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Objectives:(1) To identify the causative jellyfish species by examining skin scrapings in patients presenting to Cairns Base Hospital with marine stings, and (2) to describe clinical outcomes of those with Irukandji syndrome and those in whom nematocysts were identified from skin scrapings.

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The early life stages of the cubomedusa Alatina cf. moseri from Osprey Reef (North Queensland, Australia) and Waikiki (Oahu, Hawaii) were studied using laboratory-based culturing conditions. Spawning populations from both regions were observed with reliable periodicity allowing polyp cultures from these locations to be collected and established under laboratory conditions. The polyps of this species were successfully reared from spawning adults. Polyps of Alatina cf. moseri were cultured at temperatures of 23–28°C, developed up to 19 tentacles and reached up to 1.70 mm in height. The balloon-shaped hypostomes possessed 4 well-defined lips. The polyps increased their numbers by means of formation of either sedentary polyp buds or creeping-polyp buds, which attached after 2–3 days. Metamorphosis occurred at temperatures of 25–28°C. Development of polyps and medusae were achieved for the first time within the genus Alatina and allowed comparisons of early life history between these and other species of the Carybdeida families. The metamorphosis and young medusa of this genus showed characters that differed distinctly from those noted for other Carybdeida species, but are very similar to the one described from Puerto Rico by Arneson and Cutress in 1976 for Alatina sp. (named by them Carybdea alata). Based on this evidence, the discrepancies in original specimen descriptions and the previous genetic comparisons, we support the suggestion that the two previously described species of Alatina from Australia and Hawaii (Alatina mordens and Alatina moseri) appear to represent artificial taxonomic units and may in fact be the same as the original Carybdea alata species named from Puerto Rico. Further taxonomic studies are desperately needed in order to clarify the various species and description discrepancies that exist within this newly proposed genus.

We present a retrospective review of twelve cases of Irukandji syndrome associated with pulmonary oedema. This is a life-threatening envenoming due to a presumed jellyfish sting throughout Northern Australia, although only one case occurred outside North Queensland. Patients presented with significant and ongoing pain, tachycardia and hypertension. Half the patients became hypotensive requiring inotropic support. Cardiac echocardiography revealed significant cardiac dysfunction. Six patients required ventilatory support. There was no death reported due to pulmonary oedema, but one patient died of intracerebral haemorrhage. We believe patients may develop a toxin associated cardiomyopathy, and jellyfish other than Carukia barnesi may be responsible. As there is confusion with nomenclature, Carukia barnesi should be known as the Barnes jellyfish, and the diagnosis of cardiotoxic marine envenoming is suggested for any patient who has been stung by a jellyfish, develops no or minimal skin markings, and develops cardiogenic pulmonary oedema associated with Irukandji syndrome.