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"Box jellyfish" or "sea wasp" is also a common name for the notoriously dangerous Chironex fleckeri. The ambiguous but commonly used terms "sea wasp" and "marine stinger" are sometimes used to refer to the more venomous species of box jellyfish.

Although the notoriously dangerous species of box jellies are largely, or entirely, restricted to the tropical Indo-Pacific, various species of box jellies can be found widely in tropical and subtropical oceans, including the Atlantic and east Pacific, with species as far north as California, the Mediterranean (e.g., Carybdea marsupialis)^[3] and Japan (e.g., Chironex yamaguchii),^[4] and as far south as South Africa (e.g., Carybdea branchi)^[5] and New Zealand (e.g., Carybdea sivickisi).^[6]

Jellyfish/stinger net exclosure at Ellis Beach, Queensland

Defense and feeding mechanisms

The box jellyfish has been called "the world's most venomous creature,"^[7] though only a few species in the class have been confirmed to be involved in human deaths and some species pose no serious threat (for example, the sting of Chiropsella bart only results in short-lived itching and mild pain).^[8]

Each tentacle has about 500,000 cnidocytes, harpoon-shaped needles that inject venom into the victim.^[9] Most often, the fatal envenomations are perpetrated by the largest species of box jelly, Chironex fleckeri, owing to its high concentration of nematocysts, although at least two deaths in Australia have been attributed to the thumbnail-sized Carukia barnesi.^[10] Those who fall victim to C. barnesi may suffer severe physical and psychological symptoms known as Irukandji syndrome.^[11] Nevertheless, most victims do survive, and out of 62 people treated for Irukandji envenomation in Australia in 1996, almost half could be discharged home with few or no symptoms after 6 hours, and only two remained hospitalized approximately a day after they were stung.^[11]

In Australia, C. fleckeri has caused at least 64 deaths since the first report in 1883,^[12] but even in this species most encounters appear to only result in mild envenoming.^[13] Most recent deaths in Australia have been in children, which is linked to their smaller body mass.^[12] In April 2010, a 10 year old Australian girl survived multiple stings from box jellyfish and her survival is considered a medical miracle.^[14] In parts of the Malay Archipelago, the number of lethal cases is far higher (in the Philippines alone, an estimated 20-40 die annually from Chirodropid stings), likely due to limited access to medical facilities and antivenom, and the fact that many Australian beaches are enclosed in nets and have vinegar placed in prominent positions allowing for rapid first aid.^[13][15]

The box jellyfish actively hunts its prey (zooplankton and small fish), rather than drifting as do true jellyfish. It is capable of achieving speeds of up to 4 knots (1.8 m/s).^{[citation needed]}

Box jellyfish are known as the "suckerpunch" of the sea not only because their sting is rarely detected until the venom is injected, but also because they are almost transparent.^[16]

The venom of cubozoans is distinct from that of scyphozoans, and is used to catch prey (fish and small invertebrates, including shrimp and bait fish) and for defense from predators, which include the butterfish, batfish, rabbitfish, crabs (Blue Swimmer Crab) and various species of turtles (Hawksbill turtle, Flatback turtle). Sea turtles, however, are apparently unaffected by the sting and eat box jellies.

In northern Australia, the highest risk period for the box jellyfish is between October and May, but stings and specimens have been reported all months of the year. Similarly, the highest risk conditions are those with calm water and a light, onshore breeze; however, stings and specimens have been reported in all conditions.

In Hawaii, box jellyfish numbers peak approximately 7 to 10 days after a full moon, when they come near the shore to spawn. Sometimes the influx is so severe that lifeguards have closed infested beaches, such as Hanauma Bay, until the numbers subside.^[17][18]

Once a tentacle of the box jellyfish adheres to skin, it pumps nematocysts with venom into the skin, causing the sting and agonizing pain. Successful use of Chironex antivenom by members of the Queensland Ambulance Transport Brigade showed that Acetic acid, found in vinegar, disables the box jelly's nematocysts that have not yet discharged into the bloodstream (though it will not alleviate the pain). Common practice is to apply generous amounts of vinegar prior to and after the stinging tentacle is removed. Removal of additional tentacles is usually done with a towel or gloved hand, to prevent secondary stinging. Tentacles will still sting if separated from the bell, or if the creature is dead. Removal of tentacles without prior application of vinegar may cause unfired nematocysts to come into contact with the skin and fire, resulting in a greater degree of envenomation.^{[citation needed]}

Although commonly recommended in folklore and even some papers on sting treatment,^[20] there is no scientific evidence that urine, ammonia, meat tenderizer, sodium bicarbonate, boric acid, lemon juice, freshwater, steroid cream, alcohol, cold packs, papaya, or hydrogen peroxide will disable further stinging, and these substances may even hasten the release of venom.^[21] Pressure immobilization bandages, methylated spirits, or vodka should never be used for jelly stings.^{[22][23][24][25]} Often in severe Chironex fleckeri stings, cardiac arrest occurs quickly, so cardiopulmonary resuscitation (CPR) can be life saving and takes priority over all other treatment options.