Gulf of Thailand, about 34 athletes injured from jellyfish. These athletes participated in an international triathlon event at Cha-am District, Phetchaburi Province. An investigation was conducted to confirm the event, identify epidemiological characteristic and provide the recommendation for preventive measures for jellyfish envenomation in future athletics events.
Methods: A descriptive epidemiological study was carried out by reviewing medical records from hospitals where the injured patients sought care and collecting retrospective data of jellyfish injured cases at Cha-am hospital during the past 5 years. The survey data from MCRC on jellyfish poisoning were also reviewed. The environmental survey was conducted at the competition area as well.
Results: There were 106 people injured from jellyfish and visited four hospitals during 19-21 March 2016. Among them, 101 cases were athletes involved in the international triathlon on 19 March 2016. All were treated as outpatients. However, only 42 cases had information to analyze in the descriptive study, due to 1 hospital did not convenient to provide detail information. There were 33 males and 9 females. Median age was 36.50 years (ranged 15-58 years). All of them were Thai and 64.28% were from Bangkok. The onset started from 6:40 to 8:00 am on 19 March 2016. Most of them developed rashes, burning pain, and chest discomfort. About 94.74% of them were diagnosed as dermatitis caused by contact with jellyfish. The data from Cha-am Hospital revealed that the number of people injured by jellyfish in 2016 was higher than average of the previous five years. Before the triathlon, organizers had well prepared for first aid at the competition area, however, they did not inform the health authorities about this event. The jellyfish sampling was carried out for two times after the incident and Chrysaora chinensis was found in both surveys.
Conclusion: There was a lot of jellyfish envenomation cases among the athletes participated in a triathlon event. From clinical manifestation and the jellyfishes found in the environmental surveys, this event was likely to be caused by Chrysaora chinensis. In future events, organizers should inform public health authority in the province, in order to prepare appropriate measures for any unexpected health event, as well as trying to avoid conducting in the areas where having abundant of jellyfishes. Organizers should instruct athletes to wear protective sportswear such as long sleeves and pants to avoid potential exposure to jellyfishes.