Doctor Suphruck Vicharanyan, known as Dr. Oak and owner of the "Dr. Oak DoctorSixpack" social media page, has explained why parasitic liver fluke infections are so common in northeastern Thailand.

While many have heard that "the northeast has lots of liver flukes," this is true, but the cause isn't related to the region's geography or ethnicity. Rather, it stems from eating raw or undercooked freshwater fish combined with the parasite's life cycle in local waterways.

Why is the Northeast Most Affected?

Many traditional dishes—such as koi pla (fish cakes), larb pla ding (raw fish salad), pla som (fermented fish), pla jom, and pickled or marinated fish that haven't been heat-treated—may contain liver fluke larvae. When consumed, the larvae travel to the bile duct and can live in the body for 20-30 years.

How Prevalent Is This in Thailand?

National surveys over the years show that in 1981, about 14% of Thais were infected with liver flukes, but in the northeast the rate reached 34.6%—roughly one in three people in some areas. Although infection rates have declined due to ongoing campaigns, the northeast remains the most affected region, with some surveys still finding 13-16% infection rates through stool samples, and some communities showing even higher prevalence. A 2019 national health ministry survey found 2.2% of all Thais infected, with most cases concentrated in the northeastern region.

The Most Frightening Aspect: It's Not Just Having the Parasite

Many believe taking deworming medication is sufficient, but liver flukes can inhabit the bile duct for 20-30 years. Repeated infections from regularly eating raw fish cause chronic bile duct inflammation, which is a critical factor triggering cell mutations that develop into cholangiocarcinoma (bile duct cancer). The World Health Organization classifies liver flukes as a Group 1 human carcinogen.

Early stages often show no symptoms, but over many years, complications can include chronic bile duct inflammation, bile duct stones, hepatitis, bile duct infections, liver dysfunction, and most dangerously, bile duct cancer. Thailand, especially the northeast, has one of the world's highest rates of cholangiocarcinoma, clearly linked to chronic liver fluke infection.

Prevention Is Possible

- Always eat freshwater fish thoroughly cooked - Avoid fish cakes, raw fish salad, and unheated fermented fish - If you've regularly eaten raw fish, seek medical checkups as recommended - Don't think taking deworming medication regularly is enough—repeated infections still increase cancer risk

Liver fluke may not cause illness today but silently damages the liver and bile duct over decades. Avoiding raw fish just once may reduce future disease risk significantly.

About Salmon: FAQ

Raw salmon is generally "not" a source of Thai liver flukes. However, raw salmon does carry risks from other parasites and pathogens. Liver flukes are found in freshwater fish such as tilapia.

Portuguese midfielder Bruno Fernandes remains confident that Portugal will capture the FIFA World Cup trophy in the future following their Round of 16 exit from this World Cup.

Portugal, one of the tournament favorites, was eliminated from the 2026 World Cup at the Round of 16 stage after losing 0-1 to Spain on July 6th.

After the match, Bruno shared his feelings, saying: "I know Portugal has never won the World Cup, and we always had high expectations. But I am absolutely convinced that this team has the potential to win the World Cup."

"It's unfortunate that it won't happen now. It's impossible this time. But we must not lose faith in ourselves. We need to look ahead with a different mindset. I believe we must hold even more strongly to our identity."

Chelsea is preparing to release Argentine winger Alejandro Garnacho to a team that submits an offer during this summer's transfer window, after the player failed to deliver the expected performance.

According to Football London, Chelsea is willing to permanently part with Alejandro Garnacho during this transfer period, following his arrival from Manchester United for £40 million with a contract through 2032 last year.

Garnacho made 43 appearances across all competitions for Chelsea in the previous season but failed to perform as expected and could not secure a regular starting position at Stamford Bridge.

Despite his underwhelming form last season, the player has attracted interest from several Italian clubs including Napoli, Juventus, and AC Milan, while Roma is hoping to secure a loan deal.

Portugal captain Cristiano Ronaldo said he harbors no regret over missing the World Cup title after his final World Cup appearance ended in the round of 16 following a 0-1 loss to Spain on July 6. The 41-year-old striker emphasized that his Euro 2016 championship with Portugal holds equal weight to him as a World Cup trophy. After the match, Ronaldo reflected on his feelings, stating: "I've won three championships with Portugal. Before I played for them, we never won anything. My greatest achievement with the national team is Euro 2016, and that trophy means as much to me as a World Cup title." He added, "Elimination from major tournaments is always sad. This is the World Cup. I'm disappointed to go out this way, but I gave everything. I leave with peace of mind. Sometimes you win, sometimes you lose, but we can still hold our heads high." Regarding his international future, Ronaldo indicated he has not yet decided whether to retire from Portugal, saying he needs to consult with his family before making any announcement.

Virgil van Dijk, captain of the Dutch national football team, posted a message thanking fans after the Netherlands' campaign in the 2026 World Cup ended in the Round of 32. The Dutch fell to Morocco in a penalty shootout, forcing them to exit the 2026 World Cup at the Round of 32 stage.

Van Dijk recently posted on Instagram about the elimination, saying: "As captain, my only desire has always been to make this country proud. Having our World Cup journey end so early is deeply painful, because I know how much this team has given every single day. There are many things being said, and those conversations will come later. But right now, what matters is accepting that we failed, and all of us take full responsibility for that result. I want to thank every fan who traveled to support us, as well as everyone back home who believed in us and stood by us until the very last second. We see you, and we felt your support with every step of this journey."

The English Football Association is considering appealing the red card issued to defender Jarell Quansah during England's 2026 World Cup Round of 16 match on July 5, according to BBC News. In that match, England defeated co-hosts Mexico 3-2, with Quansah receiving a red card in the 54th minute following a challenge on Jesus Gaya. The player faces a potential two-match ban for serious foul play. However, following the case of American forward Folarin Balogun, who avoided a ban after his red card and received only a one-year suspended sentence instead, the FA has decided to explore options for appealing Quansah's punishment. England manager Thomas Tuchel previously expressed dissatisfaction with the Balogun decision, saying: "Where does this start and where does it end? Can we change decisions? That's the question I have. I don't have an answer for that."