Doctors in Thailand are warning that more young people are becoming infected with liver fluke parasites as viral social media trends encourage the consumption of raw and undercooked foods, raising concerns over a growing risk of bile duct cancer.
Speaking at the Faculty of Medicine at Khon Kaen University, Acting Director of the Cholangiocarcinoma Research Institute Associate Professor Dr Watcharin Loylom said Gen Z is increasingly exposed to online content promoting risky eating habits, including videos of influencers consuming raw fish and whole fermented fish.
According to Dr Watcharin, many influencers have popularised eating fermented fish with lime juice and chilli powder, a trend that health experts fear is encouraging younger people to consume food that may carry liver fluke parasites.
Data collected from a random sample of approximately 200,000 people across northeastern Thailand found that the average liver fluke infection rate stands at 28.8 per cent, meaning roughly one in every three people tested was infected.
While infection rates among older adults remain at around 20 to 30 per cent, Dr Watcharin said recent screenings have shown similarly high infection rates among students, reflecting a worrying shift towards younger age groups.
He explained that health authorities have been monitoring the trend for more than a decade, prompting the launch of the Isan Zero-Ov Campaign in collaboration with the Thai Health Promotion Foundation to educate young people about the dangers of liver fluke infection.
Dr Watcharin warned that even though many people now use bottled fermented fish sauce, some restaurants still serve dishes containing pieces of fermented fish, while other traditional foods such as pickled fish and fermented fish paste may also carry infection risks if not properly prepared.
He estimated that of the 24 million people living in northeastern Thailand, around six million may be infected with liver flukes.
The greatest concern, he said, is not the parasite itself but the increased risk of cholangiocarcinoma, or bile duct cancer. Around 10,000 new cases are diagnosed each year in northeastern Thailand, with repeated liver fluke infections significantly increasing the likelihood of developing the disease.
Although liver fluke infections can usually be treated successfully with medication, Dr Watcharin stressed that patients who continue consuming raw or undercooked fish remain at risk of becoming infected again.
To improve early detection, Khon Kaen University has spent 15 years developing a liver fluke test kit similar to a COVID-19 rapid test. The kit has received approval from Thailand’s Food and Drug Administration and is now available under the National Health Security Office’s benefits programme.
Eligible individuals aged 15 and above can check their eligibility through the Paotang mobile application and receive one free test kit each year after completing a risk assessment.
Meanwhile, restaurant owner Wachiraphan Wanthon said customers should not panic about eating fermented fish dishes if they are properly prepared. He said his restaurant uses only boiled fermented fish sauce sourced from trusted suppliers and cooks it thoroughly at high temperatures before serving.
He added that most reputable restaurants now boil fermented fish before use because cooked fermented fish has a milder smell and is safer to consume. He encouraged consumers to avoid eating raw or undercooked fish products and to choose trusted food outlets to reduce the risk of infection.
