Opistorchiasis – a hidden health danger in Thailand for tourists: After tropical vocation my wife lost a dream job and spent a year visiting 20+ doctors
I would like to share an important story based on my own personal struggles with a tropical parasite after traveling. If someone had informed me about this sooner, I could have saved a year of my life
I would like to share an important story based on my own personal struggles with a tropical parasite after traveling. If someone had informed me about this sooner, I could have saved a year of my life. I hope that by sharing this information, I can help others avoid the same harrowing ordeal. This may happen with any tourist or local expat in Thailand or other tropical destinations.
This experience lead me to build something around it: https://overlooked.health — a community of people who visited Asia and their doctors ignore their symptoms.
A couple, having returned from a tropical vacation, began to experience health issues. My wife developed an dermatitis, presenting as itchy skin. This seemingly innocuous symptom cost her a dream job and led her to consult over 20 doctors across 5 countries in search of answers. No one helped her. I want to inform people here, because if I returned from Thailand and someone told me about such symptoms earlier, it could probably save a year of my life. So if you want to save a year of your life, and probably, up-to 10 years of your future life, listen.
All dermatologies were wrong, all clinics were saying “you have atopic skin, use moisturiser”. Only after certain attempt she found people with same symptoms. They gave an idea it can be something with the digestion. After some luck and attempts –she got the right test and found what was the problem.
She got a parasite known as Opistorchiasis, an a liver fluke worm that resides in the bile duct. Despite their diminutive size of less than 1 cm, these worms pose a significant threat to human health. And it is very common in Thailand.
Through this journey and extensive research, the following key facts about Opisthorchiasis were uncovered:
Symptoms: Often minimal or even symptomless, it is commonly misdiagnosed as atopic dermatitis, or weakness, loss of motivation, digestion issues etc.
Lifespan: Worms can live in the body for up to 25 years.
Cancer risk: Opisthorchiasis is a major risk factor for bile duct cancer (cholangiocarcinoma/CCA) 11.
Prevalence: 2x more widespread than HIV/AIDS, affecting between 45-82 million people globally.
Thailand's infection rate: At least 10% of the population is affected, making it a major source of the illness.
Transmission: Ingesting undercooked fish or consuming food prepared in a contaminated environment.
Safe cooking guidelines: Fish must be cooked at high temperatures (above 70°C) for at least 30 minutes 22.
Also a fact, that 31 - 52 degrees celsius is an average fish temperature cooked in restaurants.
Unfortunately, accurate diagnosis is challenging:
Blood tests (IgG Opisthorchiasis) may yield false negatives due to reduced antigen production after 6 months of infection.
Fecal tests, are low sensitivity and prone to false negatives. Microscopy tests and PARASEP are largely ineffective. qPCR DNA molecular stool tests are expensive and they also are not guaranteed to be ground truth
Duodenal bile sampling with microscopy is the most reliable method, but is not widely available. Typically, 1-2 attempts yield a true-positive result, while 3 attempts are needed for a true-negative result. I know some clinics in Kazakhstan and Russia that makes this testing
In light of this, I urge you to be vigilant when consuming fish or seafood and to seek medical advice if you experience unexplained dermatitis or other symptoms consistent with Opisthorchiasis. Together, we can raise awareness and prevent this insidious parasite from causing further harm.
As someone who has endured the suffering caused by tropical parasites, I am more than willing to answer any questions about parasites, their different species, and the challenges they pose to our health. Please feel free to reach out, and let's support one another in raising awareness and combating these silent threats.
Originally posted on Reddit, and this post has became top-5 in Thailand Tourism community, thank you very much for such support