NAGO, Okinawa — An Okinawan diving instructor died Thursday after he was stung by a deadly reef stonefish off Koki Beach in Nago, according to an Okinawa prefectural spokesman.

It was the first reported death caused by the venomous fish in 27 years, said Hayashi Uezato, a spokesman for the Okinawa Health Department’s pharmaceutical team.

The 58-year-old man was giving tourists a diving lesson while standing barefoot in shallow water at 9 a.m., when he suddenly felt a sharp pain on the bottom of his left foot and quickly lost consciousness, Uezato said Friday.

“Another instructor at the beach provided first aid by pouring warm water on the bite location and sucking out poison from the sting marks but the victim stopped breathing before an ambulance arrived,” he said.

The instructor was pronounced dead at 10:35 a.m. at a hospital in Nago. The man’s name was not released, and the incident remains under investigation.

“He must have had other medical issues,” said Ed Dunn, a dive instructor for Kadena Marina on Friday. “It’s very unusual someone dies from a sting.”

Snorkeling and diving are popular with U.S. servicemembers on Okinawa, a subtropical island surrounded by warm, clear seas and coral formations.

Dunn said the last time an American was stung by a rockfish was three years ago.

“He was stung when he foolishly picked one up,” Dunn said. “He was hospitalized and underwent treatment for a while with painful swelling in his arms and hands.”

Reef stonefish are common in Okinawan waters, said Miyuki Nakazato, a researcher at the fish section of the Okinawa Churaumi Aquarium in Motobu.

Along with lion fish, they are known as the most venomous fish in the world. They are found in shallow tropical waters hanging out on coral reefs or lying dormant in the sand, Nakazato said.

“This is why it’s so important to make sure you wear felt bottom booties and bring a first-aid kit with you whenever you go in the water,” Dunn said. “And in all of our water safety courses we stress that you don’t touch anything, especially if you don’t know what it is.”

Stonefish have a mottled green or dull brown color, which aids them in blending in with their surroundings, and average about 35 centimeters long. Their back areas are lined with 13 spines that release a toxin that can cause severe pain, paralysis and even death.

“The most common cause of a stonefish sting is by stepping on one with bare feet,” Nakazato said. “They are in shallow water and are very well camouflaged as rocks.”

The prefectural pharmaceutical department urges beachgoers, snorkelers and divers to wear thick-soled footwear, because the stonefish rays are so thick and hard they can easily pierce thin soles.

If you are stung, the best first course of action is to immediately immerse the affected area in hot water, preferably 130 degrees Fahrenheit, Dunn said.

“Then, get to a hospital as quick as you can,” he said.

Thursday’s attack was the first fatality on Okinawa caused by a reef stonefish since 1983, when a 31-year-old man died on a beach in Yomitan. He was handling a stonefish he’d caught. They are considered a delicacy in Asia.

The most common injuries that marine life inflict on humans in Okinawa’s waters are jellyfish stings, according to the Okinawa Health Department.

Last year, there were 248 recorded injuries by poisonous marine life — 158 cases attributed to jellyfish or sea anemone stings. Reef stonefish, scorpion fish and eels accounted for 30 cases, and 20 cases were attributed to sea urchins and crown-of-thorn starfish, the agency reported. Forty cases were of unknown origin.

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