**9. Components of hydatid cyst**

#### **9.1 Daughter vesicles (brood capsules)**

These capsules consist of the generated layer by several endogenous budding, which are small buds formed from the germinal layer toward the cavity of the cyst [15]. These buds enlarge, and each capsule is connected to the germinal layer of the parental cyst by the stem. The process of budding is repeated, and each capsule contains large numbers of protoscolices, which have about 30–10 heads per capsule [28]; capsules are gradually separated from the germinal layer and float in the cyst fluid. These capsules are similar in their structure to the parental cyst [29].

The capsules may rupture and protoscolices may be released together with the free capsules, and this is the so-called hydatid sand. Occasionally, cysts are free from brood capsules when they grow in an inappropriate medium or due to bacterial invasion or calcification. The capsules are formed but do not produce protoscolices, and these are called sterile cysts, whereas capsules that produce protoscolices are called fertile cysts [14].

#### **9.2 Hydatid sand**

A term of hydatid sand refers to the contents of the hydatid cyst, which includes the daughter cysts, brood capsules, and protoscolices that present in the hydatid fluid of the *E. granulosus* [30].

#### **9.3 Hydatid cyst fluid**

It is a clear colorless or yellowish liquid with a specific weight of 1.005–1.009, a pH of 7.2–6.7, and inorganic substances such as iron, chlorine, magnesium, sodium, calcium, cadmium, nickel, chromium, copper, and some enzymes such as glutamic pyruvic transaminase (GTP), glutamic oxaloacetic transaminase (GOT), Acid phosphatase with lipase, oxidase, phosphatase, and dehydrate enzymes. They vary in quantity and quality depending on the source of the parasite and the location of the cyst and metabolism of parasites such as ammonia, bilirubin, and creatinine [31].

### **10. Epidemiology of** *E. granulosus*

The *E. granulosus* parasite spreads almost all over the world, but it is more common in rural areas with large pastoral areas, where there are large numbers of animals that are hosts of the parasite, such as cattle, sheep, and others, with the presence of definitive hosts in these areas especially dogs [32]. Echinococcosis is a health and economic problem in most parts of the world and some studies have recorded more than 50 cases per 100,000 people annually in high endemic areas, where the prevalence of the disease in China, Argentina, and East Africa

**53**

Echinococcus granulosus

expenses [15, 33].

countries of the world [39].

massacres [1].

hair and nails [43].

**11. Hydatidosis (Echinococcosis)**

*DOI: http://dx.doi.org/10.5772/intechopen.90708*

was about 5–10%. The disease also kills about 1 million people a year around the world and also causes a loss of about \$3 billion, including treatment and livestock

It is also highly endemic in parts of Africa, Europe, Australia, Asia, and the Mediterranean countries [34], as well as Middle Eastern countries including Iran, Saudi Arabia, Kuwait, Jordan, Palestine, Syria, Lebanon, and Iraq [35]. The epidemiology of the disease depends on the economic and agricultural factors and the level of learning and health and social culture in the human society where the parasite is spread, and what helps to spread the disease is the mixing with pets,

Iraq is a highly endemic country for the disease, due to the spread of loose parasite-infected dogs [37]. Although there are many recent studies of the epidemic of this disease, it is still a major health problem and is still endemic in Iraq, where there were not enough attempts to combat it despite the availability of modern

Epidemiology of hydatosis and cystic type (CE) is still on the rise due to its global distribution and high regional prevalence, and alveolar type (AE) has been observed during the past two decades and a decrease in the rate of morbidity and mortality, especially in Asia, as a result of intensive studies of epidemiology in all

Hydatidosis is one of the oldest known diseases of the human being. This disease was described by the Egyptians in a document dating back to 1534 BC, as mentioned by the Babylonians in the Bible Talmud. It described the cyst as a bladder filled with fluid [40]. This disease arises from the formation of hydatid cysts of different sizes in different locations such as the liver and lungs in both animals and humans, and the severity of the disease depends on the number of cysts, size, and location. These cysts may lead to loss of human life in addition to economic losses in the field of livestock; the incidence of this disease is high in humans because its risk is that it is detected only by chance during radiological examinations or various surgical operations, but in animals, it is discovered during routine detection in

The cause of hydatidosis disease is due to two important factors. The first is that it is not possible to know the infection in the early stages since the onset of the disease because it does not show symptoms until the cyst has increased in size of the cyst, which puts pressure on the adjacent tissues [41]. The second factor is the loss of therapeutic means, and the disease is very similar to the severity of its metastasis in the metastasis stage [42]. These cysts are found in all parts of the body except

This disease is one of the endemic diseases in Iraq and it has an economic, social and health impact on the human, so conducted many studies and research to investigate methods of treatment, which surgical intervention is the most important of these methods, although the patient is exposed to many problems during surgery which may be difficult to perform at times and cannot be performed at other times [44, 45], or the patient is not surgically qualified or as a result of other serious diseases such as immune compromised patients or because of age or anesthesia or the occurrence of the cyst in places difficult for the surgeon to deal with, such as in the cysts of the heart, brain or spine, so the importance of the use of extracts of a

different chemical nature treatment of aquatic cyst disease [46].

especially dogs, in the absence of appropriate health conditions [36].

conditions and equipment for diagnosis and treatment [38].

#### Echinococcus granulosus *DOI: http://dx.doi.org/10.5772/intechopen.90708*

*Overview on Echinococcosis*

**9. Components of hydatid cyst**

are called fertile cysts [14].

fluid of the *E. granulosus* [30].

**10. Epidemiology of** *E. granulosus*

**9.3 Hydatid cyst fluid**

creatinine [31].

**9.2 Hydatid sand**

**9.1 Daughter vesicles (brood capsules)**

nal layer [27].

those cavities that lead to the formation of protoscolices [26]. The fertility of the aqueous cyst is determined by the presence of protoscolices, their increasing growth, and their association with the germinal layer, as well as other criteria for determining the cyst fertility through the white color and thickness of the germi-

These capsules consist of the generated layer by several endogenous budding, which are small buds formed from the germinal layer toward the cavity of the cyst [15]. These buds enlarge, and each capsule is connected to the germinal layer of the parental cyst by the stem. The process of budding is repeated, and each capsule contains large numbers of protoscolices, which have about 30–10 heads per capsule [28]; capsules are gradually separated from the germinal layer and float in the cyst

The capsules may rupture and protoscolices may be released together with the free capsules, and this is the so-called hydatid sand. Occasionally, cysts are free from brood capsules when they grow in an inappropriate medium or due to bacterial invasion or calcification. The capsules are formed but do not produce protoscolices, and these are called sterile cysts, whereas capsules that produce protoscolices

A term of hydatid sand refers to the contents of the hydatid cyst, which includes the daughter cysts, brood capsules, and protoscolices that present in the hydatid

It is a clear colorless or yellowish liquid with a specific weight of 1.005–1.009,

a pH of 7.2–6.7, and inorganic substances such as iron, chlorine, magnesium, sodium, calcium, cadmium, nickel, chromium, copper, and some enzymes such as glutamic pyruvic transaminase (GTP), glutamic oxaloacetic transaminase (GOT), Acid phosphatase with lipase, oxidase, phosphatase, and dehydrate enzymes. They vary in quantity and quality depending on the source of the parasite and the location of the cyst and metabolism of parasites such as ammonia, bilirubin, and

The *E. granulosus* parasite spreads almost all over the world, but it is more common in rural areas with large pastoral areas, where there are large numbers of animals that are hosts of the parasite, such as cattle, sheep, and others, with the presence of definitive hosts in these areas especially dogs [32]. Echinococcosis is a health and economic problem in most parts of the world and some studies have recorded more than 50 cases per 100,000 people annually in high endemic areas, where the prevalence of the disease in China, Argentina, and East Africa

fluid. These capsules are similar in their structure to the parental cyst [29].

**52**

was about 5–10%. The disease also kills about 1 million people a year around the world and also causes a loss of about \$3 billion, including treatment and livestock expenses [15, 33].

It is also highly endemic in parts of Africa, Europe, Australia, Asia, and the Mediterranean countries [34], as well as Middle Eastern countries including Iran, Saudi Arabia, Kuwait, Jordan, Palestine, Syria, Lebanon, and Iraq [35]. The epidemiology of the disease depends on the economic and agricultural factors and the level of learning and health and social culture in the human society where the parasite is spread, and what helps to spread the disease is the mixing with pets, especially dogs, in the absence of appropriate health conditions [36].

Iraq is a highly endemic country for the disease, due to the spread of loose parasite-infected dogs [37]. Although there are many recent studies of the epidemic of this disease, it is still a major health problem and is still endemic in Iraq, where there were not enough attempts to combat it despite the availability of modern conditions and equipment for diagnosis and treatment [38].

Epidemiology of hydatosis and cystic type (CE) is still on the rise due to its global distribution and high regional prevalence, and alveolar type (AE) has been observed during the past two decades and a decrease in the rate of morbidity and mortality, especially in Asia, as a result of intensive studies of epidemiology in all countries of the world [39].
