Doctors try to put people off fish dish that can cause liver cancer

Koi pla is one of north-east Thailand's favourite foods, but it is proving fatal

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The Independent Online

Thai medics are stepping up efforts to warn people of the dangers of eating a dish made out of raw fish that can cause liver cancer.

Koi Pla is a popular dish in the north-eastern Isaan area, which is made with finely chopped up raw freshwater fish, herbs, lime juice and live red ants and it is, the BBC reported, one of the most common causes of cancer in the region.

Fish used in koi pla carry fluke worm parasites which would be killed if it were cooked.

If they are ingested they can cause infection in the which, if untreated, can develop into cancer of the bile ducts in the liver. Even if a person contracts the parasite young, they will typically not develop cancer until middle age. 

According to the World Health Organisation (WHO) there are nearly 70 million people at risk of getting this worm. In 2012, there were nine million people known to be infected in Thailand, Vietnam, Cambodia and Laos.

In fact, liver cancer makes up half of all cancer cases in the north east of Thailand, according to the BBC, while worldwide it comprises just 10 per cent.

But now, special effort is being made to educate communities in region of the dangers of eating koi pla. A team from the Tropical Disease Research Laboratory in Khon Kaen University is leading an outreach programme in villages along Lawa Lake where liver fluke infection rates are among the highest.

Dr Banchob Sripa is heading up the team and he told the BBC that the university had been “studying this link in our labs for over 30 years.“ They found that in some areas, 80 per cent of residents carried the worm.

In 2011, health authorities began addressing the problem and announced plans to start screening people for the fluke worms.

”Everyone above 30 years of age will get an annual stool examination to screen for fluke eggs” Pongsadhorn Pokpermdee, health economist and public health deputy for Nongbualanpoo province in the northeast, told Reuters.

Banchob’s work will involve getting people to use proper toilets, instead of going in the lake and spreading the eggs. So far, his efforts are proving a success and infection rates on villages where he has worked are, he said, dropping.

“I think 60 per cent do understand the causes of the liver cancer” Banchob told the BBC, “they are aware of the liver fluke.

”But 10 per cent are still eating raw fish. I believe that 10 per cent probably cannot change. So we should change the environment, make the fish cleaner, to get fewer infections.“

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