Hydatid disease: the Lebanese contribution.

Hydatid disease (HD) or cystic echinococcosis (CE) has been an important zoonotic disease causing medical, economic and public health problems in many parts of the world, including South America, North Africa, Turkey, and Middle Eastern countries. Humans as well as animals, primarily sheep and cattle, are infected by the ingestion of food, usually leafy vegetables, contaminated with the eggs (oncospheres) of the dog tapeworm Echinococcus granulosus. Hydatid cysts, which are the larval stage of the parasite, are located mostly in the liver and lungs of the infected host. Because of its chronic endemicity in Lebanon and neighboring countries, this disease has constituted an integral part of research studies conducted by medical doctors and researchers in Lebanon, mostly spearheaded by those at the American University of Beirut (AUB) and its medical center (AUBMC) since the early turn of the last century (1920s). Over 130 wide ranging studies were published; some were innovative e.g. the introduction of the once famous Indirect Haemagglutination (IHA) test for serodiagnosis, and the use of dilute cetrimide as a protoscolicidal agent during surgery. Although the incidence of HD is decreasing in our country, it has acquired increasing public health concern and is considered as an emerging or re-emerging disease in many parts of the world. In this review, we shed light on the numerous studies/publications done in Lebanon as a tribute to those researchers who have impacted the literature of HD in many aspects. The latter include epidemiology and ways of transmission, clinical features and radiological tools for diagnosis, serodiagnosis and immunology, and investigation of different therapeutic modalities for different aspects of the disease. Moreover, consolidating these studies in this review would hopefully represent the historic foundation for interested researchers and investigators, especially in this country, to pursue and build on such studies. The advances in technology, and the availability and utilization of new methodologies will hopefully help find more reliable and efficient ways for the diagnosis, and management of this disease.