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This study suggests that the frequency and severity of jellyfish stings affecting tourists in Southeast Asia have been significantly underestimated. Severe and fatal cases of chirodropid-type stings occur in coastal waters off Peninsular Malaysia and Sabah, Borneo. Indeed, the first Malaysian cases consistent with Irukandji-like syndrome are reported here. Reports to DAN, a provider of emergency advice to divers, offer one method to address the historic lack of formalized reporting mechanisms for such events, for photo-documentation of the possible culprit species and treatment advice. The application of marine stinger prevention and treatment principles throughout the region may help reduce the incidence and severity of such stings. Meanwhile travelers and their medical advisors should be aware of the hazards of these stings throughout the Asia-Pacific.

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Douglas 2015, Provisional report on diving-related fatalities in Australian waters 2010, Diving and hyperbaric medicine, vol. 45, no. 3, pp. 154-175. This is the published version.Abstract (Lippmann J, Lawrence CL, Wodak T, Fock A, Jamieson S, Walker D, Harris R. Provisional report on diving-related fatalities in Australian waters 2010. Diving and Hyperbaric Medicine. 2015 September;45(3):154-175.) Introduction: An individual case review was conducted of known diving-related deaths that occurred in Australia in 2010. Method: The case studies were compiled using statements from witnesses and reports of the police and coroners. In each case, the particular circumstances of the accident and details from the post-mortem examination, where available, are provided. A root cause analysis was made for each case. Results: There were 20 reported fatalities, one less than the previous year. Five of the victims were female (four scuba divers) and 15 were males. Twelve deaths occurred while snorkelling and/or breath-hold diving, seven while scuba diving (one of whom was using a rebreather), and one diver died while using surface supplied breathing apparatus. At least two breath-hold divers likely drowned as a result of apnoeic hypoxia. Cardiac-related issues were thought to have contributed to the deaths of at least three and possibly fi ve snorkellers, and of at least one, possibly two compressed gas divers. Conclusions: Snorkelling or diving alone, poor supervision, apnoeic hypoxia, pre-existing medical conditions, lack of recent experience and unfamiliar and/or poorly-functioning equipment were features in several deaths in this series. Reducing delays to CT-scanning and autopsy and coroners' reports documenting that the victim of a drowning was snorkelling or scuba diving at the time are aspects of the investigation of these fatalities that could be improved.