Stonefish (Synanceja verrucosa)
The Reef Stonefish is the most venomous fish in the world. Its dorsal area is lined with 13 spines that release venom from two sacs attached to each spine. Its venom causes severe pain with possible shock, paralysis, and tissue death depending on the depth of the penetration. This level can be fatal to humans if not given medical attention within a couple of hours. Immediate first aid treatment requires immersion of the affected limb in hot water, ensuring that it is not so hot that skin damage may occur. The immobilisation of venom at penetration site by tourniquet or firm constrictive bandaging is no longer recommended.
The venom consists of a mixture of proteins, including the hemolytic stonustoxin, the neurotoxic trachynilysin and the cardioactive cardioleputin; an antivenom is available.
The venom is protein based, and it can be (partially) denatured by the application of a very hot compress to the injury site. Some relief can be gained from infiltrating the wound with a local anaesthetic. This is a temporary measure to reduce localized pain and shock. Medical aid must be sought at the earliest opportunity. Typically, surviving victims suffer localized nerve damage occasionally leading to atrophy of adjoining muscle tissues.
There have been unproven reports of osteo-arthritic sufferers experiencing improved mobility and reduction in joint pain following envenomation episode. The responsible agent has not been identified.
The pain is said to be so severe that the victims of its sting want the affected limb to be amputated. The poisonous sting of Scorpion Fish and Lionfish are said to deliver almost the same level of pain.
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