Editing Portuguese man o' war (section)

==Venom==
The stinging, venom-filled nematocysts in the [[Tentacle#Cnidarians_and_ctenophores|tentacles]] of the Portuguese man o' war can paralyze small fish and other prey.<ref name=Yanag2002/> Detached tentacles and dead specimens (including those that wash up on shore) can sting just as painfully as those of the live organism in the water and may remain potent for hours or even days after the death of the organism or the detachment of the tentacle.<ref name=Auerbach1997>{{cite journal|last=Auerbach|first=Paul S.|title=Envenomations from jellyfish and related species|journal=Journal of Emergency Nursing|volume=23|issue=6|pages=555–565|year=1997|doi=10.1016/S0099-1767(97)90269-5|pmid=9460392}}</ref>

Stings usually cause severe pain to humans, lasting one to three hours. Red, whip-like welts appear on the skin that last two or three days after the sting. In some cases, the venom may travel to the [[lymph node]]s and may cause symptoms that mimic an allergic reaction, including swelling of the [[larynx]], airway blockage, cardiac distress and shortness of breath. Other symptoms may include fever, [[Shock (circulatory)|circulatory shock]] and in extreme cases, even death,<ref name=Stein1989>{{cite journal|last1=Stein|first1=Mark R.|last2=Marraccini|first2=John V.|last3=Rothschild|first3=Neal E.|last4=Burnett|first4=Joseph W.|title=Fatal Portuguese man-o'-war (''Physalia physalis'') envenomation|journal=Annals of Emergency Medicine|volume=18|issue=3|pages=312–315|year=1989|pmid=2564268|doi=10.1016/S0196-0644(89)80421-4}}</ref> although this is extremely rare. Medical attention for those exposed to large numbers of tentacles may become necessary to relieve pain or open airways if the pain becomes excruciating or lasts for more than three hours, or if breathing becomes difficult. Instances in which the stings completely surround the trunk of a young child are among those that may be fatal.<ref name="Clinchy1996">{{cite book|author=Richard A. Clinchy|title=Dive First Responder|url=https://books.google.com/books?id=rKhW53U7FtwC&pg=PA19|year=1996|publisher=Jones & Bartlett Learning|isbn=978-0-8016-7525-6|page=19|access-date=2016-11-03|archive-url=https://web.archive.org/web/20170217043550/https://books.google.com/books?id=rKhW53U7FtwC&pg=PA19|archive-date=2017-02-17|url-status=live}}</ref>

The species is responsible for up to 10,000 human stings in Australia each summer, particularly on the east coast, with some others occurring off the coast of [[South Australia]] and [[Western Australia]].<ref name="Fenner1996">{{cite journal|last1=Fenner|first1=Peter J.|first2=John A.|last2=Williamson|date=December 1996|title=Worldwide deaths and severe envenomation from jellyfish stings|journal=Medical Journal of Australia|volume=165|issue=11–12|pages=658–661|doi=10.5694/j.1326-5377.1996.tb138679.x|issn=0025-729X|quote=In Australia, particularly on the east coast, up to 10 000 stings occur each summer from the bluebottle (''Physalia'' spp.) alone, with others also from the "hair jellyfish" (''Cyanea'') and "blubber" (''Catostylus''). Common stingers in South Australia and Western Australia, include bluebottle, as well the four-tentacled [[cubozoa|cubozoa or box jellyfish]], the "jimble" (''Carybdea rastoni'')|pmid=8985452|s2cid=45032896}}</ref>

===Treatment of stings===
Stings from a Portuguese man o' war can result in severe [[dermatitis]] characterized by long, thin, open wounds that resemble those caused by a whip.<ref>{{cite web|url=http://www.medicinenet.com/image-collection/portuguese_man_of_war_sting_picture/picture.htm|title=Image Collection: Bites and Infestations: 26. Picture of Portuguese Man of War Sting|website=www.medicinenet.com|publisher=MedicineNet Inc |quote=The sting of the Portuguese man-of-war. One of the most painful effects on skin is the consequence of attack by oceanic hydrozoans known as Portuguese men-of-war, which are amazing for their size, brilliant color, and power to induce whealing. They have a small float that buoys them up and from which hang long tentacles. The wrap of these tentacles results in linear stripes, which look like whiplashes, caused not by the force of their sting but from deposition of [[proteolytic]] venom toxins, [[urticariogenic]] and irritant substances.|archive-url=https://web.archive.org/web/20180603114215/https://www.medicinenet.com/image-collection/portuguese_man_of_war_sting_picture/picture.htm |archive-date=2018-06-03 |access-date=2014-06-13}}</ref> These are not caused by any impact or cutting action, but by irritating [[Hives|urticariogenic]] substances in the tentacles.<ref name=James2006>{{cite book |last1=James |first1=William D. |last2=Berger |first2=Timothy G. |first3=Dirk M. |last3=Elston |first4=Richard B. |last4=Odom |title=Andrews' Diseases of the Skin: Clinical Dermatology |url=https://archive.org/details/andrewsdiseasess00mdwi_659 |url-access=limited |publisher=Saunders Elsevier|year=2006 |page=[https://archive.org/details/andrewsdiseasess00mdwi_659/page/n439 429] |isbn=978-0-7216-2921-6}}</ref><ref name="Bolognia">{{cite book |last1=Rapini |first1=Ronald P. |last2=Bolognia |first2=Jean L.|last3=Jorizzo|first3=Joseph L. |title=Dermatology: 2-Volume Set |publisher=Mosby |location=St. Louis |year=2007 |isbn=978-1-4160-2999-1}}</ref>

Treatment for sting pain is immersion in {{convert|45|C}} water for 20 minutes.<ref name=Loten2006>{{cite journal|last1=Loten|first1=Conrad|last2=Stokes|first2=Barrie|last3=Worsley|first3=David|last4=Seymour|first4=Jamie E.|last5=Jiang|first5=Simon|last6=Isbister|first6=Geoffrey K.|title=A randomised controlled trial of hot water (45&nbsp;°C) immersion versus ice packs for pain relief in bluebottle stings|journal=Medical Journal of Australia|volume=184|issue=7|pages=329–333|year=2006|doi=10.5694/j.1326-5377.2006.tb00265.x|pmid=16584366|s2cid=14684627|url=https://www.mja.com.au/system/files/issues/184_07_030406/lot11135_fm.pdf}}</ref> The [[cnidocyte]] found in the [[box jellyfish]] react differently than the [[nematocyst]] in the Portuguese man o' war; cnidocytes are inhibited by application of [[vinegar]], but nematocysts can discharge more venom if vinegar is applied.<ref name=Galsziou2013>{{cite journal|last1=Galsziou|first1=Paul T.|last2=Bennett|first2=John|last3=Greenberg|first3=Peter|last4=Green|first4=Sally|title=Hot water immersion for bluebottle stings|journal=Australian Family Physician|volume=42|issue=6|year=2013|url=https://www.racgp.org.au/getattachment/572969cd-e853-42a6-8392-653145b96a1b/Bluebottle-stings.aspx}}</ref>