Thai food is undoubtedly delicious. But one dish is so deadly that doctors in Thailand are trying to educate people about the risk – with reports that it kills 20,000 people every year.
Koi Pla is a delicacy in Isaan, in the northeast of Thailand, where the mighty Mekong River separates the country from its neighbour Laos. The dish is made with finely chopped up raw freshwater fish, herbs, lime juice – and live red ants.
But it’s not the ants that are the problem. It’s the raw freshwater fish, caught in the Mekong.
More specifically, the parasitic flatworms called liver flukes that they can contain. These parasites can cause cholangiocarcinoma, or bile duct cancer – and explain why this region has the highest cholangiocarcinoma rates in the world.
One study said that more than 600 million people across Southeast Asia are at risk of infection from these trematode parasites – with more than 6 million people in Thailand already infected.
Infections are often symptomless – but, if left untreated, heavy, long-standing infections are associated with a number of nasty liver diseases, including bile duct cancer.
Liver surgeon Narong Khuntikeo said: “It’s a very big health burden around here. But nobody knows about this because they die quietly, like leaves falling from a tree.”
Health officials are now teaching children about the risks of raw foods as part of their curriculum. But Khuntikeo says turning the older generation off the dish is a tough task.
He told: told Agence France-Presse: “They’ll say: ‘Oh well, there are many ways to die’. But I cannot accept this answer.”
The murderous meal can be made safer by cooking the fish. However, die-hard fans of the dish say this ruins its distinctive flavour.