Bullrout Freshwater Stonefish

Bullrout Freshwater Stonefish

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Posted 2022-10-18 by Roz Glazebrookfollow
Bullrout (Freshwater Stonefish)



In Christmas 1986, I wrote a short article for the Townsville Bushwalking Club Magazine entitled "Escape" about bullrouts and ticks. At that time, I had been living in Townsville for thirteen years and had only just learned about bullrouts. I also had my first tick bite that year too. I had moved to North Queensland from Tasmania. I had a bad reaction to the tick bite in the rainforest at Mt Spec. I didn't get another tick bite until many years later - even though I spend a lot of time in on bushwalking and camping trips. I developed a meat allergy from the second tick bite. I wrote about that experience here .

I became interested in bullrouts when our bushwalking President told me one had stung a friend of his in rapids in the Tully River. The pain was severe and he was admitted to hospital and given pain-killing injections. I was a registered nurse at the Townsville hospital at the time and had never heard of bullrouts. I had heard of stonefish that lived in the sea but not the freshwater ones. I was into kayaking in rapids at that time, so was interested in learning more about bullrouts. The bullrout belongs to the Scorpaeniformes order of fish. Its scientific name is Notesthes robusta and it has fifteen dorsal, three anal, and a single spine in each ventral fin.

The spines have venom glands and the first symptom of envenomation is pain, which can be excruciating. It lives in freshwater rivers and creeks and will usually move away from intruders but large groups of bushwalkers who leap into the water together are at risk, especially if the water is murky.

A good friend's husband told me he was stung when he was ten years old at Freshwater Creek near Cairns. He trod on it as he was walking along the creek bank. He remembers the pain was severe and he had strong pain injections at the Cairns Base hospital. I also heard about another person who was stung when he brushed against one on a wave ski in a North Queensland river. I have heard bullrout stings are rare but maybe they aren't as rare as people think.



The volume of venom introduced depends on the depth of penetration of the spine. People usually get stung on their hands or feet. The pain can last for several hours or days. They can be commonly found in many rivers and creeks throughout Eastern NSW and QLD. They are often found around obstructions such as rocks and logs in or near fast flowing water. I hadn't even thought about bullrouts since that time until recently, when a relative heard from a friend, who told him she had been stung badly by a bullrout.



She had been swimming in shallow waters in a rock pool at a popular swimming creek in North Queensland. She was totally unaware of the lurking danger. She felt something prick her hand, but thought it was nothing to worry about, but as she sat in the sun she felt her hand go numb. She looked down and her left hand was completely white with a red coloured band around her wrist. As she watched with two friends, the redness ran right through her veins up the arm across her shoulder and chest area and down her right arm in a few minutes. She said she felt a sharp short pain in her right chest area too. She wrote to me in an email "I thought plant or a snake perhaps, I had better go and get some antihistamine. Feeling a bit sick, dizzy, and very (not good) I went back to the camping area when all the excruciating pain started".

She struggled through the next three days using a heat pad only for comfort and finally went to Cairns Hospital. After five hours she had an ECG, X-ray, ultrasound and blood tests. They were all clear. She was given endone, which didn't touch the pain. She then got pain patches from the chemist, but they didn't help the pain either.
After five more days, she went to Townsville hospital. The doctors there didn't have any answers either. A toxicologist thought her body might not be able to deactivate the toxins because she had some other health issues, including immune problems. Heat was suggested and she did use that but said it started to make her muscles twitch and convulse. She changed to ice packs and did find keeping her arm very still and slightly raised helped.


She wrote "It is now 42 days after the event. I think it is maybe starting to slightly improve. I get up and think all is well till I move around and start using the arm. Once I start moving the muscles, it starts with shooting pains and often the whole arm feels like a toothache sensation. & #8232 ;The pain radiates from the back muscle of the shoulder into the inside muscle of the upper arm, the outside muscle of the upper arm and the muscle below the elbow. Right now, my whole right hand is tingly numb".

This woman felt there needs to be improvement among hospital staff's knowledge about bullrout stings. She said none of the doctors she saw had heard of a bullrout and this could easily be dismissed as something else. All the doctors were surprised when they heard there was such a thing as a freshwater stonefish. The doctors said stonefish live in the ocean. They hadn't heard of freshwater ones.



She said no one could help with the pain. She told me she did have a high pain threshold and explained she broke her shoulder once in two places and didn't even take one panadol over a four-month period.

She also thinks there needs to be more information for the public about bullrouts and signage at popular swimming spots. She wrote to National Parks and they responded they would put up signage at the creek where she was stung. They said there had never been reports of bullrouts there previously. She did say there was a sign on the gate at the campsite about bullrouts, but she had missed it.
It is easy to miss signs. I remember in my twenties, a Tasmanian friend and I had only been in Queensland a few months when we had the opportunity to go on a road trip to Cairns from Brisbane. We arrived at beautiful Ellis beach on a hot January day. Our Brisbane friend went off somewhere and my friend and I went for a swim. We were only in waist deep water when my friend started screaming. I thought a shark had attacked her. I bravely swam over throwing my arms around to try and chase it away and expecting to be bitten any minute.

I helped her out of the water onto the beach where we discovered the culprit. She had box jellyfish tentacles wrapped around her legs. Neither of us knew what they were. We'd never heard of them. Luckily some people on the beach came to our rescue and removed the tentacles and poured vinegar over her legs.

I lived on a beach north of Townsville for many years and used to swim frequently, but I always completely covered up to prevent being stung by box jellyfish. Just before moving to Brisbane though in 2001 a small shark brushed past me on my swim. When I went back years later, I saw large signs warning people against swimming there because of crocodiles!

When no medical aid is immediately available the limb can be immersed in hot water to lessen the pain (not so hot that it burns tissue). Fish venoms are protein compounds and may be partially denatured and detoxified by the application of heat. Further treatment is symptomatic.

St John Ambulance advises:1. Check the water to ensure it is as hot as you can comfortably tolerate before treating the patient. 2. Place the stung area in hot water for 20 minutes—help patient under a hot shower, place a stung hand or foot in hot water, or pour hot water over the stung area. Do not burn the patient. 3. Remove briefly before reimmersing. 4. Continue this cycle if pain persists. 5. Urgently seek medical aid at a hospital if symptoms are severe

Other information states, if you step on a bullrout, the first thing you should do is to remain calm. If you panic, your heart rate will increase and the venom will spread more quickly through your body. For immediate relief of pain associated with the sting of a bullrout, wash the wound site and immerse in hot water about 45ºC for a maximum duration of 90 minutes. Then seek medical attention as soon as possible.

I did read that morphine didn't work for pain relief in a couple of cases. The authors suggested Infiltration with a local anaesthetic is the method of choice for relieving patients of their pain because it is simple, effective, and mercifully quick.There is an antivenom for stonefish stings for people who have severe systemic reactions. Further information [LINK=https://www.nps.org.au/medicine-finder/stonefish-antivenom-solution-for-injection]here[/here].

Hospitial treatment for stonefish stings from the National Prescribing Service (NPS) website states:1. Irrigate the wound and remove foreign debris2. Radiography to exclude remaining spiny material3. Give oral or parenteral analgesia and occasionally local or regional anaesthesia for severe pain4. Stonefish antivenom is available for stonefish stings with severe pain or systemic effects.5. Surgical consultation for involvement of joints or bones

I discovered bullrouts live as far south as NSW. It would be interesting to know how frequently they do sting people. I discovered bullrouts are responsible for most fish stings that occur in upper tidal reaches and freshwaters of New South Wales and Queensland. They are well camouflaged and sluggish and stand their ground and erect their spines when disturbed, rather than retreat as most other fishes do.They usually shelter among waterweeds, rocks or sunken logs. Stings often occur at popular swimming spots such as river crossings and causeways.The best preventative measure is to wear sturdy footwear in areas likely to be frequented by Bullrouts and to avoid diving among stands of aquatic plants and submerged tree roots.



On bushwalks, I mostly keep my boots on when crossing creeks, but I must remember to look out for bullrouts when swimming and kayaking and wear water sandals or shoes in creeks and rivers.It is now nine weeks since the woman's sting. She wrote to me
%%"Pain and muscle contractions are very intermittent with gaps of days. The left hand is tingly all the time, becoming much more pronounced when using hot water and whilst bathing in a hot bath.
Yesterday the left hand was very aggravated when completing a jigsaw. Fingers crossed overtime this also disappears…%%I contacted the Queensland Museum and obtained two photographs of bullrouts to use in this article. I hope this article can help other people learn about these dangerous freshwater stonefish. I would love to hear if anyone reading this has been stung by a bullrout.


#nature
#queensland
#swimming
#unusual_events
%wnbrisbane
202352 - 2023-06-16 05:15:17

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