High school student dies after eating Som Tam (Papaya Salad)

[timendres]

Just now, Vacuum said:

It's the use of pla raa in (mostly) Isaarn, which will give you 'problems' with your liver. It'll take long time, but eventually... Do a searh (preferably not with google).

You are correct. This is the same problem with a certain dried fish so many love. But bacteria is a problem with any uncooked food. It requires diligent preparation. Just look at the spinach fiasco in the US years ago.

[evadgib]

My first thought upon reading the OP was appendicitis. 

[Baerboxer]

4 hours ago, kellersphuket said:

It doesn't surprise me at all,

that stuff is dangerous!

 

I tried it once in Chiang Mai and ended up in hospital on a drip after vomiting repeatedly for days on end.

 

I'll stick to my pepperoni pizza thanks!

 

I've eaten huge amounts of som tam, all sorts of varieties, from all sorts of sellers, home made, posh restaurants, street vendors etc for over 15 years. Never had a problem!

 

Some other foods have got me. 

 

It's just bad luck if you get some bad bacteria.

[glennb6]

GF loves her somtam boo, naturally.  And always spends extra time in the toilet as penance for her obsession.  Usually gets a bloated stomach to the point she looks 5 mths pregnant. Takes a day or two to go away. Yummy. Few days ago she must have had some extra special pa-ra and was complaining and making sounds like the Don Knotts fish Limpet (old movie).  I firmly suggested she stick with somtam-thai.

[Tayaout]

33 minutes ago, NanLaew said:

It's quite vile and there's no earthly need for foreigners to stoop to these ridiculous culinary depths just so they can show they're trying to assimilate here.

 

Regular somtam is good, clean and healthy enough.

I prefer Poupala to somtam Thai. 

[puchooay]

I have just been informed that the existing condition was gastric ulcers.

 

Having researched further is appears that this is caused by the bacteria Helicobacter pylori (H. pylori). 

 

Many causes of this infection, an infection that Doctors believe affects half of the world's population. Interestingly, one of the causes is living with someone who has the infection.

 

As I posted in my previous post, the girl's father died of the same/similar ailment 6 months ago.

 

So it seems that eating Somtam, spicy food has been proved not to be a cause of ulcers, was not the cause of death but may have aggravated and existing condition.

[brokenbone]

prawns that isnt well boiled can be lethal, but not just in thailand, my uncle ate it and got his nervous system destroyed, he could barely walk at all after that

[Dumbastheycome]

1 hour ago, RotBenz8888 said:

So how do they know it was that som tam? Just guessing and leave it there?

The source of the sauce at the  end of the  soi might need a bit of a look at if as it  seems she and her father had ongoing issues ! Issan fish sauce is not a specific science in the  making. Basically is  just fish put in a pot, left to rot, then blended with rice flour , worms and all ! It is  known to be potentially lethal which is  why the Thai Health Dept. has issued warnings  about it. To me  just the smell of it is  vomitous enough without any desire to eat anything that contains it. Issan Thai eat it regularly if  not  daily.

[soalbundy]

2 hours ago, NCC1701A said:

wait what about the two Australians who said their whole lives were destroyed by eating papaya salad?

 

That's normally a woman's quote, "my life has been ruined"

[marin]

I enjoy a nice somtam especially with a good Kor Mu Yang, or Gai Yang. But I would never eat the Lao style with Pa La so popular with Isaan folk. The answer is simple the fermented fish often is home made and the risk of liver flukes is high. But a good somtam Thai with a peanuts and green beans, and no fermented fish or little pesticide filled crabs is a great salad. 

[wombat]

3 hours ago, daiwill60 said:

My missus does a great Som Tam, but it never ceases to amaze me how they can use fermented fish, raw crabs and prawns in its preparation.  Just asking for trouble, surely. 

digestive systems us round eye can only envy.

[P Funk]

Som tam should rather be pronounced “some time” as in some time you get sick and “some time” you don’t...

[Pattaya Plies]

#sAVAGES

[Kerryd]

One must remember that the average life expectancy in Thailand is somewhat less than in most of the countries you (that're reading this) come from.

The World Health Organization ranks Thailand at 70th overall in average life expectancy (males/females combined).

The United Nations ranks Thailand at 92nd.

The CIA World Factbook ranks Thailand at 116th.

There are a variety of factors of course. Lifestyle, healthcare, economy. Access to clean water (and food). Pollution. Culture.

Little known fact. Countries that still use the "left hand" method when going to the toilet also tend to be the world leaders in Cholera epidemics (as cholera is transmitted through human feces).

In Isaan they have a problem with "liver flukes". A worm-like creature that people ingest when they eat fish caught in local ponds and streams (canals, sloughs, etc). The flukes infest the liver leading to cancer in the host.
When the flukes lay eggs, they are transported out of the body in the feces, which often end up in the same ponds, streams and other water sources that the fish live in (especially during the rainy seasons when flooding often leads to various sewers and septic tanks to overflow and add their contents to rest of the <deleted>, literally, that is already there).
The flukes then infest the fish which get caught and eaten and so on and so on.

I've often wondered at all the food carts running around all over the country with "fresh" and/or cooked meats sitting in display cases, hanging from racks or above grills all day long. The list of things you can get sick from (relating to bad or improperly handled food) is scary.
Ptomaine posioning, botulism, samonella, legionaires disease, Trichinosis (from poorly cooked pork products) as well as nearly a dozen different ailments from bad seafood products alone.
I reasoned it that, if it was a major problem then the locals would be dropping like flies to the point the crematoriums would be running non-stop day and night.

I've eaten a lot of food from street vendors and food carts over the years and rarely have a problem. 
I eat Som Tam from the local motocart vendor guy maybe 3 times a week. I ask him to use shrimp instead of crab though and the fish sauce he uses is the bottled stuff. The shrimp are dried little things that you can buy by the bagfull in some places. I rarely eat any kind of fish here (never was a fan of fish to begin with though). 

When I ask him to make it "phet nit noi" I can usually eat it with just a bit of a runny nose to show for it. If I ask him to make it "phet Thai" - I usually find myself anchored to the toilet 3 hours later. (It's amazing how fast that stuff will move through your system when it wants to !)
Only once have I had a stomach problem from it and that may have been from eating it too spicy on an empty stomach. The problem only last a couple hours (I think I had finally diluted my stomach contents enough to counteract the chilies) and the pain went away.

 

For someone as young as the girl in the OP was, there had to be something more than just Som Tam at work. As mentioned in the thread already, if she did have a previous GI problem, spicy Som Tam could have aggravated it.

I had a friend many years ago who thought she was pregnant as she was developing a stomach bulge. I told her it wasn't a baby as the bulge was in the wrong spot. She went to the hospital. Turns out she was suffering from septic poisoning (Sepsis or Scepticimia) from a problem in her intestines. She was lucky she went to the hospital in time as they were able to stop it before it killed her.

Something like that, or the appendix as someone else mentioned or severe gastric ulcers could all be aggravated by very spicy foods and lead in many cases lead to death.

 

I would think it pretty rare for it to be an appendix or ulcer issue in someone so young though. Not impossible of course.

Pretty sure if it was the Som Tam there'd be more people having severe problems as well.

 

 

[canuckamuck]

The dilemma with the fermented fish and crabs is a good example of cognitive dissonance. Most Thais know that this stuff can kill you, but the alternative is to not eat it, and that is just inconceivable. Even doctors eat this stuff.

[Isaanbiker]

2 hours ago, timendres said:

Somtham does not infect any part of the body. Bacteria do. Hence Somtham is only as dangerous as the preparation is dangerous. I assure you I can make any food dangerous. What you mean to say is that, due to it being a fresh, uncooked dish, Somtham must be prepared properly, or it can harbor dangerous bacteria.

Please think about your post. What I wrote was about the use of fermented fish- Pla Raa and the often used way too old crabs that kill people.  

 

   Please stop lecturing me, it's not only the preparation,of Somtham, or any other food, regarding Somtham it's the use of Pla Ra and crabs that are way over their due date. 

 

But for those who love to eat the Lao style version is unthinkable to eat it without the stinky fermented fish and old crabs. 

 

  "What I mean to say"? I know what I'm saying. I don't think that you've ever made Somtham with your wife. I did and I know about the dangers.

 

I'm too old to have a lecture that isn't even true. Peace!

 

   

 

 

 

[Fred31]

6 hours ago, canuckamuck said:

Is that the medical opinion? A serious bug. Too bad we have no idea what that means. 

Too bad you think a journalist talks like a doctor...

[kensisaket]

And that in a nutshell is the answer to a previous post questioning why many ex-pats prefer not to eat Thai food.

[Nanaplaza666]

3 hours ago, NCC1701A said:

wait what about the two Australians who said their whole lives were destroyed by eating papaya salad?

 

By my knowlidge that whas pad thai 

[alzack]

6 hours ago, kellersphuket said:

It doesn't surprise me at all,

that stuff is dangerous!

 

I tried it once in Chiang Mai and ended up in hospital on a drip after vomiting repeatedly for days on end.

 

I'll stick to my pepperoni pizza thanks!

I'll stick to Fish N Chips

[TSF]

Years ago the TGF I was with at the time, an Udon Thani gal, would have her friends over regularly for a somtum session. It was like a ritual, they sit on the floor in a circle eating their somtum (the Lao version with the stinking plarah) then 30 minutes later, one by one they rush into the toilet and come out smiling and happy...that was the sign of a great somtum if it sent them rushing into the toilet.

[thaiowl]

Eating fermented raw fish can lead to liver fluke which can cause cirrhosis and cancer of the liver. This condition is prevalent in Isaan due to the consumption of som tam pla raa (ส้มตำปลาร้า).

https://en.wikipedia.org/wiki/Liver_fluke

[manchega]

did the sellers <deleted> in the som tum, I expect that could cause a nasty bug, yes sterile with what ever nasties the pisser is carrying

[Yinn]

2 hours ago, puchooay said:

I have just been informed that the existing condition was gastric ulcers.

 

Having researched further is appears that this is caused by the bacteria Helicobacter pylori (H. pylori). 

 

Many causes of this infection, an infection that Doctors believe affects half of the world's population. Interestingly, one of the causes is living with someone who has the infection.

 

As I posted in my previous post, the girl's father died of the same/similar ailment 6 months ago.

 

So it seems that eating Somtam, spicy food has been proved not to be a cause of ulcers, was not the cause of death but may have aggravated and existing condition.

Thankyou say the true story. Too many fake story.

 

I recommend not eat blaraa. Can get liver fluke from raw, fresh water fish.

The Issan people have number 1 in the world liver cancer because liver fluke from blaraa. 

They know about that, but many refuse to stop. Like a cigarette smoker.

 

There are more than twenty style of somtam. I never eat the blaaraa one. If they boil the blaaraa it kill the fluke worm. But I never trust them. Who know?

 

Also the field black crab can cause problem. The blue swimmer crab one ok, because from the sea.

 

i also ask the seller to clean the “krok” and “saak” before make my one. Because I worry the liver fluke maybe still in it from the last one for other customer. 

 

The liver fluke worm not kill you quickly. But make you have cancer. 

[terje johnsen]

in somtam there can be a lot of parasites cause the dish is raw. and when they write bug they can mean parasites.

[timendres]

1 hour ago, Isaanbiker said:

Please think about your post. What I wrote was about the use of fermented fish- Pla Raa and the often used way too old crabs that kill people.  

 

   Please stop lecturing me, it's not only the preparation,of Somtham, or any other food, regarding Somtham it's the use of Pla Ra and crabs that are way over their due date. 

 

But for those who love to eat the Lao style version is unthinkable to eat it without the stinky fermented fish and old crabs. 

 

  "What I mean to say"? I know what I'm saying. I don't think that you've ever made Somtham with your wife. I did and I know about the dangers.

 

I'm too old to have a lecture that isn't even true. Peace!

 

I was in no way lecturing you. Just trying to point out that Somtham, by itself, is not dangerous, which the OP implied. Properly prepared SomTham is delicious and not dangerous. I apologize for not mentioning bplaa raa (ปลาร้า) or the crabs, and am grateful others have added that to the discussion.

 

As for making Somtham with my wife, you are correct.

Since I am not married, I make it myself using this:

 

 

I apologize if I do not measure up to your mighty Thainess.

[legendcat]

I have seen on a tv show that the little crab that they put in that salad can have a nasty  parasite in it.

[RJRS1301]

The standard of "journalism" , fact , and investigative information in this article is appalling.

I have been eating Som Tam for over two decades and love it.

 

[Bangkok Barry]

6 hours ago, puchooay said:

A serious case of under reporting here.

 

The girl was a student at the same school as my daughter. My daughter knew her well.

 

She had been troubled with a stomach ailment for sometime. A medical condition rather than something caused by food. In fact her Father died only 6 months ago from the same condition.

 

But who would read a story that says 'Schoolgirl dies of genetic stomach ailment'? The report though does say 'apparently', but based on no facts whatsoever. Just typical Thai reporting.

[Monkeyrobot]

5 hours ago, NCC1701A said:

wait what about the two Australians who said their whole lives were destroyed by eating papaya salad?

 

It was Pad Thai they ate and then after questioning they said it also could have be the smoothies they drunk.