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Vietnam vets urged to get tested for liver fluke

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    Command Sgt. Maj. Gary Flaherty, Columbia County Veterans Services director, is urging his clients who served in Vietnam to get tested for liver fluke, a parasite that the Veterans Affairs Bureau found in several veterans during a pilot test to find a connection between bile duct cancer and service in Vietnam.
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    Senate Minority Leader Charles Schumer, D-N.Y., is pushing for the National Academies of Sciences, Engineering and Medicine to conduct more tests to determine if a correlation exists between bile duct cancer in Vietnam veterans and a parasite, the liver fluke, found commonly in Southeast Asia.
December 5, 2017 - 11:30 pm

Officials representing veterans in the Twin Counties are urging Vietnam veterans to ask their Bureau of Veterans Affairs doctors for a blood test to check for the presence of a potentially deadly parasite.

The recommendation comes after the bureau found 20 percent of Vietnam veterans who participated in a pilot test revealed a parasite known as the liver fluke.

News spread quickly last week that a VA medical center in Northport, New York, sent 50 blood samples to a laboratory in South Korea in the spring to detect evidence of exposure to the liver fluke parasite in Vietnam veterans.

“This study — which tries to evaluate a possible link between eating raw or undercooked fish from Vietnam rivers to a rare form of cancer — is the first of its kind in America,” said VA Press Secretary Curt Cashour. “Some samples have tested positive, and we have notified all of those veterans, but exact numbers will not be revealed until the study has been peer-reviewed and accepted for publication in a medical journal.”

The liver fluke is a parasite commonly found in more than 50 countries, especially where sheep or cattle are raised, as well as in developing countries and tropical locations, according to the Centers for Disease Control.

The parasite is contracted through eating raw watercress or other contaminated freshwater plants, drinking infected water or eating vegetables irrigated by infected water.

The main concern is infection from these parasitic worms could cause bile duct cancer, which has different survival rates depending on the location of the tumors.

The five-year survival rate, or the number of people who survive five years, for intrahepatic bile duct cancer is 15 percent for localized tumors, 6 percent for regional tumors and 2 percent for distant tumors, according to the American Cancer Society’s website. The five-year rate for extrahepatic bile duct cancer is 30 percent for localized tumors, 24 percent for regional tumors and 2 percent for distant tumors.

“I have one veteran who has been complaining of severe stomach pain for awhile now,” said Command Sgt. Maj. Gary Flaherty, Columbia County Veterans Services director. “We filed a claim with the VA, but it was denied. I am going to tell his doctor in Albany to give him a blood test.”

Peter Potter, head of public affairs for the Albany-Stratton VA Medical Center, which serves Columbia and Greene counties, said the medical center has not seen any cases of liver fluke infection.

“No one has really contacted the office about the [liver flukes], although I am sure we will get an influx when this article is printed,” said Zachary Snyder, the veterans benefits representative for the Greene County Veteran Services Agency. “If anyone is concerned they may have contracted liver flukes, they should notify their doctor, who can run relatively simple blood tests to see if they have them or not.

“If anyone is diagnosed with having liver flukes, they should contact our office at 518-943-3703 and we would be more than happy to assist them with possibly getting that condition service connected.”

Some people feel sick during the chronic phase of the infection, or when adult flukes are in the duct system of the liver, according to the CDC. The symptoms associated with this phase, if any, such as inflammation and blockage of bile ducts, can appear months to years after exposure. Other symptoms can include fever, malaise, abdominal pain, enlarged liver and abnormal liver tests.

Flaherty said he will advise all his clients who served in Vietnam to ask their doctors to test them for liver fluke. Flaherty served in Vietnam in the U.S. Army.

“Thirty years ago, the doctors told me I had a fatty liver,” Flaherty said. “They asked me if I drank, because fatty liver is associated with alcohol consumption. I have never had a drop of alcohol in my life. They just dropped it.

“When I go up to Albany for my next doctor appointment, I am going to ask for the blood my next doctor appointment, I am going to ask for the blood test,” he said.

There is a blood test for liver fluke, known as an ELISA test, using a multi-helminth-antigen assay, but Cashour said the test is not approved by the Federal Drug Administration. Because of this, the VA was forced to send the samples to the research lab at Seoul National University College of Medicine in South Korea to be tested.

“No laboratory in the country can test for this particular parasite,” Cashour said.

No companies have come forward to ask for FDA approval to market the test, said FDA spokeswoman Tara Rabin.

“The FDA is aware of an unapproved assay for Clonorchis being used in the U.S., however, no company has sought the FDA’s marketing authorization of this device for use in the U.S. based on any supporting clinical studies of the device,” Rabin said. “The FDA welcomes information from all medical product developers and is fully committed to reviewing an application if one were to be submitted.”

News of the VA pilot test has reached the ears of representatives in Washington, who are asking for more tests to determine if there is a connection between serving in Vietnam and bile duct cancer.

U.S. Rep. John Faso, R-19, said he will be ready to do what is needed should the issue come to legislative action.

“Ensuring our veterans get the care that they have earned will always be a priority,” Faso said. “My office has yet to receive inquiries from local veterans regarding the possible side effects from liver fluke. However, we will be working with the VA to understand this issue more and stand ready to assist our veterans.”

“Our brave service members fought to protect our freedom and it’s our obligation to care for them now that they’re home,” said Senate Minority Leader Charles Schumer, D-N.Y. “Hundreds of veterans have been diagnosed with bile duct cancer over the past decade and many who may have it might not know they are at risk for it.

“It’s time for the feds to study whether this is more than a coincidence. I’m urging the National Academies of Sciences, Engineering and Medicine to immediately launch a new scientific study to examine whether a correlation exists between bile duct cancer and parasites known to live in the Vietnam region during the Vietnam War,” Schumer said.

Flaherty wants to bring the issue to the forefront, adding the VA has not been straightforward about it and compared it to the issue of Cold War Navy veterans who do not receive compensation for possible complications caused by Agent Orange exposure.

“I will be bringing this up to the VA to find out more,” Flaherty said. “It’s amazing this has been going on for years — I knew nothing about this until this morning.”

Schumer said if veterans were infected during their time serving overseas, they are entitled to compensation from the government.

“We know that some parasites commonly found in Southeast Asia can lead to bile duct cancer if ingested, so if these parasites infected our veterans while defending our way of life overseas, they should be get the compensation they earned and deserve,” Schumer said.