Thai food’s bold blend of flavours: A culinary delight with a fatal bite

[Kerryd]

2 hours ago, StayinThailand2much said:

And?? What is carcinogenic about it, the fish, the herbs and spices, or the lemon juice?

The fish.

The Liver Fluke lives in klongs and paddies and ponds.
Fish eat the Fluke larvae in the water. People catch the fish and eat them (or turn them into fish paste).

The larvae get into your blood stream and when they get to the liver or bile duct they attach and grow into adult Flukes.
That is what gives you the cancer. (Though you could be infected with them for decades before getting cancer.)

The grown Flukes deposit eggs into the liver (or bile ducts) which get flushed out with your poop.
In Isaan (and other areas) people will crap in the paddies or their "septic" tank outflow is simply a pipe draining out of the tank - often at ground level.

When the monsoons come, the septic tanks flood, the paddies flood, the ponds and klongs flood and all those Fluke eggs get scattered around.
They start to grow and get eaten by the fish. People catch the fish and - you know the rest.

It seems the lifespan of a Liver Fluke can be up to 25 years. However, if you are living in Isaan and eating raw fish paste (and anything else harvested from the klongs and ponds that isn't washed and cooked, like watercress) you are probably going to get infected many times over that time.

I avoid fish here like the plague. Even cooked fish makes me wary. Same for the small raw crabs they put in the Papaya Salad. 

(Coincidentally, Cholera is usually spread the same way. Cholera is spread by contact with infected feces (normally).
People infected with it poop (wherever) and the poop ends up in the water. People come in contact with the water (or eat stuff that was in the water) and end up getting Cholera. It's purely a coincidence that Cholera is more prevalent in countries that "use the left hand" or "a bowl of water" to clean themselves. In countries that use the "wipe it with toilet paper till it's clean" method - Cholera is (generally) not an issue.) 
 

[StayinThailand2much]

3 minutes ago, Kerryd said:

The fish.

The Liver Fluke lives in klongs and paddies and ponds.
Fish eat the Fluke larvae in the water. People catch the fish and eat them (or turn them into fish paste).

The larvae get into your blood stream and when they get to the liver or bile duct they attach and grow into adult Flukes.
That is what gives you the cancer. (Though you could be infected with them for decades before getting cancer.)

The grown Flukes deposit eggs into the liver (or bile ducts) which get flushed out with your poop.
In Isaan (and other areas) people will crap in the paddies or their "septic" tank outflow is simply a pipe draining out of the tank - often at ground level.

When the monsoons come, the septic tanks flood, the paddies flood, the ponds and klongs flood and all those Fluke eggs get scattered around.
They start to grow and get eaten by the fish. People catch the fish and - you know the rest.

It seems the lifespan of a Liver Fluke can be up to 25 years. However, if you are living in Isaan and eating raw fish paste (and anything else harvested from the klongs and ponds that isn't washed and cooked, like watercress) you are probably going to get infected many times over that time.

I avoid fish here like the plague. Even cooked fish makes me wary. Same for the small raw crabs they put in the Papaya Salad. 

(Coincidentally, Cholera is usually spread the same way. Cholera is spread by contact with infected feces (normally).
People infected with it poop (wherever) and the poop ends up in the water. People come in contact with the water (or eat stuff that was in the water) and end up getting Cholera. It's purely a coincidence that Cholera is more prevalent in countries that "use the left hand" or "a bowl of water" to clean themselves. In countries that use the "wipe it with toilet paper till it's clean" method - Cholera is (generally) not an issue.) 

Great info. Thanks.

[Jimjim1]

48 minutes ago, Chaspul said:

Having lived for many years in Saudi I understand  why the Muslim clerics ban pork completely-just to save lives of the uneducated population.

Sorry but it goes much deeper than that, the pig is considered unclean starting with the fact that whilst it may keep its bed relatively clean it c - - ps on its doorstep and wallows in it, also it’s faeces is the worst and all pervading smell of any animal, yet funnily enough the organs of the pig are known to be closer to humans and more usable to us than the animal we have all supposedly evolved from, The great ape.

Mind you there are more pigs than apes so the numbers for medical research are obvious.

 

[KayDeeDee]

  Fish from the River carry the parasite .  Dirty River water is the problem .   

[Cabradelmar]

My GF is from the NE and she won't touch the stuff. 

[stix40]

I nearly eat a raw pork chop last night ! 

That nearly killed me 

Sent it straight back 

One restaurant off of my list . 

[dinsdale]

Well I've scrolled through the 1st page. That was enough. No one mentioned pra ra. That's the biggest offender when it comes to liver fluke. Seems the OP also missed this point.

[alex8912]

7 hours ago, SiSePuede419 said:

My wife told me the same thing and fried this dish for me when her family ate it raw.

But then at an upscale Thai restaurant she eats raw salmon.  A lot of it maybe a quarter kilo. ????

 

I only eat "raw" fish when it's "cooked" in lime juice or vinegar with salt and only in America at top Italian restaurants.  Never eat sushi in Thailand OMG 

Life's too short to see flukes crawling out your ears after they've been feasting on your brain. ????

Really?  How many deaths from sushi do you know about in Thailand? 

[Caldera]

16 hours ago, webfact said:

it enjoys immense popularity in the Thai province of Khon Kaen. Known as koi pla, it comprises minced raw fish blended with herbs, spices, and lemon juice, forming a dish relished by millions of Thai people, especially in Isaan, one of the nation’s most impoverished provinces.

The Isaan isn't a province. Khon Kaen isn't exactly impoverished compared with other Isaan provinces. Hopefully the rest of the article has some basis in fact. 

[Gottfrid]

6 hours ago, pacovl46 said:

Yep, here we have it again, an absolutely cretinous overgeneralizing stereotype of how stupid and uneducated Thais are and how educated and superior the west is. How many people die again in the west every year because they eat like pigs and are massively overweight, and how many people die of drugs, smoking and or drinking, despite the fact that they are SO EDUCATED on the adverse effects of smoking, drinking and co? But of course you conveniently blend that out because it doesn't suit the view from your high horse! 

 

 

Sorry to break it to you, but I did not say all Thais. It´s a fact, that Isaan, are the most poor and uneducated region in Thailand. So, now you know that too.

[Gottfrid]

6 hours ago, pacovl46 said:

Well, it kills 20000 people a year in an area that has how many millions of inhabitants who eat that dish regularly? 

 

I wouldn't eat it, but I guess smoking and drinking kills a lot more people every year. 

Might be right, still as you say, I would also avoid it, as I see it as a stupid risk. Quit smoking as well, but are still drinking. ???? 

 

[Kalasin Jo]

7 hours ago, VBF said:

Slightly but in UK almost no restaurants will serve burgers RARE. Why? Because a government ministry has advised (not instructed) that minced meat may not be properly cooked on all sides unless it's well done. Restaurants are therefore scared of being sued if someone gets sick after eating a rare burger!

If Thailand is the land of scams (if!) UK is the land of OTT Health & Safety - almost a polar opposite to Thailand, in fact.

    

Yeah. I hate grilled to death and beyond burgers. I like mine à point ( medium rare like my steaks) as the French say. I am also very fond of steak tartare. Which is rather like a raw burger but should be made with good quality minced steak not cooking mince.

[DTL2014]

ok -so we know that we might be exposed to parasites .....what's the medication that we should be taking ( say once every 3-months?)..i mean i de worm the dog...shouldnt i be doing myself just in case ?? 

[eastlight]

10 hours ago, jacko45k said:

Perhaps so, but raw fish, straight from the water can also come with plenty of parasites...I would think avoiding raw fish (and other meats) is a safer approach. I have also heard of negative comments relating to the much loved and eaten Som Tam, some versions of which contain small raw crabs.

Why don't they just cook it and solve the problem.

[wealthychef]

12 hours ago, kwilco said:

Not a bacteria...its a parasite...liver fluke. 

This has been known about fit decades and linked to liver cancer.

The problem is its a bit like smoking.... people know its harmful but the damage is over a long period and incremental..so there is a temptation to continue.

I wonder why the journalist who wrote this confusing article didn't think to include this important factual information.  Used to be a time when the "news" contained "information."  

[kwilco]

1 hour ago, wealthychef said:

I wonder why the journalist who wrote this confusing article didn't think to include this important factual information.  Used to be a time when the "news" contained "information."  

Yes - it gives the impression you eat it and die - it is a problem that has been known for a long time - and not a lot has been done but the cuases and it's history have been disregarded in the name of sensationalism

[wealthychef]

5 minutes ago, kwilco said:

Yes - it gives the impression you eat it and die - it is a problem that has been known for a long time - and not a lot has been done but the cuases and it's history have been disregarded in the name of sensationalism

Well, I would say nothing needs to be done other than do the research and let people know the danger they are facing.  If they don't listen then som nam na right?  

[kwilco]

4 minutes ago, wealthychef said:

Well, I would say nothing needs to be done other than do the research and let people know the danger they are facing.  If they don't listen then som nam na right?  

THere needs to be a better government information campaign and the health service needs to gear up to treat infections of liver luke before serious damage occurs.

Its 'like smoking tobacco - if the research hadn't been published and the public informed millions more would have died.

 

Most countries have hygiene laws too which prevent selling of these products, so restaurants could be made iether to stop selling it or comply with regulations that prevent contamination.

Parasites occur in food all over the world - the USA has a whole range of parasites that occasinallu=y affect the public, but sellers know they can be sued r prosecuted.

THailand has very basic consumer laws and many foods are consumed outside regulation either through lack of legic=slation or enforcement - fish, meat insects, slad, mushrooms etc

[gearbox]

9 hours ago, fdimike said:

I believe you're incorrect about freezing killing parasites.  It's my understanding that the only way to kill parasites and their eggs is by cooking thoroughly.

Nope, raw sashimi is made from frozen fish, and there are requirements for how long the fish needs to be frozen, it is something like a week at -30 degrees Celsius. If you cook the fish the sashimi won't be raw anymore.

 

In Macro they sell in the frozen fish area blocks of frozen tuna sashimi from Indonesia, pretty good.

[kwilco]

11 hours ago, arick said:

Take deworming pills every year. You need to take 3 in a go.  

THis depends what drug you are taking - you need one that kills liver flukes and before other damage is caused.

[kwilco]

11 minutes ago, gearbox said:

Nope, raw sashimi is made from frozen fish, and there are requirements for how long the fish needs to be frozen, it is something like a week at -30 degrees Celsius. If you cook the fish the sashimi won't be raw anymore.

 

In Macro they sell in the frozen fish area blocks of frozen tuna sashimi from Indonesia, pretty good.

I wouldn't be so confident....

 

THis is the advice of te US department of Agriculture

 

"Trichina and other parasites can be destroyed by sub-zero freezing temperatures. However, very strict government-supervised conditions must be met. It is not recommended to rely on home freezing to destroy trichina. Thoroughly cooking food will destroy all parasites, however the incidence of trichinosis has declined in the United States due to changes in hog feeding practices. Presently, most cases in the U.S. are caused by consumption of raw or undercooked wild game."

Edited September 13, 2023 by kwilco

[kwilco]

Here's a diagram of the life cycle of the particular fluke I believe the article is talking about........

[kwilco]

24 minutes ago, gearbox said:

Nope, raw sashimi is made from frozen fish, and there are requirements for how long the fish needs to be frozen, it is something like a week at -30 degrees Celsius. If you cook the fish the sashimi won't be raw anymore.

 

In Macro they sell in the frozen fish area blocks of frozen tuna sashimi from Indonesia, pretty good.

the fluke parasites are particular to freshwater fish.

[kiwikeith]

17 hours ago, kwilco said:

Not a bacteria...its a parasite...liver fluke. 

This has been known about fit decades and linked to liver cancer.

The problem is its a bit like smoking.... people know its harmful but the damage is over a long period and incremental..so there is a temptation to continue.

They sell Ivermectin over the counter in Thailand, that's supposed to be excellent in killing river parasites 

[kwilco]

52 minutes ago, kiwikeith said:

They sell Ivermectin over the counter in Thailand, that's supposed to be excellent in killing river parasites 

Both work best against the adult flukes, but there is some effect on the migrating juvenile flukes. Clorsulon is effective only against liver flukes and it is sold alone as Curatrem® or in combination with ivermectin as Ivomec® Plus.

 

Used by vets in Europe

[jacko45k]

14 hours ago, Aviatorhi said:

It's going to depend on the country. In Japan you can (literally) safely eat raw chicken. Their food hygiene and controls are that high. In Thailand, not as much. 

Perhaps not at all.... fish from the Mekong or some stagnant waters, or the seawaters off Pattaya .... anyhow, topic isn't about Japan....

[jacko45k]

7 hours ago, eastlight said:

Why don't they just cook it and solve the problem.

Some raw item dishes are quite delicious, in the west we have steak tartar and pickled items.... I have been offered raw pork in Thailand and told it is safe as the pig was squealing it's head off moments earlier! I nevertheless avoid raw things and undercooked items as best I can... 

[pacovl46]

9 hours ago, Gottfrid said:

Sorry to break it to you, but I did not say all Thais. It´s a fact, that Isaan, are the most poor and uneducated region in Thailand. So, now you know that too.

So what? It’s still an over-generalization, it’s still stereotyping and you utterly missed my point, which was, people all over the globe from all races make stupid decisions on a daily basis. It’s not just an occurrence in Thailand or the Isaan for that matter! 
 

And by the way, there’s nothing you can tell me about Thailand that I don’t already know myself. 

[arick]

5 hours ago, kwilco said:

THis depends what drug you are taking - you need one that kills liver flukes and before other damage is caused.

All the Isan doctors know what to take there are also signs and brochures warning everybody 

[arick]

17 hours ago, arick said:

Take deworming pills every year. You need to take 3 in a go.  

Apparently the flux can be so big it causes blockages after you take deworming pills. ''Albemed''.

There are different deworming anti- parasitic medicines depending what province you live in parasites can differ between areas and provinces.