Marine toxins, envenomations, and bites

1. Toxins
   1. Scombroid
   2. Ciguatera
2. Stingers
   1. Stingrays
3. Venomous fish (catfish, zebrafish, scorpion fish, stonefish)
   1. Sea urchins
   2. cone shells
4. Nematocysts
   1. Jellyfish (Cnidaria)
   2. Portuguese man-of-war
   3. Corals
   4. Fire Corals
   5. Sea anemones
   6. Sea wasps
5. Bites
   1. Octopus

CME

Environmental emergencies question – Regarding black widow and brown recluse spider envenomations, which of the following is FALSE?

	Black widow spiders (BWS) are found in the temperate regions of six continents and are widespread through North America, including the western United States (California included).
	Signs and symptoms associated with BWS (e.g. diffuse pain, muscle cramps, tachycardia, and hypertension) usually develop begin within 30 to 120 minutes of the envenomation.
	After antivenom for BWS is administered, symptoms typically resolve within 30 minutes, with complete relief within 2 hours.
	Brown recluse spider (BRS) envenomation is most common in west coast states, such as California.
	Most bites from BRS have a benign clinical course, but necrosis with induration and eschar formation may occur, and systemic effects, such as fever, chills, headache, malaise, arthralgia, and myalgias progress after more than 24 to 48 hours and resolve by 72 to 96 hours post bite.