On a trip, it is tempting to taste local specialties. But in Thailand, in the province of Isaan in the northeast of the country, a dish, however delicious is wreaking havoc: Koi pla. This chopped raw fish salad, embellished with herbs, spices and lime, is popular with inhabitants as tourists. Cheap, fragrant and colorful, it does not guess nothing of its dangerousness. However, it is the source of a heavy sanitary price of around 20,000 deaths per year. The culprit is not the fish itself, but a microscopic flat worm, the liver moat. Present in freshwater fish in the Mekong region, this parasite infiltrates the bile ducts and can cause, long -term, particularly aggressive liver cancer called cholangiocarcinoma. The World Health Organization (WHO) lists two species in question: Fasciola Hepatica and Fasciola Gigantica.
A disease that is declared too late
The drama of cholangiocarcinoma is that it evolves in silence. Symptoms (jaundice, itching, abdominal pain) often appear years after infection, when the disease is already advanced. Without surgery, the survival rate is among the lowest of all cancers. And in the province of Isaan, the incidence is the highest in the world. To complicate the situation, many inhabitants remain attached to this culinary tradition and continue (…)
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