Thailand fights cancer-causing parasitic worms

HONG KONG Thu Jun 30, 2011 6:49am EDT

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HONG KONG (Reuters) - Health authorities in northeast Thailand plan to screen people for fluke worms to detect early signs of bile duct cancer, a deadly disease linked to eating uncooked freshwater fish.

Rivers in northeast Thailand, Vietnam, Laos, Cambodia, the Koreas and China are infested with the tiny parasitic worms which find their way into the human body when seafood is eaten raw.

According to the World Health Organization, 67 million people are at risk of this worm and 9 million are infected in Cambodia, Laos and the northeastern parts of Thailand and Vietnam.

Most of the infected people are men and they can develop bile duct cancer by the time they are 40 or 50.

"Everyone above 30 years of age will get an annual stool examination to screen (for fluke eggs). Those who are infected will be treated (with drugs)," said Pongsadhorn Pokpermdee, health economist and public health deputy for Nongbualanpoo province in the northeast.

"Those who are over 40 and found infected will get an ultrasound to detect any signs of tumor (early cancer)," he told Reuters in an interview.

Any tumor detected will be surgically removed, he added.

While the cancer is a leading cause of death in the Mekong region, the screening program will start in Nongbualanpoo province, Pongsadhorn said.

Just one tablet of praziquantel, which is given free, can get rid of the worms but that does not solve the problem as people get infected repeatedly if they continue to eat raw seafood.

The plan is in line with Thailand's overall goal to provide better disease prevention health services at a time when its people are living longer and increasing numbers of them are crippled with chronic, non-communicable diseases that take far longer to treat and are more expensive to treat.

"This is the top cause of mortality for this province, higher than heart disease, stroke," said Pongsadhorn.

"It is a neglected disease that affects mainly poor people ... if left untreated, it can develop into cancer in 10 to 20 years," he said, adding that it affected more men than women in a ratio of 3:1.

"The disease affects mostly men in their 40s and 50s ... it affects the family because they are heads of families and they can't work once they have cancer," Pongsadhorn said.

A raw fish dish, called Koi-pla, is not only a culinary favorite in the Mekong, it has also found its way into other parts of Asia, such as Hong Kong and Singapore, because of the popularity of Thai cuisine.

The fluke, which has two suckers, attacks the human bile duct by biting on its wall, which causes ulcers and cancers years later.

Bile duct cancer, or cholangiocarcinoma, is usually diagnosed at an advanced stage because symptoms surface late.

(Editing by Sugita Katyal)

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