Cystic echinococcosis (hydatid disease): current insights into epidemiology, diagnosis, therapy, and prophylaxis

BACKGROUND: Cystic echinococcosis (CE) poses a significant medical and socio-economic burden worldwide, particularly in highly endemic, low-income regions with resource-limited settings, where control efforts are hindered by limited access to diagnostics and appropriate treatment options. In contrast, low prevalence settings, such as high-income countries, often face challenges related to low awareness of the disease, which can lead to misdiagnosis and inappropriate treatments including potentially harmful invasive procedures. Therefore, it is recommended that an interdisciplinary approach be adopted to prevent misdiagnosis and treatment failure in CE, a chronic, but mostly benign and preventable zoonosis. This review provides an updated synthesis of current research on CE, focusing on its epidemiology, clinical management, and recommended strategies for improving outcomes in diverse healthcare settings. SOURCES OF DATA: Published scientific literature in PubMed, MEDLINE, Web of Science, EMBASE, and Cochrane databases from the year 1980-2025. AREAS OF AGREEMENT: The World Health Organization (WHO) classification system for CE is based on ultrasound to assess cyst activity and size, thus facilitating the correct use of treatment options, including benzimidazole therapy, surgery and/or the PAIR technique.It is imperative to rule out CE before undertaking any invasive diagnostic procedures in order to prevent cystic dissemination. GROWING POINTS: Given the lack of current updated guidelines this review gives a standardized overview over current recommendations for diagnosis and therapy. AREAS TIMELY FOR DEVELOPING RESEARCH: There is a need for more accurate, standardized diagnostic protocols and development of effective medical therapy and/or vaccines.