What is Stingray Sting?
Stingrays are a type of fish that fall under the category of cartilaginous fish, also known as rays. Rays are in the same class of fish, called Chondrichthyes, along with sharks and skates. All rays have a flattened body shape and large side fins, which are permanently attached to their heads. The stingray’s mouth is located on the underside of the animal.
The most dangerous part of a stingray is its tail, which has a spinal blade known as a stinger or barb. Stingray species with longer spines, located near the end of their tails, pose the highest risk for causing injurious stings.
What Causes Stingray Sting?
Stingrays have between one and three blades on their spine. These stingers are lined with multiple sharp, spine-like structures which are made from a material called vasodentin, something similar to cartilage. Due to this, they can easily cut through skin. Stingrays are different from other animals that produce venom because they don’t store their venom in a special venom gland. Instead, the venom is kept inside cells that produce it, located in grooves along the underside of their spine.
Freshwater stingrays possess a greater number of these venom-producing cells that cover more space on the blade. This leads to these stingrays having more potent venom compared to their saltwater cousins. While there hasn’t been a lot of research conducted on stingray venom, what we do know is that it can be weakened by heat and that it has a harmful effect on the heart.
Risk Factors and Frequency for Stingray Sting
Stingrays are abundant in tropical marine and freshwater environments. With over 150 different species around the world, their sizes can vary from a few inches to 6.5 feet, with the heavier ones reaching up to 800 pounds. These creatures often inhabit areas around coral reefs, leading to many human injuries. The lower and upper extremities are commonly injured.
- In the United States, between 750 to 2000 stingray injuries are reported each year.
- Thousands of additional cases occur annually in tropical regions where freshwater stingrays inhabit inland rivers.
- In a study of 119 cases in a California emergency department, most of the victims—80%— were males and the average age was 28 years (ages ranged from 9 to 68 years old).
- In a similar study in Brazil, between 80% to 90% of freshwater stingray injuries happened to men.
- While most stingray injuries are non-severe, injuries from freshwater stingrays tend to be more severe than those from marine stingrays.
- Severe cases and fatalities do occur, albeit rarely. In the US and Indo-Pacific nations, there are about one or two fatalities per year. In South American countries, however, fatality rates relating to Amazonian stingrays can reach up to 8 per year.
Signs and Symptoms of Stingray Sting
People with stingray injuries usually have a puncture wound or cut and experience pain that feels more intense than what the wound appears to warrant. They often know they’ve been stung by a stingray or they might mention stepping on something while in the ocean. The pain typically starts right away, reaching its worst within 30 to 90 minutes and can linger for as long as 48 hours. The skin around the wound may look swollen and discolored. If the person didn’t seek help right away, the wound could show signs of tissue death. Additionally, people might feel unwell in general, with symptoms like:
- Nausea
- Vomiting
- Diarrhea
- Feeling light-headed
- Fainting
- Difficulty breathing
- Headaches
- Stomachache
- Dizziness
- Seizures
Testing for Stingray Sting
If you get injured, normal procedures will be used to examine your wound. This includes cleaning the wound thoroughly. X-rays might be taken to look for anything foreign that might have entered your wound. This decision will be made by your doctor. If you were injured by a stingray, the barb (or spine) can be seen on an x-ray. But there isn’t a set standard or rule yet for when to get an x-ray for stingray injuries. However, in one investigation, more than half of the patients who were stung by stingrays had an x-ray done. Out of 119 cases, only 2 had a foreign object found (and it was definitely a stingray barb in one case, but maybe a barb in the other case).
If you come in with an injury to your chest or stomach or if you have severe symptoms that affect your whole body, your doctor might consider getting an EKG (a test that checks how your heart is working), lab tests, and chest x-ray. If there’s a concern that you may be very sick, including possibly going into shock from weakness of the heart, the doctor may transfer you to a hospital with intensive care unit (ICU) facilities, and you might be asked to see a toxicology specialist (doctor who specializes in poisonings).
Treatment Options for Stingray Sting
If you are stung by a stingray, the standard treatment is to immerse the affected area in hot water. The heat helps neutralize the stingray’s venom. It’s important to make sure the water isn’t too hot, as it could cause burns. One way to check is by testing the water’s temperature on a part of your body that hasn’t been stung. Ideally, the immersion in hot water should start as soon as possible, sometimes done by lifeguards or emergency health personnel. Studies have shown that this treatment alone can significantly reduce the sting’s pain. In certain cases, anti-inflammatory or pain relief medications may also be used along with the hot water treatment.
Even after hot water treatment, only a small portion of patients might need additional pain relief when leaving the hospital. In some cases, hot water treatment was found to help reduce pain but did not decrease skin damage during freshwater stingray injuries.
Stingray stings require usual wound care. The injured area should be cleaned, and any remaining foreign bodies like stingers should be removed, as they can delay healing and cause more damage. If the wound is small, it’s best to let it heal naturally over time to reduce the risk of infection. It’s also important to check and update your tetanus shots if needed. If the area around the wound starts to die, known as necrosis, it must be clean-cut or “debrided.”
Doctors are yet to reach a consensus about giving antibiotics after stingray injuries. Some argue that only deep wounds, wounds with foreign bodies, or patients with weak immune systems should get prophylaxis, a preventive antibiotic. But a study showed that most patients were given prophylaxis initially, and only a few returned with potential early infection, indicating it might be a wise approach. This preventative antibiotic would protect against several harmful bacteria types.
What else can Stingray Sting be?
Possible causes of aquatic injuries could be:
- A cut or tear in the skin (laceration)
- Skin infection (cellulitis)
- A serious skin infection that quickly kills the body’s soft tissue (necrotizing fasciitis)
- Injury from sea urchin
- Injury from a lionfish
- Jellyfish sting
- Coral scrape or cut
- Sting from a sea anemone
- Shark bite
- Octopus bite
- Attack by an alligator or a crocodile
- Ciguatera fish poisoning (a type of food poisoning)
- Scombroid fish poisoning (another type of food poisoning)
- Pufferfish tetrodotoxin poisoning
- Poisoning from shellfish toxin
What to expect with Stingray Sting
When someone gets injured by a stingray, whether it’s a puncture wound, a deep cut, or a venomous sting, they generally recover well. It’s important for these patients to watch out for signs of infection after they’ve been treated. Although it is possible to get an infection, most people will experience a significant decrease in pain within one to two days after the stingray injury.
In some cases, the venom from a stingray can cause tissue death or necrosis. This is uncommon in the United States but it is more frequent with freshwater stings in Brazil. In a study in Brazil examining 84 freshwater stings, around 90.4% of the cases developed ulcers and necrosis. These ulcers lasted around 3 months and often caused scarring.
Serious poisoning or death due to a stingray injury is very rare and usually related to injuries causing deep inside wounds in the abdomen, chest, or neck. These injuries could lead to a deep cut in the heart, a buildup of fluid that restricts heart function, a collapsed lung, difficulty breathing, or severe bleeding. There have been cases where patients have died after the initial incident due to severe infection, bone infection, gangrene, or a certain type of infection caused by a bacteria that produces a nerve toxin called wound botulism.
Possible Complications When Diagnosed with Stingray Sting
The primary complication that occurs when a stingray stings a person is usually an infection in the wound or tissue death. Particularly when the stingray is found in freshwater, there is a higher chance of skin tissue dying. Some individual cases have reported deep tissue infections, specifically necrotizing fasciitis, which results from a stingray injury.
Common Side Effects:
- Infection in the sting wound
- Death of skin or tissue around the wound
- Higher chance of skin death with freshwater stingrays
- Deep tissue infection (necrotizing fasciitis) as reported in some cases
Preventing Stingray Sting
Stingrays are usually peaceful creatures that don’t typically attack humans unless they feel threatened. The best way to prevent getting hurt by a stingray is by not upsetting them. This advice is particularly relevant for people who like to swim, dive, or spend time at the beach. A common way people get injured is by accidentally stepping on a stingray. To prevent this, you can shuffle your feet in the sand without lifting them, or use a stick to poke the sand in front of you before putting your foot down. Divers can also stay safe by not getting too close to the ocean floor. If a fisherman accidentally catches a stingray, it’s best to refrain from trying to untangle it from the net or line.
