Who doesn't like a beautiful beach stay with a beautiful sundown and who doesn't dream to observe more nearly the colourful, exotic life of a reef? The Philippine archipelago still offers such possibilities.

But the beautiful stay at the beach can easily become a nightmare if the lightly dressed hiker becomes the target object of a general attack of bloodthirsty sand flies or the swimmer or diver steps by mistake on a stone fish. Although such encounters are relatively rare on the shores of the Philippine island archipelago, they cannot be excluded. Therefore a few information can be useful.

Sand flies – also named as: "Nik-Niks", "No-see-Ums" and "Phlebotominae" – can be found in different species all over the world, for example also in the south of the USA or in Iraq. Their main area of living are the tropical and subtropical zones, however. In the Philippines the tormenting insects could be found particularly on Palawan; some reports refer especially to the beaches of Sabang, Port Barton and El Nido. The swarms of biting insects – counting sometimes myriads - get mainly active in the dawn and in the night.

Sand flies remind of rather tiny gnats. However, they do not sting, they bite. With only 1-2 mm body length they have only a third of the size of mosquitoes, this also means that they can slip through very fine-meshed mosquito nets. On their little grey-black body we see two white very hairy wings which are stretched in resting position upward like a "V". The fly passes the classical development phases from egg, to larva and pupa, until it becomes a volitant insect. A fall in temperature impedes the development. "Nik-Niks" – to use this in the Philippines very popular name - fly very badly. They shy wind breezes and rain and are as short-distance flyer relatively bound to their location. Only the females bite because they need blood for the production of eggs.

The attack and the bites are hardly recognized, because the itching of bites starts round about ten minutes after the bite. Natives also are bitten, but often they feel no more itching anymore. The hag-ridden fair-skinned tourist however wishes sometimes more than two arms to scratch all the itching parts of body at the same time after a wild attack of a swarm. But scratching makes more worse the pain. Normally the itching lasts for two to four days. If there is also a bout of fever it fades away approximately after three days.

The troubles can last, however, also over weeks and months particularly if with the bite other pathogens are communicated. Besides other bacteria and viruses sand flies can transfer for example tiny Leishmania parasites, which will have a further development under the scup of wound. The red reddish bite then changes to an inflamed nodule, the nodule to a papilla, the papilla to a sore. Fever, head and rheumatic pains can be concomitants. The "coetaneous leishmaniasis" can leave ugly face scars ("pizza faces"); the untreated "visceral leishmaniasis" leads in the worst case to meningitis, chronic fever, marrow and blood cell reduction, paralyses, strong loss of weight and organ damages. Up to now there exists no vaccination against the sand fly fever. On the Internet we found however no information that the last mentioned heavy illness cases would have occurred in a considerable number on the Philippines.

What measures could be taken for protection? The hints are very different. They reach from "You can do nothing" to the recommendation of antibiotics. In the house precautionary measures could be the use of dens-meshy mosquito nets and the igniting of smoking repellents. An author suggests a big bath towel with a broad margin distance from the laying person (+ 20 centimetres), so that the badly flying insects would not reach the person. Natives frequently only rub themselves with coconut oil. It is also recommended to mix the coconut oil with some drops of "Autan" or "Off" or to use these repellents exclusively. Others seek remedy by using ointments containing menthol like "Tiger Balsam".

"Nik-Niks" have one little positive aspect. It is reported that fishes are better biting when there are sand flies on place.

The stone fish (Latin name: synanceia verrucosa) belongs to the family of scorpion fishes like the beautiful lionfish or rockfish, which show all poison stings. The stone fish belongs to the most venomous fish of the oceans and could to be found in a depth of 2 -30 meters in most tropical waters.

It attains up to 40 cm and has a broad body with strong pectoral fins and a mighty head. The body doesn't show any shacks, for this many pits and wart like glands. By changing the color of its body according to the color of the bottom it has a good camouflage. The back skin is often overgrown with algae for further disguise; moreover it buries with its pectoral fins most of its body under rubble or sand remaining stationary and snapping prey that comes near. So the stonefish is a master of deception and disguise. By creating a vacuum in its mouth it is able to suck the prey – little fish and crayfish – in milliseconds. Characteristic features are a mouth which is directed upwards like an "U" and a curved tail. The lack of an air bladder makes the laying on the bottom easier. A total of 72 spines protect the body, 18 spines (13 thorns in the dorsal fin, 3 in the anus fin and 2 in the ventral fin) have a venom glance at the base. The venom in the spines serves for self-defence. If the fish is excited, it exposes the dorsal fin, which is put on side in lie and wait position. The sharp, stout dorsal spines can sometimes penetrate the soles of light sneakers or flippers.

If swimmers, snorklers or diver grasp the fish or step unintentionally on the fish in the flat waters the result can be a punction and venom injection. The stonefish injects a muscle and neurotoxin which immediately causes strong, vehement hammering pains and swellings around the blue and red coloured pricked part of body. If there are no suitable countermeasures, then the excruciating pains (stronger than renal colic's) are associated with high fever, shivering fit, vomiting, paralysis of the extremities and the diaphragm as well as arrhythmias of heart. Deaths are relatively rare, if they happen, however, sixty percent of the affected persons die within the first eight hours. In lab-attempt tests mice died within thirty minutes.

An immediate treatment is urgently required. First steps are the remove of the mostly broken spine, an immobile position of the patient and cleaning of the wound with hot water. The temperature of water should be as high as possible (+50⁰ C), because the venom is dissolved by heat. The transportation to a hospital is urgently required. The pains and paralyses can last even for weeks - Morphine does not help, but Boscupan.

Some owners of a an aquarium keep the dangerous stone fish in their aquarium. It is offered in the Internet for a price of approx. € 120.

We should add, that even further dangerous meetings can wait on the swimmer. So for example Jellyfishes can – if there is a contact with body - trigger intensive skin irritations with strong itching and blistering. Even more dangerous can be the skin contact with the lovely marked cone snails. They inject in case of endangering a strong venom into the skin which affects intensive pain and paralyses. Also in this case of accident an immediate medical treatment is required, because there have been deaths eight hours after the injection.

The expert knows the described risks and mostly he will not develop a beach- and seawater phobia, because he knows that the Philippine beaches and shore zones are too beautiful and dangerous encounters are mostly rare.

© Wolfgang Bethge, 2004