Hydatid disease (Echinococcosis granulosis) diagnosis from skeletal osteolytic lesions in an early seventh-millennium BP forager community from pre-agricultural northern Vietnam

Melandri Vlok* (Corresponding Author), Hallie R. Buckley, Kate Domett, Anna Willis, Monica Tromp, Hiep Hoang Trinh, Tran Thi Minh, Nguyen Thi Mai Huong, Lan Cuong Nguyen, Hirofumi Matsumura, Nghia Truong Huu, Marc Oxenham* (Corresponding Author)

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)
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Objectives Con Co Ngua is a complex, sedentary forager site from northern Vietnam dating to the early seventh millennium BP. Prior research identified a calcified Echinococcus granulosis cyst, which causes hydatid disease. Osteolytic lesions consistent with hydatid disease were also present in this individual and others. Hydatid disease is observed in high frequencies in pastoralists, and its presence in a hunter-gatherer community raises questions regarding human-animal interaction prior to farming. The objective of this paper is to identify
and describe the epidemiology of hydatid disease in the human skeletal assemblage at Con Co Ngua.

Materials and Methods 155 individuals were macroscopically assessed for lesions. Of these, eight individuals were radiographed. Hydatid disease was diagnosed using a new threshold criteria protocol derived from clinical literature which prioritizes lesions specific to the parasite.

Results Twenty-two individuals (14.2%) presented with osteolytic lesions consistent with hydatid disease, affecting the distal humerus, proximal femur and forearm, and pelvis. Seven individuals radiographed (4.5%) had multilocular cystic lesions strongly diagnostic for hydatid disease. All probable cases had lesions of the distal humerus. The remaining lesions were macroscopically identical to those radiographed and were considered possible cases. Discussion While hydatid disease has previously been found in pre-agricultural communities, the high prevalence at Con Co Ngua is non-incidental. We propose that the presence of wild canids and management of wild buffalo and deer increased the risk of disease transmission. These findings further reveal subsistence complexity among hunter-gatherers living millennia prior to the adoption of farming in Southeast Asia.
Original languageEnglish
Pages (from-to)100-115
Number of pages16
JournalAmerican Journal of Physical Anthropology
Issue number1
Early online date9 Nov 2021
Publication statusPublished - 1 Jan 2022

Bibliographical note

Grant sponsors: Australian Research Council DP110101097, FT120100299; National Geographic Society EC-54332R-18; Royal Society of New Zealand Skinner Fund Grant; and a University of Otago Doctoral Scholarship.
Funding information: Australian Research Council, Grant/Award Numbers: DP110101097, FT120100299; National Geographic Society, Grant/Award Number: EC-54332R-18; Royal Society of New Zealand Skinner Fund; University of Otago Doctoral Scholarship


  • agricultural transition
  • forager farmer
  • South East Asia
  • zoonosis


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