John Plahovinsak
Liver flukes are tiny parasitic worms that may have infected Vietnam veterans and caused bile duct cancer or cholangiocarcinoma. This cancer of the biliary duct system, includes the gallbladder, bile ducts and certain cells inside the liver.
On June 30, 2023, Congressional Representatives Nick LaLota and Pat Ryan introduced bipartisan legislation, the H.R. 4424, the Vietnam Liver Fluke Cancer Study Act.
Passage of this Act would require the Secretary of Veterans Affairs (VA) Denis McDonough to conduct an epidemiological study on the prevalence of cholangiocarcinoma (CCA) in the Vietnam Veteran population.
The proposed Study would focus on Vietnam Veterans who unknowingly ate raw or undercooked fish that could have been exposed to or currently carrying the dormant parasite Platyhelminthes, commonly known as “liver fluke.”
The liver fluke worms are found in the fresh waters of Southeast Asia. This is the parasite that causes very serious and life-threatening health conditions including bile duct cancer and liver disease.
A previous Liver Fluke Study was conducted by the Northport Veterans Affairs Medical Center (VAMC) in 2018, which was the only known Study on the prevalence of “liver flukes” in a group of fifty (50) Vietnam-era Veterans.
Of the 50 Veterans examined in the Study, 24% tested positive for serum IgG antibodies to C. sinensis, which is related to liver flukes. Of those Veterans examined who tested positive had no detectable liver fluke parasites by fecal examination.
Summary reports from the Northport VAMC Study highlighted the need for additional research, the development of standard treatment and increased access to care for Vietnam Veterans at VA facilities across the country.
Currently, there are no available research or studies to show that bile duct cancer occurs more often in Vietnam Veterans than in other groups. Approximately 8,000 people in the United States are diagnosed with CCA every year.
“The results from the 2018 study at the Northport VA show ‘liver fluke’ is a serious medical issue that needs further research and treatment,” said Congressman LaLota, a United States Naval Academy graduate.
“Authorizing this study will increase our understanding of ‘live fluke’ and allow our Veterans to receive the best treatment possible,” commended LaLota. “Our Vietnam Veterans were treated poorly while serving our nation and in the years after they came home, the least we can do is provide them assistance today.”
“I’m proud to join my colleague Rep. LaLota on this critical legislation that will finally help our Vietnam veterans stricken with ‘liver fluke’,” said Congressman Ryan, a West Point graduate. “Our fellow veterans risked their lives for this country — I will keep fighting every day to get them the care they deserve when they come home. “
As of August 31, 2023, there are seven (7) congressional co-sponsors of this bipartisan legislation.
My Opinion: The Vietnam Liver Fluke Study can help determine if environmental exposures faced by Vietnam Veterans can be linked to bile duct cancer. If so, then this cancer can be designated as a service-connected condition.
It should be noted that liver fluke infection is just one cause of bile duct cancer. Liver fluke parasites grow to adulthood inside the human biliary duct system. Two of the major risk factors are liver fluke infection with the Hepatitis B or C virus.
The Disabled American Veterans (DAV) organization has supported, in the past, further studies on the possible negative impact of liver flukes on Vietnam Veterans. They have included this issue in their 2023-24 Legislative Critical Issues.
I would join with them and support the passage of the Vietnam Liver Fluke Cancer Study Act.
BioSketch: John Plahovinsak is a 32-year retired Army veteran, who served from 1967 to 1999. He is the Disabled American Veterans (DAV) Department of Ohio Hospital Chairman and Adjutant of DAV Chapter #63 (Clermont County). He can be contacted at: plahovinsak@msn.com.