Liver fluke infections in Maha Sarakham prompt urgent health action
Maha Sarakham officials plan training and checks after screening found liver fluke infections among new university students.
- Health screenings in Maha Sarakham revealed high liver fluke infection rates, reaching 11% among the general population and as high as 33% among new university students.
- The infections are primarily linked to the local custom of consuming dishes like som tam with raw or improperly prepared pla ra (fermented fish) that may be contaminated with parasite eggs.
- Officials have raised urgent concerns that chronic infection can lead to a fatal form of bile duct cancer (cholangiocarcinoma) in the future.
- In response, authorities are launching a campaign to train food vendors and students on safe food preparation, focusing on using cooked pla ra, and will inspect restaurants to certify safe practices.
Chumpit Dejarath, governor of Maha Sarakham, chaired a meeting to discuss plans for the “New Generation Isan People Free from Liver Fluke and Cholangiocarcinoma” event.
It was attended by Dr Danai Wangboonchai, manager of the Media, Arts and Culture for Health Promotion Programme at the Thai Health Promotion Foundation (ThaiHealth), and Associate Professor Dr Nittaya Wannakit, vice-president for student development and corporate image at Mahasarakham University, along with officials from the Mahasarakham Provincial Public Health Office, on Monday (July 6, 2026), at Maha Sarakham Provincial Hall.
During the meeting, Suksan Sirisuriyasunthorn, head of the communicable disease control group at the Mahasarakham Provincial Public Health Office, presented the situation of liver fluke spread in Maha Sarakham province.
Screening of 20,000 residents found an infection rate of about 11%.
Screening was also conducted among more than 12,700 new students at Mahasarakham University who enrolled in the 2026 academic year, finding 4,233 infected with liver fluke, or 33%.
Screening of 1,922 new students at Rajabhat Maha Sarakham University found 380 cases, or 19%.
On this issue, Chumpit instructed the Mahasarakham Provincial Public Health Office to urgently issue measures to deal with the problem after it was found that young people liked eating som tam with pla ra, and that the pla ra might not have passed inspection by the Food and Drug Administration (FDA) or could be contaminated with raw pla ra containing parasite eggs.
This could allow parasite eggs to enter consumers’ bodies, causing liver fluke infection.
If this continues, in another 15-20 years, these young people could become ill with bile duct cancer and harm the country’s future.
Chumpit also said som tam shop operators and restaurants using pla ra as an ingredient would be invited to take part in training under the New Generation Isan People Free from Liver Fluke and Cholangiocarcinoma event, to be held on Monday (August 3, 2026), at Mahasarakham University.
Mahasarakham University students would also be invited to join the training so they could better understand how to eat food free from parasites and how to protect themselves from liver fluke infection from scaled freshwater fish in the carp family.
“This is a major issue that cannot be left alone because the screening figures for students show a very high level of liver fluke infection.
We must urgently find the cause of the liver fluke infection, which comes from food that has been eaten.
If it is found to come from raw pla ra, measures will have to be introduced to control pla ra production so it is hygienic and cooked, making it parasite-free,” Chumpit said.
At the same time, the provincial public health office would be asked to inspect food outlets, particularly som tam shops, to provide information.
Shops that use cooked pla ra would be allowed to put up a sign saying their pla ra is cooked and safe, giving students and the general public a choice when eating, particularly at som tam shops using cooked pla ra.
Associate Professor Dr Nittaya Wannakit, vice-president for student development and corporate image at Mahasarakham University, said she was shocked by the data reported by the provincial public health office.
She said the figure was very high because she had not expected that new students who had just begun study in the 2026 academic year would have such a high level of liver fluke infection.
She wanted all students at the university, together with staff, totalling more than 50,000 people, to be screened.
This was because nearly everyone was likely to be at risk of liver fluke infection.
Most were from Isan and had a habit of eating som tam with pla ra, while not knowing whether the pla ra used had been boiled until cooked or met FDA standards.
Urgent measures were also needed, including inviting food operators at Talat Noi and university canteens to attend training so they would know that preparing food, especially raw pla ra, carries a risk of contamination with liver fluke, which could infect students and possibly cause cancer in the future, which could be fatal.
