Bangkok: Doctors emphasize that the primary cause of liver fluke infections is the consumption of freshwater fish containing fluke larvae that have not been adequately cooked. High-risk dishes include raw fish salad (koi pla), minced fish salad (larb pla), and various forms of raw, fermented, or pickled fish that haven't been properly prepared. Fermented fish (pla ra) that is produced under standard conditions and cooked thoroughly poses a low risk.
According to Thai News Agency, Dr. Jetsada Bunyawongviroj, Deputy Director of Maharaj Nakorn Ratchasima Hospital, highlighted the issue through a Facebook post. The post discussed the screening of liver fluke infections among new university students in Maha Sarakham province. At Maha Sarakham University, 12,733 new students were screened, with 4,233 found to be infected, translating to approximately 33%. Similarly, Maha Sarakham Rajabhat University screened 1,922 students, identifying 380 infections, or approximately 19%. Additionally, screenings of over 20,000 individuals in the province showed an infection rate of about 11%.
Dr. Jetsada explained that liver fluke disease is a silent ailment, with infections potentially persisting for decades without symptoms. The scientific consensus is that liver fluke infections arise from consuming inadequately cooked freshwater fish containing parasite larvae. While the potential for fermented fish paste (plara) to be a source of infection requires further investigation, it's crucial not to blame all types of plara, as those produced hygienically and heated before consumption pose a much lower risk.
'This news highlights that liver fluke disease is a concern for both the older and younger generations. If eating habits don't change, the impact may manifest in 15-20 years as bile duct cancer, a disease that is challenging to treat and often fatal,' stated Dr. Jetsada.
He further elaborated that liver fluke (Opisthorchis viverrini) is prevalent in Thailand, particularly in the Northeast and North, as well as in neighboring countries such as Laos and Cambodia. Confirmed sources of infection include raw or undercooked freshwater fish. High-risk foods encompass raw fish dishes like "koi pla" and "larb pla," locally prepared raw fish, uncooked fish, and improperly aged or heated fermented fish. However, properly fermented and boiled "pla ra" poses minimal risk. Conversely, raw pla ra produced unhygienically or using contaminated freshwater fish that hasn't been heated carries a potential risk.
Thus, it is premature to generalize and label all dishes of papaya salad with fermented fish sauce as dangerous.