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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

Monday 15 June 2015 11:43 BST

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.

Trial and terror: 10 of the strangest foods in the world

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1/10Trial and terror: 10 of the strangest foods in the world

Trial and terror: 10 of the strangest foods in the world

Tepa (Stinkheads) - Alaska

Also called ‘Stinkheads’, Tepas are fermented whitefish heads, and if you haven’t quite grasped the clues given already, they don’t exactly smell like roses. Traditionally, preparation includes placing fish heads and guts into a wooden barrel, covering them with burlap and burying them in the ground, allowing them to ferment over a week. Once complete, they can be 'enjoyed' immediately.

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Trial and terror: 10 of the strangest foods in the world

Rocky Mountain Oysters - USA

Thinking of the seafood that apparently provides an aphrodisiac? Think again. This American dish, usually an appetiser served with a cocktail sauce dip, is something more out of I’m a Celebrity Get Me Out of Here than the Deep South, as it consists of bull testicles - how delightful - being deep fried to present a crispy finish. An old-time favourite with cowboys back in the Wild West, it is more likely these days to be found at festivals and carnivals in the United States.

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Cockcombs - France

Ever wondered what the red, fleshy Mohican-like feature on top of a rooster’s head tastes like? Perhaps not. In which case, you may be interested to learn that it can be used in a variety of dishes. Cockcombs are predominantly used in France as part of a famous garnish, but the biggest surprise is that they can also be used either as a main dish or even as a desert, with one food website Offalgood.com comparing them to “warm gummy bears in your pocket.”

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Sannakji - Korea

There’s nothing strange about eating octopus, as millions around the world do every year. But how about eating live octopus tentacles which could potentially kill you? Sannakji, a raw Korean dish, is formed by bits of chopped octopus usually seasoned with sesame seeds and oil. It represents a health hazard because the suction cups on the tentacles still function even when cut off – as do the wriggling tentacles – and there is a possibility that they could stick to your throat as you swallow them. Sounds terrific.

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Witchetty Grub - Australia

It sounds like something you might find in an East London café, although it certainly doesn’t look it. This large, wood-eating larvae of several moths is actually found in central Australia, and despite its unattractive exterior, it’s quite a healthy and delicious treat. It can be eaten raw or lightly cooked in hot ashes, and they are sought out as a high-protein food by Indigenous Australians. When raw, the witchetty grub tastes like almonds, but when cooked, the skin becomes crisp like roast chicken while the inside becomes light yellow, like a fried egg.

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Trial and terror: 10 of the strangest foods in the world

Fugu (Puffer fish) - Japan

One of the most dangerous foods in the world, it takes specially-trained chefs to ensure that the toxic parts of the fish are not included in the meal. Since 2000, there have been 20 deaths in Japan related to this. Containing highly poisonous tetrodotoxin, it can be fatal if the liver - the most poisonous part of the fish banned from sale in 1984 - is consumed. Fugu is available to buy in a package in supermarkets but due to its lack of availability, can cost up to £130 in some restaurants. People brave enough to try it claim fugu is definitely worth the risk, and it remains one of the most popular aspects of Japanese cuisine, but is the seafood delicacy worth risking your life for?

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Fried Bat - Asia

On a warm summer’s evening in Britain, you may notice bats flying around as the sun goes down. Travellers in parts of China, Thailand, Guam and even Australia, however, might stumble across bats being sold in food markets and even restaurants. Varieties of fruit bats, including the sizable flying fox bat, are the most popular to eat. The main way of cooking is to roast the bats after skinning them, and other cultures might toss bits of bat into soups and stir-fry, claiming that tastes similar to chicken.

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Durian Fruit - Asia

When you mention foods with a somewhat odorous scent, the usual suspects such as garlic and onion spring to mind. But a type of fruit, called durian fruit, is an unexpected addition to that list. If you’re planning on eating durian fruit in a public place in Asia, you can’t. The smell that it produces has been likened to sewage and rotten onions, which hardly gives it the most appetising description. In fact, it’s so bad that in some areas in Asia, people are banned from eating them in public. But don’t let that put you off, as durian fruit’s flesh is rumoured to be quite pleasant to consume. We’re not promising anything, though.

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Fried Tarantula - Cambodia

A regional delicacy in the Cambodian town of Skuan, it’s a cheap and popular snack for the increased number of tourists passing through the South East Asian country. Costing the equivalent just five pence, the taste of the tarantula is said to be slightly bland, with a mix between cod and chicken. Fried in oil for a crispy finish, the popular choice is to eat the head, which has a good amount of meat inside. Those who take a bite into the abdomen might get a nasty surprise, however, with a brown taste containing organs and excrement remaining inside.

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Trial and terror: 10 of the strangest foods in the world

Haggis - Scotland

With all the odd foods in the world, who could forget the strangest of them all? The Scottish trademark dish of Haggis - made from sheep heart, liver and lungs - has been around for hundreds of years and is usually accompanied by a glass of Scotch whisky. Even in spite of its ingredients and appearance, the dish is said to have a nutty texture and a real savoury flavour. There is even a sport called ‘Haggis Hurling’ where competitors throw the meat as far as possible, with the record standing at 217ft.

Twitter (@JackWills)

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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