Deadly dish: the dinner that can give you cancer

[tinsom]

What is dish called

[impulse]

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

Can't blame them on the oysters. Back home, the rule is to only eat raw oysters in months with an "R", which are the colder months. Weatherwise, Thailand has no months with an "R". I wouldn't touch a raw oyster from Thai waters, or one that has been through the Thai distribution chain on its way to my plate. Keeping food at a proper temperature (hot or cold), and away from fecal material isn't a strong point here.

[noahvail]

I live in the area and occasionally used to buy the large barbecued fish in the market, but have not for years, but I have contacted Hep C Genotype 3.

Going to KKUniversity Hospital Srinakarind, Still waiting to see Dr. re blood tests results but liver scan shows fatty liver, I expected to be diagnosed with liver cancer, Dr. says not.

I do not believe anything I am told in Thailand, even coming from a liver doctor.

Dr. keeps pointing to a tatoo on my arm I had done 20 years ago in Canada

Appointments one month apart. Pretty hopeless. 6,610 Baht for blood test.

Doctor said she would call when she has blood tests results, she had them two weeks ago an no call.

Could have been the fish,or the pussy that I ate, since it is communicable.

Next appointment July something.

Did your doc do an ultrasound scan on your liver? That's really the first and least invasive test for fatty liver. If she didn't, grab the blood test results and find another doc. Srinakarin in KK has some excellent docs, but the teaching docs are best . They are the ones who head up departments in the private hospital where'd you pay a lot more than Srinakarin. Sincerely, best of luck to you!

[noahvail]

My wife's father succumbed to liver cancer when she was just 9. She knows enough to stay away from the plah rah unless it comes from one little family-company that actually pasteurizes it. Unfortunately, it's not well-known that the flukes can for a while on the plants growing on the river bank, and of course those are generally eaten raw, although sometimes steamed for a few minutes.

[Arkady]

There are also Isaan raw shrimp and raw pork dishes. I tried the raw shrimp dish once or twice when I first arrived and found it tasty, until I realised how dangerous it was. The raw pork dish always struck me as suicidal and I believe it racks up the most kills.

[amerasianex]

I call bullshit on that one

most Isam people start every morning with a generous helping of Lao kow

rice whisky no way any parasites are going to live their that...just sayin.....lol

[Ceruhe]

The 2nd day I arrived in Thailand and went to Big C and Makro and saw how "professional" foodhandling is done, one has to be _mad_ to even remotely consider eating raw seafood in this country, let alone from street vendors and some other rather run down businesses.

Of course this isn't to say that there aren't places with proper foodhandling and quality around, but I feel one can drive from city to city and keep counting them on 1 hand alone. Which means, any seafood I eat is prepared at home only.

If this is indeed "up to date" news, not that I would be much surprised whatsoever, then it's just another sign of a country in desperate need of proper education. Take "proper" with a hillsized spoon of salt, the west isn't all that great either, but how will you keep sheep under control if they keep thinning out.

[SOTIRIOS]

...problem is...mashed up...and put in a dish...you may never even know it.....

...when was the last time a Thai consulted you about what you wanted...and did not want...in your dish......

...ahh...thought so.......

[SiSePuede419]

"people do eat ant eggs"

Surprisely, a bit bland, like cottage cheese. You Euros should love it, since 99.99% of your diet is bland food.

Like any eggs, ant eggs are high in choline, which makes it one of the healthiest foods. Along with caviar, egg yolks, crickets and liver.

555

Edited June 14, 2015 by SiSePuede419

[SiSePuede419]

" blood tests results but liver scan shows fatty liver"

Fatty liver disease is caused by a bad diet of too many processed foods and not enough exercise. It's not the grilled fish, it's the lack of (raw) vegetables. And too little exercise. Let me guess, you own a motorbike? Never walk anywhere? Eat Farang food everyday? Drink like a fish?

555

[SiSePuede419]

"but also I always ask not to use crab on my favorite Thai dish"

Doesn't matter. Ever see them clean the mortor and pestle in-between orders? 555.

Since the fresh water crabs are pickled in vinegar, there is no bacteria problem.

The problem is with the pesticides used in the fields where the crabs come from. If they use pesticides, then the crabs could contain carcinogens.

I always ask for mai sai bpuu, but only because I don't want to spit the little buggers out...

[connda]

...and it smells worse than durian which is why Isaan Som Dtam was never on my menu. However, here in Chiang Mai I personally know a gal who sells Som Dtam, and she cooks her Plaa-raa. And considering she lives right across the hall way of our apartment, we always know exactly when she is cooking Lol. On a positive note though, I really, really do like Som Dtam but with lime juice and minus the Plaa-raa. If fact, I ask her to wash out the bowl before making mine. Oh, and no freaking raw rice paddy crabs. I limit my raw fish to quality ocean fish sashimi and that's only a once or twice a year treat. Probably less than that in the future unless the Sushi establishment has a Mazer Geiger Counter available to scan the fish -- thanks much to our Japanese Nuclear Industry friends in Fukushima.

[ALFREDO]

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.

But only, if Thais stop making "ugly faces and rejecting gestures"

when I mix and eat my raw Beef - Steak -Tartare.

https://en.wikipedia.org/wiki/Steak_tartare

[connda]

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...

The US doesn't need chemicals to kill you. Now they have GMOs to do the job.

[bbbbooboo]

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

I agree

[MAJIC]

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.)

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 ?)

Yes I have seen this disgusting eating habit: live ants are swimming in some kind of sauce,probably fish sauce or Soy sauce and eaten alive!

Don't we have enough variety of foods without torturing living creatures ???

[carlyai]

So, is that why my wife insists on us having these two types of worm tablets about once per month.

Do the worm tablets that you buy in the local drug stores kill the flukes?

If they cook the plaa, does that kill the flukes and therefore it's alright to eat?

What tests are done to show if a person has an infestation of these flukes?

Som tam with out MSG added is OK or not? If not why?

[Kerryd]

So, is that why my wife insists on us having these two types of worm tablets about once per month.

Do the worm tablets that you buy in the local drug stores kill the flukes?

If they cook the plaa, does that kill the flukes and therefore it's alright to eat?

What tests are done to show if a person has an infestation of these flukes?

Som tam with out MSG added is OK or not? If not why?

Q) If they cook the plaa, does that kill the flukes and therefore it's alright to eat?

A) "But it is only in the last decade that a serious effort has been made to get people to change their eating habits, by cooking koi plaa to kill the flukes before they eat it."

Q) What tests are done to show if a person has an infestation of these flukes?

A) "They also take a portable ultrasound machine around the villages to screen people for liver fluke infection."

Q) Do the worm tablets that you buy in the local drug stores kill the flukes?

A) "An experimental drug called tribendimidine could help cure millions of people infected with liver fluke. In a study published in The Lancet medical journal, researchers found that tribendimidine is as safe as and more effective than the standard treatment for liver fluke. The standard treatment is a generic drug called praziquantel, which has a cure rate of 70 percent. The cure rates for tribendimidine were much better than praziquantel, although this needs to be confirmed in larger clinical trials." (https://www.liverdoctor.com/liver-problems/liver-fluke/)

A) "Human fascioliasis can be easily treated with a single dose of a drug called triclabendazole." (http://www.nicd.ac.za/?page=alerts&id=5&rid=261) (Note: would only be effective if currently infected and wouldn't prevent future infections.)

A) "An open-label phase II trial found that tribendimidine had similar tolerability and efficacy to praziquantel against the liver fluke, Opisthorchis viverrini.[29] In contrast, mefloquine, artesunate, and mefloquine-artesunate were not effective in the same trial and were associated with vertigo, nausea, vomiting, and anxiety. Further large-scale clinical trials are needed to identify the best role of tribendimidine; future data may support this drug as yet another potential treatment option." (http://emedicine.medscape.com/article/219662-treatment)

No clue about eating Som Tam.

[Sheryl]

In terms of infectious disease, the addition of MSG or not has nothing to do with the safety of som ham, issue is whether raw fish and/or crab was added.

[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 !

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

What? Are you serious? How can this be disrespectful? And how can i be giving farangs a bad name?

I don't like that stuff, so why don't you zip it and only post when you know what you are talking about !

[maxtingtong]

Just to point it out: koi pla and pla ra aren't the same thing. Pla ra is fermented for long time and the article isn't referring to it. Not sure if it's subject to same issues.

Koi pla is a spicy salad of very small raw fishes.

In the koi dishes (fish, shrimp, shells) there can be ant eggs and also ants. I eaten koi kung just other day, would be nice to know if also shrimps can carry that worm

[Kerryd]

Just to point it out: koi pla and pla ra aren't the same thing. Pla ra is fermented for long time and the article isn't referring to it. Not sure if it's subject to same issues.

Koi pla is a spicy salad of very small raw fishes.

In the koi dishes (fish, shrimp, shells) there can be ant eggs and also ants. I eaten koi kung just other day, would be nice to know if also shrimps can carry that worm

Q) I eaten koi kung just other day, would be nice to know if also shrimps can carry that worm

A) "Alternatively, the cercariae can also encyst under the exoskeleton in the muscle tissue of freshwater crustaceans, such as crabs or crayfish. Human infection occurs following the ingestion of undercooked fish or crustaceans that harbor encysted metacercariae". (http://www.infectionlandscapes.org/2012/06/liver-flukes-part-1-clonorchis-sinensis.html)

A) "Larvae emerge from the snail and encyst in the muscles and underscales of many freshwater fish species and a few shrimp species." (http://www.who.int/zoonoses/diseases/trematodosis/en/)

A) "Liver-fluke infection is a zoonotic disease that is mainly caused by consumption of raw freshwater fish and shrimp throughout Southeast Asia." (http://www.nejm.org/doi/full/10.1056/NEJMicm1102441) (New England Journal of Medicine - the article is actually about a liver fluke attached to a woman's larynx. She claimed to have eaten raw carp 3 weeks earlier and 2 weeks later developed throat problems but her liver was unaffected. Treated with praziquantel.)

[Jonmarleesco]

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!

And nothing to do with the live red ants?

[brling]

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.

What a pathetic reply. This thread is about a "deadly dish", so why should you eat it. Do this forum a favour and YOU zip it.

[F4UCorsair]

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!

Scaling fish as small as a centimeter long would be an interesting exercise.

Any raw meat is potentially dangerous, and that includes ants!!

[jtTamad]

No, som tam (pok pok) is different, but might have raw fish added. I had my gal checked at the hospital and she was positive for Opisthorchiasis. No symptoms, no complaints, but I told her about the cancer risk. She's taking a 5-day course of praziquantel (Opticide is the trade name).

Edited June 16, 2015 by jtTamad

[bobrussell]

Sitting here in the madly Health & Safety world of the UK!

Liver fluke are killed by freezing as are Trichinella spiralis, tapeworms and toxoplasma!

7 days in a mediocre freezer or 15 hours in an all singing, all dancing commercial deep freeze.

Just need to convince my wife that cooked food is better in the fridge overnight rather than in or on the cooker. Some chance!!

[jtTamad]

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2683991/pdf/WJG-14-666.pdf

Sent from my iPad using Tapatalk

[SantiSuk]

Many Isaan dishes (which of course creep into mainstream thai restaurants) can let the potential liver-cancer inducing parasite give you opisthorciasis. Particularly:

Somtam made in the traditional way with palaar (the rotten smelly fish condiment) - if the palaar has not been cooked

Any somtam incorporating small land crabs, if they are uncooked.

Laarb Plaa the traditional lao/isaan fish salad made with mint and roasted sticky rice grains - if the fish has not been cooked

I suffered opisothorciasis a few years ago. It was not pleasant and was not quickly detected in Pattaya, Bangkok and the UK*. Very unpleasant flash fevers. i was eventually hospitalised in the UK and it was diagnosed on samples sent to the London Hospital for Tropical Disease. Hopefully my treatment with Praziquantel, which worked almost immediately and which many Thais don't get (they don't go for treatment and the disease can appear to go away) was early enough to cancel out the risk of it returning later as bile-duct/liver cancer.

Avoid uncooked fish and land crabs plus uncooked palaar. As always in the tropics with it's scope for insect borne diseases in addition to food risks, go to a good clinic and insist on a full range of tests at the first sight of a long running or returning fever. A blood test is insufficient for opisthocarsis - get a stool sample tested.

*I was later told by my own doctor in Isaan that this would have been tested immediately on presentation at an Isaan clinic, but I would not rely on that. He also said that some Issan large towns have the water supply dosed with very small amounts of Praziquantel - seems unlikely somehow.

Edited June 17, 2015 by SantiSuk