Raw dishes in Thailand

Most Thai food is cooked, often in front of you. A few traditional dishes are not: minced pork salads made with raw meat and raw blood, salads of raw freshwater fish, raw fermented fish, raw crab in papaya salad and raw shellfish. Thailand’s Department of Disease Control (DDC) warns about them again and again, because they cause diseases that cooked food does not: a bacterium from pigs that can leave people deaf, and a liver worm that can lead to cancer years later.

You don’t have to skip these dishes. Almost all of them exist in a cooked version, and the rule from Thai officials is simple: heat makes them safe, lime and fermenting do not.

Which dishes are raw

Many of these dishes come from the Northeast (Isan) and the North, where Thai officials record the most cases, but Isan food is sold all over the country. The same name can mean a raw or a cooked dish, so ask.

Dish	What may be raw	The risk Thai officials name
Larb dib (raw larb), larb leuat (blood larb)	Minced pork, raw pig’s blood	Streptococcus suis
Lu (หลู้)	Raw pig’s blood mixed with spices	Streptococcus suis
Koi (ก้อย)	Raw meat or fish	Streptococcus suis (pork), liver fluke (fish)
Nham dib (raw nham, แหนม)	Fermented pork sausage, eaten raw	Streptococcus suis
Koi pla, larb pla dib, pla pla dib	Raw freshwater fish	Liver fluke
Pla som	Fermented freshwater fish	Liver fluke
Pla ra dib, som tam pla ra	Raw fermented fish, in papaya salad too	Liver fluke
Som tam with raw crab	Raw freshwater crab	Lung fluke (WHO)
Blanched cockles, squid, shrimp; raw oysters	Seafood barely cooked or raw	Food poisoning, Vibrio

The DDC’s lists come from its warnings on raw pork in Nakhon Ratchasima and Chiang Mai, and on raw freshwater fish.

Raw pork and blood: Streptococcus suis

Streptococcus suis lives in the airways and blood of infected pigs. In Thai it is called ไข้หูดับ, “deafness fever”, because it can cause sudden hearing loss and permanent deafness. People catch it by eating raw or undercooked pork or blood, or through a cut while handling raw pork.

• Symptoms start 1 to 14 days later, according to the DDC office in Nakhon Ratchasima: sudden high fever, severe headache, dizziness and loss of balance, vomiting, a stiff neck and hearing loss. It can spread to the blood and the brain (meningitis), and it can kill.
• It is not rare. From 7 January to 6 March 2024, the DDC counted 82 cases and 5 deaths nationwide. In the four provinces around Nakhon Ratchasima alone, 197 people fell ill and 22 died in 2024. In June 2026, the DDC office in Ubon Ratchathani reported that a survey of raw pork in the province found contamination as high as 83.3%.
• More at risk: people who drink alcohol heavily, people with diabetes, high blood pressure, kidney disease, heart disease or cancer, and people without a spleen. Cases are most common in people aged 65 and over, then 55 to 64. The DDC also warns against eating raw pork with alcohol.
• Lime does not cook pork. The DDC says not to squeeze lime on pork to “cook” it: only heat works. It advises cooking pork and blood above 70 °C for at least 10 minutes.
• At the grill. At a mookata (Thai barbecue) or any grill where you cook your own pork, use separate tongs for raw meat, don’t eat with the chopsticks that touched raw pork, and make sure every piece is cooked through.

Raw wild boar and raw pork can also carry Trichinella, a worm that causes trichinellosis. In 2006, 28 people in a village in Uthai Thani province fell ill after eating undercooked wild boar from a hunt. The CDC says curing (salting), drying or smoking meat alone does not consistently kill the worms, so a fermented or dried sausage is not automatically safe.

Raw freshwater fish and fermented fish: liver flukes

The liver fluke (Opisthorchis viverrini, พยาธิใบไม้ตับ) is a small worm whose larvae live in freshwater fish, especially white-scaled fish such as the many kinds of pla taphian (ตะเพียน, barbs) and pla khao na. If you eat the fish raw or half-cooked, the worms settle in your bile ducts and, over time, inflame them.

• The cancer link. The WHO says long-term infection can lead to cholangiocarcinoma, a bile duct cancer that is often fatal. The DDC estimates that about 6 million people in Thailand, around 10% of the population, have liver flukes, with the most cases in the North and Northeast.
• Fermenting, lime and salt don’t kill them. The DDC says sour seasonings (lime juice, tamarind) and salty ones (fish sauce, salt, pla ra) do not cook the fish: only heat kills the larvae. That includes pla ra and pla som, which are fermented but not cooked.
• Symptoms are easy to miss. A light infection often causes none. The DDC lists loss of appetite, weight loss, bloating, indigestion, and discomfort or fullness under the right ribs. The WHO says heavy infections can cause fever and pain in the upper right abdomen.
• If you ate raw freshwater fish, the DDC advises a stool test for parasite eggs. The infection is treated with praziquantel (WHO).

Raw freshwater crab, sometimes crushed into som tam, can carry a different worm: the WHO says freshwater crabs and crayfish can carry the lung fluke (Paragonimus), which can cause a long-lasting cough with blood in the sputum, and headaches or seizures if it reaches the brain.

Raw and barely cooked seafood

Raw prawns in fish sauce (goong chae nam pla), raw oysters and blanched cockles are popular, especially by the sea. The DDC office in Songkhla advises avoiding seafood that is only blanched, particularly in the hot season (see our page on eating safely in Thailand). The CDC says most Vibrio infections come from raw or undercooked shellfish, particularly oysters, and that severe illness is more likely with liver disease, diabetes, cancer, a weak immune system or medicines that lower stomach acid. Our guide to seafood and shellfish when traveling explains Vibrio and the other risks of seafood, raw or cooked.

How to order a cooked version

The word to know is suk (สุก), cooked. Dib (ดิบ) means raw.

• Larb: ask for larb suk (ลาบสุก), cooked larb. Most restaurants make it that way already, but in the North and Northeast, check.
• Som tam: som tam Thai is the version usually made without pla ra or crab. If you want the Isan version, ask mai sai pla ra dib (no raw pla ra) or mai sai pu (no crab), or check that the pla ra has been boiled.
• Fish: choose grilled, fried or steamed fish. Avoid koi pla and larb pla unless the fish is cooked through.
• Nham: eat it grilled or fried, hot, rather than as it comes from the packet.
• Seafood: order shellfish grilled or steamed through, and choose cooked prawns over goong chae nam pla (raw prawns in fish sauce).
• Saying no: you may be offered raw dishes at a village party or a festival, often with alcohol. “Mai gin dib” (I don’t eat raw food) is a polite answer.

Pregnant travelers and people with weak immunity should avoid all raw meat, fish and shellfish: see our guide to eating abroad while pregnant.

If you feel ill after a raw dish

Fever, a severe headache, a stiff neck, vomiting, dizziness or sudden hearing loss in the days after eating raw pork or blood need a doctor straight away. The DDC says to tell the doctor that you ate raw pork: early diagnosis and antibiotics reduce the risk of deafness and death. The DDC’s hotline, 1422, answers questions on these diseases.

For emergency numbers, hospitals and the rest of what to know about eating in the country, see our page on eating safely in Thailand. For ordinary stomach upsets, read our guide on food poisoning while traveling.