The season has begun and diving is great! However some unscruplous marketers are trying to exploit people’s fears. Trying to sell divers, snorkelers and visitors some “magic cream” that prevents jellyfish stings – people can be put at risk of injury or death.

Avoid this cream, let any dive shop or retail outlet that supplies it know how they are endangering their clients and please avoid it at all costs!!!

If you think this is just opinion…please read the email below regarding this product. Written and signed by the world’s leaders in Jellyfish stings, envenomation and the head of DAN. I guess they might know a bit more than someone who makes and sells magic creams?

From: JOHN LIPPMANN
Sent: 03 November 2009
To:
Cc: ‘Lisa Gershwin’; ‘Andrew Jones’; ‘Peter Fenner’; ‘Dr. Kenneth D. Winkel’; somchai.bussarawit; potjaman; lthaikru
Subject: FW: Marketing of Safe Sea in Thailand

We have been following the recent renewed correspondence about the proposed marketing of Safe Sea in Thailand. As you are aware, there are a group of us, including some well-known medical and marine biological jellyfish experts, who have been closely monitoring the situation with dangerous jellyfish in Thailand and we are all very concerned about the introduction of Safe Sea at this point in time.

Let us re-state some important facts:

1. There is definitely at least one variety of potentially lethal box jellyfish found in Thai waters. This includes the Chironex species as well as other chirodropids, currently unidentified, but probably just as venomous . There is absolutely no doubt about this as we have received good photographic evidence of these jellyfish, and have extensive evidence from numerous cases over more than a 20 years of the distinctive scarring caused by the stings of these particular jellyfish.

2. There have been numerous documented deaths caused by jellyfish in Thailand over many years: we currently have an article in print with details of a number of documented deaths and “near-misses”. The death of the Swedish girl last year was certainly not an isolated case, although to date it was the one that received the broadest media attention. We also have a steadily increasing number of case reports of life-threatening stings, including those with permanent scarring as well as those producing Irukandji syndrome.

3. Substantial experience from northern Australia over many years has shown the importance of effective prevention strategies. To date these have included the wearing of protective clothing, suitable netting, appropriate signage and education. As a result, despite the presence of large numbers of dangerous jellyfish at certain times of the year, there are very few serious stings.

4. The Safe Sea may have been shown to be an effective barrier to the stings of certain species of jellyfish. However, it appears that there is absolutely no evidence that it is effective in the prevention of stings from life-threatening box-type jellyfish, especially Chironex.

5. We are further concerned that even if Safe Sea should someday be demonstrated to be “as effective” for Chironex-type box jellyfish as it claims for other species (i.e., 75% efficacy, in reducing the frequency and severity of stings), this is still unacceptably high for otherwise unprotected exposure to lethal species.

In light of the above, we consider it to be irresponsible and dangerous to promote an unproven product in an area where the consequences of using the product could prove fatal. It is likely that tourists and Thai locals would be lulled into what could well be a false sense of security by using Safe Sea instead of taking preventative measures that have proven to be effective. Severe stings or deaths occurring without added protection of these preventative measures we suggest could have ongoing consequences.

Receiving FDA approval from Thailand does not indicate that the product is effective against Chironex-type box jellyfish stings and can be misleading in this context.

For all the above reasons we implore you to refrain from marketing Safe Sea in Thailand until such time that it has been independently demonstrated to be effective against the potentially lethal species found there and it is established that this product effectively prevents envenomation when interacting with these species.

Sincerely,

John Lippmann OAM Dr. Lisa-ann Gershwin Dr Peter Fenner AM
Executive Director Director MD (London), DRCOG, FACTM, FRCGP
DIVERS ALERT NETWORK (DAN) ASIA-PACIFIC Australian Marine Stinger Australian Marine Stinger Expert and author
PO Box 384 (49A Karnak Rd) Advisory Services
Ashburton VIC 3147
Australia Dr Ken Winkel Andrew Jones
Tel: +61-3-9886 9166; Fax: +61-3-9886 9155 Director Father of jellyfish sting survivor
www.danasiapacific.org Australian Venom Research Unit

Please feel free to contact us, DAN or any of the above with questions regarding this and other products promising to “prevent jellyfish stings”

-Similan Diving

And never forget – it’s just for fun, no need to get stressed or panic. Just end the dive.

KEY WEST, Fla. — A Texas man died while diving near Key West.
The Monroe County Sheriff’s Office reports that 51-year-old Richard McCoy Jr., from Cypress, Texas, was scuba diving near the Vandenburg wreck Friday. McCoy had flown into Miami the day before as part of an organized dive trip.
McCoy had been down about 95 feet with two instructors, just after noon, when he reportedly began having trouble. The instructors began helping McCoy, but he stopped breathing about 25 feet from the surface.
Officials say CPR was started back at the boat and continued by paramedics on shore.
McCoy was taken to a nearby hospital, where he was pronounced dead.
A medical examiner will determine cause of death, and authorities will inspect the dive equipment.

http://www.miamiherald.com/news/florida/AP/story/1332446.html

safediving.com

-Safe Diving

According to the Centers for Disease Control, four kinds of malaria can infect humans: Plasmodium falciparum (plaz-MO-dee-um fal-SIP-a-rum), P. vivax (VIGH-vacks), P. ovale (o-VAHL-ley), and P. malariae (muh-LAIR-ee-uh).

Where Does Malaria Happen?

Malaria occurs in more 100 countries and territories worldwide. More than 40 percent of the people in the world are at risk of contracting the disease. Large areas of Central and South America, Hispaniola (Haiti and the Dominican Republic), Africa, the Indian subcontinent, Southeast Asia, the Middle East and Oceania are considered malaria-risk areas.

How Common Is It?

The World Health Organization estimates that yearly 300-500 million cases of malaria occur; more than 1 million people die of malaria each year. About 1,200 cases of malaria are diagnosed in the United States annually. Most U.S. cases are in immigrants and travelers returning from malaria-risk areas – mostly from sub-Saharan Africa and the Indian subcontinent.

Which Drug To Take?

Prescription Only. Antimalarials are available only by prescription through a healthcare provider, who typically prescribes such medication based on your travel itinerary and medical history. Some antimalarials are more effective in some parts of the world than others. In fact, certain areas of the world have developed strains of malaria (e.g., in P. falciparum or P. vivax; the “P” in both stands for “Plasmodium”) that are resistant to conventional suppression with chloroquine phosphate. Additionally, a medical condition may prevent someone from taking certain drugs. Later in this article, you’ll read about some available alternative drugs.

Specific to Diving:

There is no clinical data that establishes any interactions with antimalarial drugs and diving. Most dive medicine professionals do not expect any complications with the antimalaria drugs and diving. However, the use of Mefloquine (Lariam) by divers is not universally accepted by all dive medicine professionals. Please consult the dive operator at your destination for the local opinon regarding Mefloquine (Lariam).

Watch Your Dosage.

Overdosage of antimalarials can be fatal. Keep drugs in childproof containers out of the reach of children. Follow dosage schedule exactly, without missing doses. Buy antimalarials in the United States before traveling overseas. The quality of antimalarials sold outside the United States may not be reliable, and they may be difficult to obtain.

Your healthcare provider will prescribe the antimalarial best suited to you and your destination. If you have any questions about the drug recommended, call your healthcare provider or pharmacist or contact Safe Diving

Prevention

Protect yourself from mosquito bites. Wear long-sleeved shirts and long pants, and apply insect repellent to exposed skin. Mosquitoes that transmit malaria bite between dusk and dawn.

Use insect repellents that contain DEET (chemical name N,N-diethyl-meta-toluamide), a colorless oily liquid insect repellent developed in the early 1960s. The concentration of DEET varies among repellents. Those with concentrations of 30-35 percent are quite effective, generally lasting about four hours. Follow label directions and take these precautions:

In your initial scuba diving course, you were instructed to follow the rules. For example, you learned to follow the no-decompression table limits; monitor your depth and pressure gauges; monitor your bottom time; and ascend slowly. Plus, you learned how important it is to keep yourself in shape and be prepared for anything strenuous that might happen during a dive. By following the rules and by using common sense, it seems logical that you should be able to avoid the problems frequently associated with scuba diving such as the bends, a form of decompression illness (DCI).

Unfortunately, however, even when we follow all the rules for avoiding decompression illness, there are no guarantees that it won’t occur. And what is even more perplexing is when you know you haven’t violated any of the established rules – and yet find that you’re bent. When signs and symptoms of DCI occur after a dive, series of dives or days of diving, and the diver has not violated any safety guidelines, it is sometimes referred to as “unexpected DCI.” It is these unexpected cases that have stimulated research into methods of preventing them.

Such cases of mild DCI – these unexpected hits – occasionally have occurred during DAN’s Flying After Diving (FAD) research project, during or after the “dive” section of the tests. This article describes safety measures for DAN’s FAD tests. Volunteer divers undergo medical screening to minimize the chances of serious injury. Mild DCI occasionally occurs during or after the flights. As with actual day-to-day dives, DCI can occur after chamber dives that are within the accepted exposure limits of many tables. All FAD dives are dry and at rest. The results for immersed, exercising dives might be different, due to such factors as exercise level and water temperature. These conditions will be tested in the future. Safe diving

Screening of Volunteer Divers

When divers express an interest to participate in Flying After Diving research, they begin a rather rigorous screening and control process, to ensure they are physically qualified; then they are carefully monitored every step of the way.

The first control present in this process is the pre-screening. DAN’s Research team sends detailed questionnaires to each potential subject. These questionnaires are returned to DAN, where they are screened. Any problems are brought to the attention of a Diving Medical Officer (DMO). This permits obvious health problems to be eliminated early, and saves a potentially disappointing trip to the Duke Hyperbaric Center. During the pre-screening, the questionnaire is reviewed for health problems, including height/weight standards; any gas-trapping disorders, such as asthma; head trauma; recent injuries; or ear-clearing problems. Although a “yes” to one of these questions does not automatically disqualify a potential subject from participation, further clarification is required to determine the nature and extent of the illness or injury. Approximately 2 percent of the prospective volunteers are excluded.

Most people who pass the pre-screen are able to participate as subjects, but they must be interviewed by a DMO and undergo a thorough neurological baseline exam before they’re allowed to participate. In this step, the DMO will once again refer to the medical history to establish a baseline for an individual. The DMO will analyze “skills” that could be affected by decompression illness, including strength and coordination testing. Additionally, the DMO performs “routine” tests such as listening to lungs and examining the ears. By establishing a baseline examination, the DMO can often identify very subtle signs which could later be attributed to DCI but which are actually already a part of that person’s make-up. An example of such subtle attributes might be small areas of numbness on a diver’s skin that may or may not have been previously noticed by the diver.

The Chamber Trials

During actual “dive” and “altitude” exposures, the pressure within the chamber is painstakingly controlled. The rates of compression and decompression are maintained at a steady 30 feet / 9.1 meters per minute unless an individual has difficulty equalizing the ears. The rates can be slowed to accommodate any ear-clearing problems. Once at pressure, the depth control is a lot tighter than any diver can maintain – within an inch of the desired depth (No “dolphining” allowed here!). The result of this rigid dive profile is truly a “square” dive, rather than the “sawtooth” dive often experienced in open-water diving.

At the end of each dive or flight, the FAD research team asks participants to assess themselves and report any changes to the DMO. If any symptoms or problems are reported, the research team response is quick and decisive, ensuring symptoms are treated immediately. “By following this practice,” notes DAN Research Director Dr. Richard Vann, “we are certain that all participants are symptom-free prior to undertaking further pressure changes.”

Four hours post-flight, all participants again see the DMO. This is yet another physical to verify that everyone remains at their baseline status established during the first physical. At this point, individuals are “released” from the study, and allowed to travel home if they live within two hours. Otherwise, they can leave the next morning. If they are not at their baseline status, a neurological exam is performed to determine why and what further action is necessary.

However, the observation period does not end here. All participants are contacted by telephone both 24 and 48 hours post-flight. According to the 1997 edition of DAN’s Annual Report on Decompression Illness and Diving Fatalities, 95 percent of all DCI symptoms occur within 33 hours of the dive exposure. By following each individual so closely, we continue to collect data even on those obscure cases that occur outside normal time windows. If a diver has no complaints after this 48-hour call, participants are considered to be symptom-free.

Why Such Rigid Controls?

Why are we so careful? First, and foremost, it’s for protection of the divers. The Flying After Diving project is carefully designed to minimize the chance of serious injury and these controls are necessary to accomplish this. We must have cases of decompression sickness, however: if we didn’t, we wouldn’t be able to estimate the relationship of preflight surface interval to DCI risk. But if DCI does occur, the safety of the subjects must be paramount.

The second reason for rigid controls is for uniformity of the data. Most of the symptoms we have encountered in this study have been minor, the kind that might be overlooked on a dive site. By monitoring our subjects so closely, we can recognize these minor symptoms as potentially DCI-related. Additionally, we know our dive profiles, and we’re performing the data analysis on a known set of conditions. This ensures reliability of the information we release to the diving community.

A Little History…

DAN began its FAD studies in 1993 with initial support from PADI. Dive profiles were selected using the DSAT Recreational Dive Planner. The first trials examined one dive to 60 feet / 18.2 meters. The study has continued with a two- and three-dive series, to 60 feet, 100 feet / 30.4 meters, 40 feet / 12.1 meters and currently a multidive profile.

Overall, 580 dive profiles have been completed. Of this number, a total of 22 individuals have had signs and symptoms of DCI and were treated in the hyperbaric chamber. Five individuals suffered DCI after the dive and prior to the flight. These cases of unexpected DCI were within the table limits. They are summarized below.

Cases of Unexpected DCI

Case 1 – A Two-Dive Profile to 60 feet for 55 minutes, with a one-hour surface interval, then 60 feet for 30 minutes. Approximately 15 minutes after the second dive, the subject complained of tingling in the fingertips. The tingling progressed through the hand and up the left arm to the shoulder. There was no pain or weakness associated with the tingling. Diagnosed with DCS II, he was recompressed to 60 feet. After treatment, he reported that all symptoms had resolved.

Case 2 – A Single-Dive Profile to 100 feet for 20 minutes. During decompression from this single dive, the subject experienced hip pain. Approximately 10 minutes post-dive, she experienced some relief, without treatment. Diagnosed with DCS I, she was recompressed to 60 feet and experienced 90 percent relief almost immediately, with complete relief after the treatment.

Case 3 – A Single-Dive Profile to 100 feet for 20 minutes. Approximately one hour after this dive, the subject noticed an aching sensation in her left hip and lower leg. It lasted for five to 10 minutes. One and a half hours later, she had a burning sensation in her left hip and ankle, with a general aching in her left leg. That evening, she was very restless and had trouble sleeping. Upon rising the next morning, however, she was asymptomatic upon waking up. She did not report pain to us until it returned during the flight. Her pain disappeared with descent from altitude, but it returned again approximately five hours after the flight. She was diagnosed with DCS I and recompressed to 60 feet. Her pain was gone prior to the end of the treatment.

Case 4 – A Single-Dive Profile to 100 feet for 15 minutes. Ten minutes after surfacing from a this dive, the participant complained of numbness in the left hand. He was diagnosed with DCS II and recompressed to 60 feet, with complete resolution of symptoms by end of the treatment.

Case 5 – A Single-Dive Profile to 100 feet for 15 minutes. While ascending, the subject noticed a transient sharp pain in the middle of her back. When she surfaced, she noticed bilateral neck pain and crackling sounds in ears when she turned her head. When she awoke the next morning, she noticed a return of the neck pain, as well as pain in her right calf. She was diagnosed with DCS I and recompressed to 60 feet. She experienced complete relief of all symptoms within the first 30 minutes of the treatment.

Lessons to be Learned

These divers were well-rested, well-hydrated and physically fit; they stayed within the limits, made a controlled ascent in the chamber and had a non-stressful, non-demanding dive at rest. They followed all the rules, but they still experienced decompression illness. Why? DCI is still a mystery in many ways: we do not yet understand why some individuals follow the same dive profile and get DCI one day but not the next. The cases involving individuals who do not follow the “rules” – those divers who overstay their limits, ascend too rapidly, have other health problems or party too hard the night before – are easier to understand.

Unfortunately, many of the DCI cases DAN deals with are unexpected DCI – they’re not easy to explain because they occur in individuals who follow all the rules. This is why divers should be familiar with the symptoms of DCS and know exactly what to do if they occur (calling the DAN Hotline is a good first step).

-Safe Diving