They also rely on anthelmintics, as such they will not change their behavior after having been infected and treated. They are not aware that liver fluke can kill people by causing liver or bile duct cancer. Sriraj et al.(Sriraj et al., 2013a, 2013b) demonstrated that alcohol can induce O.viverrini metacercariae excystation, leading to early development of parasites in the hepatobiliary system. The preference of men to eat raw fish and drink alcohol may explain why males are at a significantly higher risk of infection with O. viverrini.