Blue-Ringed Octopus Bite

Several blue-ringed octopus species live in tidal areas around Australia. Bites are very rare and occur only when the octopus is handled or disturbed. The venom contains tetrodotoxin (the same toxin as puffer fish poisoning).

Clinical features

• The bite itself is typically painless and may go unnoticed
• Local numbness/paraesthesia develops, followed by ascending flaccid paralysis 1–2 hours after the bite
• Paralysis can extend to respiratory paralysis, requiring ventilatory support
• Full recovery is expected — paralysis resolves over 2–5 days with supportive care

Treatment

• Pressure bandage with immobilisation of the affected limb, as for snake bite
• Transport to hospital for monitoring and supportive care — including mechanical ventilation if needed — until paralysis resolves
• No antivenom exists; if the patient becomes unconscious, commence CPR

From Marine envenomations, Berling & Isbister, Australian Family Physician 44(1-2), 2015 (reprinted).