Vergiftungen durch Petermännchen (Echiichthys spp.) - Eine retrospektive Analyse von 323 humanen Expositionen des Giftinformationszentrums-Nord

Intoxications with (Echiichthys spp.) - A retrospective analysis of 323 cases by the Poisons Centre for northern Germany

by Adrienne Kilian
Doctoral thesis
Date of Examination:2020-06-03
Date of issue:2020-05-27
Advisor:Prof. Dr. Andreas Schaper
Referee:Prof. Dr. Andreas Schaper
Referee:Prof. Dr. Stephan Sehmisch
Persistent Address: http://dx.doi.org/10.53846/goediss-7987

 

 

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Abstract

English

The weever fish is among the most venomous fish present in Europe and its sting is considered one of the most painful of all poisonous animals. In recent years an increase in exposures to weever fish has been observed at the GIZ-Nord Poisons Centre (GIZ-Nord). Systematic studies of this type of poisoning have so far only involved small number of cases and the current literature is mostly limited to individual case reports. In this study, a retrospective analysis of 323 human exposures to weever fish reported to the GIZ-Nord from 1996 to 2017 was performed. Demographic and geographic data as well as clinical features and course of poisoning were analysed. Anglers, a subgroup at particular risk for exposure, were also examined separately. The majority of enquiries (75%) were made to GIZ-Nord in summer or in the late summer months. Notably, a more than eightfold increase in enquiries related to weever fish stings during the study period was confirmed. Exposure predominantly involved adults and adolescents (87%) either on vacation or fishing. Men (59%) were more commonly affected than women (39%); children (13%) relatively seldomly. The majority of cases with a documented location occurred in the Mediterranean Sea (25%), followed by the Atlantic (9%) and North Sea (9%) with Spain (12%) and Germany (10%) the most frequently mentioned countries. The feet (41%) and hands (39%) were the most likely site of injury. The number of moderate (46%) and severe (0,6%) cases combined almost totalled the number of mild (53%) exposures. No fatalaties were observed. Hand injuries (57%) were more commonly classified as moderate compared to foot injuries (43%). The most frequently reported symptoms were swelling (57%), pain (53%) and redness (15%). Symptoms lasting up to one month were not uncommon in this study. In individual cases, symptoms lasting up to one year and beyond have been reported. Foot injuries could result in a longer symptom duration than hand injuries. Documented therapeutic measures included hot water- or temperature shock method, drug therapy (pain relievers, antihistamines, corticosteroids and antibiotics) as well as surgical wound treatment. Anglers (n=25) represent a special risk group in terms of the geographical location of weever fish exposure, sting site and severity of poisoning. In this subgroup a higher percentage of cases occurred in a country bordering the North Sea or Baltic Sea, the injury predominantly involved the hand (96%) and the poisoning was more frequently documented as moderate (64%) compared to the total number of exposed cases. Summary: A weever fish sting is a poisoning associated with substantial pain and discomfort and often requires medical attention. Prolonged duration of symptoms and moderately severe courses are not uncommon. Long-term damage such as functional restrictions of the affected limb have even been observed. Follow up of all exposures could improve current information and provide a clearer picture of the course of the poisoning, in particular the occurrence of long-term sequelae.
Keywords: weever; intoxication
Schlagwörter: weever ;intoxication; Petermännchen; Vergiftungen
 
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