Deadly dish: the dinner that can give you cancer

[Lite Beer]

Deadly dish: the dinner that can give you cancer
By Jonathan Head

BANGKOK: -- A local delicacy in north-east Thailand, made from raw fish, has been found to be behind a high incidence of liver cancer in the area, and doctors are trying to educate people about the risk.

The Isaan plateau of north-eastern Thailand is poor, dry, and far from the sea. Home to around one third of the country's population, most of them ethnic Lao in origin, it is renowned for its spicy and inventive cuisine, using whatever ingredients are available.

Where there are rivers or lakes, they use the smaller fish they catch in a pungent dish called koi plaa. The fish are chopped up finely, and mixed by hand with local herbs, lime juice and live red ants, and served up raw.

It is very popular, but also dangerous.

Read More: http://www.bbc.com/news/health-33095945

-- BBC 2015-06-14

[lee b]

Well there is no way on earth i will be eating that rubbish, so I suppose thats a little bit of good news to start the day lol !

[Always18]

Hardly "news"...........the evidence that fish-scale parasites were linked to the high incidence of Isaan liver cancer was public knowledge five years or more ago!

Edited June 14, 2015 by Always18

[clockman]

Highest rate of liver cancer, in the world. But they love it.

[Kerryd]

The good news is they've determined the cause and have been taking steps to educate the public about the problem. As a result the infection rate has apparently dropped sharply.

Fish parasites that cause liver inflammation that leads to cancer is bad enough. To learn that part of the problem is all the residents that (apparently) normally crap in the lake (wetlands) which delivers not just crap, but the eggs of the parasite that get excreted from the liver as well makes it worse. The same lake/wetlands they are catching the fish in (and probably bathing and drinking from as well).

Sheesh, I was never a fan of raw fish before and now the thought of eating any fish at all (especially in Isaan) makes me queasy. And what's with the "live red ants" in the recipe ? Is that to add a little "zing" ? (Are those the little buggers that deliver a nasty little burning bite ?)

Awhile ago I was in my friends shop. Every time I went in there I noticed frikken ants everywhere. On the shelves, on the desks, on the chairs, crawling in/on/around the various plates and bowls and bags of food scattered around. He couldn't figure out why I had such a problem with that.

Even after I pointed out the ants had been crawling over the dirty floor, and seem to be coming from a crack at the base of a wall in the toilet, he was still unconcerned.

I guess having a steady stream of germs and bacteria crawling over your food, your clothing and your skin is just "mai pen rai".

(I went out and bought a package of those little ant traps and put 4 in his office. The next day - no more ants. I was happy but he never even noticed that the legions of critters that used to be crawling over everything were no longer there. I gave up.)

[dageurreotype]

The good news is they've determined the cause and have been taking steps to educate the public about the problem. As a result the infection rate has apparently dropped sharply.

Fish parasites that cause liver inflammation that leads to cancer is bad enough. To learn that part of the problem is all the residents that (apparently) normally crap in the lake (wetlands) which delivers not just crap, but the eggs of the parasite that get excreted from the liver as well makes it worse. The same lake/wetlands they are catching the fish in (and probably bathing and drinking from as well).

Sheesh, I was never a fan of raw fish before and now the thought of eating any fish at all (especially in Isaan) makes me queasy. And what's with the "live red ants" in the recipe ? Is that to add a little "zing" ? (Are those the little buggers that deliver a nasty little burning bite ?)

Awhile ago I was in my friends shop. Every time I went in there I noticed frikken ants everywhere. On the shelves, on the desks, on the chairs, crawling in/on/around the various plates and bowls and bags of food scattered around. He couldn't figure out why I had such a problem with that.

Even after I pointed out the ants had been crawling over the dirty floor, and seem to be coming from a crack at the base of a wall in the toilet, he was still unconcerned.

I guess having a steady stream of germs and bacteria crawling over your food, your clothing and your skin is just "mai pen rai".

(I went out and bought a package of those little ant traps and put 4 in his office. The next day - no more ants. I was happy but he never even noticed that the legions of critters that used to be crawling over everything were no longer there. I gave up.)

It's not just Isaan, here on Phuket I see people going about the bush with long bamboo poles with nets attached gathering red ants from the trees. They're a delicacy. Not one I'd try, those buggers bight. As to to the koi plaa, the most worrying thing is that the development of the liver cancer doesn't show up until past fifty, so some very worried Isaanites out there and explains to me why they refuse to eat sushi ..

[Briggsy]

This has been known for decades. There have been sporadic public health eradication efforts which yield results and then soon peter out followed by years and years of increasing rates of cancer specifically linked to the liver fluke.

[anon467367354]

people do eat ant eggs, not the same as eating the ants.

The harvesting of ant eggs is done in a very specific way so as to not harm the colony.

[Saan]

Must have been a quiet news day. This has been known about for decades. I suppose it all help in educating communities.

Opisthorchiasis and Clonorchiasis: Major Regional Public Health Problems

Liver fluke infection caused by Opisthorchis viverrini, O. felineus, and Clonorchis sinensis is a major public health problem in East Asia and Eastern Europe. Currently, more than 600 million people are at risk of infection with these trematodes [1]. O. viverrini is endemic in Southeast Asian countries, including Thailand, Lao People's Democratic Republic, Vietnam, and Cambodia [2], and C. sinensis infection is common in rural areas of Korea and China. Opisthorchiasis has been extensively studied in Thailand, where an estimated 6 million people are infected with the liver fluke (calculated from overall 9.4% prevalence within the population in 2001).

Infection with these food-borne parasites is prevalent in areas where uncooked cyprinoid fish are a staple of the diet. Due to poor sanitation practices and inadequate sewerage infrastructure, people infected with O. viverrini and C. sinensis pass parasite eggs in their faeces into natural water reservoirs, where the parasite eggs are eaten by intermediate host snails, for example, aquatic snails of the genus Bithynia, the first intermediate host of O. viverrini. After hatching, free swimming parasites, called cercariae, are released from the infected snails. Cercariae then locate their next intermediate host, cyprinoid fishes, encyst in the fins, skin, and muscles of the fish, and become metacercariae. The metacercariae are infective to humans and other fish-eating mammals upon ingestion of raw or undercooked fish in dishes such as koi-pla, and in turn the parasite's life cycle is completed.

[bamukloy]

I am told the red ants add sourness wih a bite.

Id be more worried about why folksseem to hate putting stuff they cooked in the fridge even when they have a perfectly good one

No noib the festy cabinet it goes and deep fried the next day eww

[cumgranosalum]

Nothing to do with drinking a couple of bottles of Lao khao everyday, then?

[Suradit69]

Well there is no way on earth i will be eating that rubbish, so I suppose thats a little bit of good news to start the day lol !

"Well there is no way on earth i will be eating that rubbish ..."

That's the same thing I've always said about McDonald's and similar fast food purveyors ... and for essentially the same reason.

people do eat ant eggs, not the same as eating the ants.

The harvesting of ant eggs is done in a very specific way so as to not harm the colony.

Yes, I enjoy khai mot daeng from time to time.

Edited June 14, 2015 by Suradit69

[MockingJay]

Chef's recommendation of the day:

[recycler]

Still very hard to convince Isaan people to cook the Pla-Ra before consumption, even if you tell them about the cancer many keep eating it raw.

[sabaii69]

So, now they're tell me I can't eat my ants?

[kkup]

I have heard quite a few stories about liver issues from the wife's family members, we live in Isaan and many of them love this stuff, then again they also love Lao Khao.

[Brindles]

Well there is no way on earth i will be eating that rubbish, so I suppose thats a little bit of good news to start the day lol !

A selfish and disrespectful comment. Giving farangs a bad name again. Do Thailand a favour and zip it.

[heybuz]

might as well take a knife and fork to the local tip as eat that stuff

[Lupatria]

The good news is they've determined the cause and have been taking steps to educate the public about the problem. As a result the infection rate has apparently dropped sharply.

Fish parasites that cause liver inflammation that leads to cancer is bad enough. To learn that part of the problem is all the residents that (apparently) normally crap in the lake (wetlands) which delivers not just crap, but the eggs of the parasite that get excreted from the liver as well makes it worse. The same lake/wetlands they are catching the fish in (and probably bathing and drinking from as well).

Sheesh, I was never a fan of raw fish before and now the thought of eating any fish at all (especially in Isaan) makes me queasy. And what's with the "live red ants" in the recipe ? Is that to add a little "zing" ? (Are those the little buggers that deliver a nasty little burning bite ?)

Awhile ago I was in my friends shop. Every time I went in there I noticed frikken ants everywhere. On the shelves, on the desks, on the chairs, crawling in/on/around the various plates and bowls and bags of food scattered around. He couldn't figure out why I had such a problem with that.

Even after I pointed out the ants had been crawling over the dirty floor, and seem to be coming from a crack at the base of a wall in the toilet, he was still unconcerned.

I guess having a steady stream of germs and bacteria crawling over your food, your clothing and your skin is just "mai pen rai".

(I went out and bought a package of those little ant traps and put 4 in his office. The next day - no more ants. I was happy but he never even noticed that the legions of critters that used to be crawling over everything were no longer there. I gave up.)

...steps to educate the public about the problem.

I wonder how well this works in Isan.

[curtklay]

Well there is no way on earth i will be eating that rubbish, so I suppose thats a little bit of good news to start the day lol !

A selfish and disrespectful comment. Giving farangs a bad name again. Do Thailand a favour and zip it.

Spoken like a true newbie.

[little mary sunshine]

Oh, Yum!! Best if eaten with 4 day old puffer fish!!

[Chicken George]

Well there is no way on earth i will be eating that rubbish, so I suppose thats a little bit of good news to start the day lol !

A selfish and disrespectful comment. Giving farangs a bad name again. Do Thailand a favour and zip it.

Spoken like a true newbie.

Yep some people have no sense of humour..

[toonsai]

Not only liver cancer unfortunately. These small fishes are all heavily infected by all the highly dangerous chemicals and pesticides used to grow rice, I would like to remind here that in Thailand, there is NO law (and even less enforcement) about usage of dangerous chemicals and pesticides. Most of the chemicals and pesticides used here are banned for decades in EU/US... And this is also valid for fruits, vegetables, shrimps.

Simple question: why there is a local and an export quality for all products. Most of the local quality products would pass any health and safety check in EU/US. Enjoy the cheap mango and pineapple you buy in the street... Look no further if you want to understand why cases of cancer sky rocket in Thailand.

Not only cigarettes kill...

[Built2last4ever]

Rubbish for some, survival for others....

Wonder if the liver problem could be because of the unbelievable high amount of hepatitis A og B infections. 1/3 of all tested - TESTED ( MEANING THAT THE NUMBER PROBABLY IS HIGHER ) - are Hep B positive. And we all know that it causes cancer in the end.

So water and unprotected sex could be the the cause here - just saying. Perhaps the dish itself ain't the problem.... must saying.

Education education education vaccination vaccination vaccination....

[dirtycash]

this dish is som tam / pok pok , right ? wife loves it .

[gchurch259]

I have personal experience with this issue, in that a Very Good friend of mine has lost her Father and Older Brother to the Fluke Worm caused Bile Duct Infection and Cancer from eating the raw fish. When you do not cook the fish the worm lives and finds a home in the person that eats them. They like the Bile Duct. My Oncology Doctor at Bumrungrad told me they have know about this for years and have tried to educate the Issan people about this.

Now she and her Mother must run the family farm. To make things worse is the history of crop failure in Issan Rice farms due to either too much raim or no rain. Hard place to make a living, so off to BKK.

[Peterbkk7]

They would not take any advice anyway

[dageurreotype]

people do eat ant eggs, not the same as eating the ants.

The harvesting of ant eggs is done in a very specific way so as to not harm the colony.

I can assure you those big red bitey things with legs on crawling out of the 'nets' I was offered a sample of, but politely refused, were most certainly not the eggs.

Apropos the topic, the report states many more men suffer the fluke than women. Assuming the women also partake of this raw fish salad, it's possible the imbibing of the laokao shots along with it don't help.

[dageurreotype]

They would not take any advice anyway

Well someone's scared the bejazuz out of them as certain of my Isaan friends absolutely refuse to eat any raw fish. Including oysters, which come from the sea

[spermwhale]

Hardly "news"...........the evidence that fish-scale parasites were linked to the high incidence of Isaan liver cancer was public knowledge five years or more ago!

It was not presented as hard news. It was a feature piece on BBC this morning. I saw it and thought it informative. This was an item about what the authorities are doing to educate people starting in grade school and to teach them about cooking the food instead.