deaths in West Malaysia. Protection and treatment Protective clothing Wearing pantyhose, full body lycra suits, dive skins, or wetsuits is an effective protection against box jellyfish stings. The pantyhose were formerly thought to work because of the length of the box jellyfish's stingers (nematocysts), but it is now known to be related to the way the stinger cells work. The stinging cells on a box jellyfish's tentacles are not triggered by touch, but by chemicals found on skin, which are not present on the hose's outer surface, so the jellyfish's nematocysts do not fire. First aid for stings Once a tentacle of the box jellyfish adheres to skin, it pumps nematocysts with venom into the skin, causing the sting and agonizing pain. Flushing with vinegar is used to deactivate undischarged nematocysts to prevent the release of additional venom. A 2014 study reported that vinegar also increased the amount of venom released from already-discharged nematocysts; however, this study has been criticized on methodological grounds. Vinegar is made available on Australian beaches and in other places with venomous jellyfish. Removal of additional tentacles is usually done with a towel or gloved hand, to prevent secondary stinging. Tentacles can still sting if separated from the bell, or after the creature is dead. Removal of tentacles may cause unfired nematocysts to come into contact with the skin and fire, resulting in a greater degree of envenomation. Although commonly recommended in folklore and even some papers on sting treatment, there is no scientific evidence that urine, ammonia, meat tenderizer, sodium bicarbonate, boric acid, lemon juice, fresh water, steroid cream, alcohol, cold packs, papaya, or hydrogen peroxide will disable further stinging, and these substances may even hasten the release of venom. Heat packs have been proven for moderate pain relief. The use of pressure immobilization bandages, methylated spirits, or vodka is generally not recommended for use on jelly stings. Possible antidotes in humans In 2011, researchers at the University of Hawaii announced that they had developed an effective treatment against the stings of Hawaiian box jellyfish by "deconstructing" the venom contained in their tentacles. Its effectiveness was demonstrated in the PBS Nova episode "Venom: Nature's Killer", originally shown on North American television in February 2012. Their research found that injected zinc gluconate prevented the disruption of red blood cells and reduced the toxic effects on the cardiac activity of research mice. It was later found that