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Prior research identified a calcified <jats:italic>Echinococcus granulosis<\/jats:italic> 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\u2010gatherer community raises questions regarding human\u2010animal interaction prior to farming. The objective of this article is to identify and describe the epidemiology of hydatid disease in the human skeletal assemblage at Con Co Ngua.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>One hundred and fifty\u2010five 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010two 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>While hydatid disease has previously been found in pre\u2010agricultural communities, the high prevalence at Con Co Ngua is non\u2010incidental. 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\u2010gatherers living millennia prior to the adoption of farming in Southeast Asia.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ajpa.24435","type":"journal-article","created":{"date-parts":[[2021,11,9]],"date-time":"2021-11-09T13:49:43Z","timestamp":1636465783000},"page":"100-115","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Hydatid disease (<i>Echinococcosis granulosis)<\/i> diagnosis from skeletal osteolytic lesions in an early seventh\u2010millennium <scp>BP<\/scp> forager community from preagricultural northern Vietnam"],"prefix":"10.1002","volume":"177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5259-3819","authenticated-orcid":false,"given":"Melandri","family":"Vlok","sequence":"first","affiliation":[{"name":"Department of Anatomy University of Otago  Dunedin New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1047-4288","authenticated-orcid":false,"given":"Hallie R.","family":"Buckley","sequence":"additional","affiliation":[{"name":"Department of Anatomy University of Otago  Dunedin New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5091-3105","authenticated-orcid":false,"given":"Kate","family":"Domett","sequence":"additional","affiliation":[{"name":"College of Medicine and Dentistry James Cook University  Townsville Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3265-862X","authenticated-orcid":false,"given":"Anna","family":"Willis","sequence":"additional","affiliation":[{"name":"College of Arts, Society &amp; Education James Cook University  Townsville Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0747-9099","authenticated-orcid":false,"given":"Monica","family":"Tromp","sequence":"additional","affiliation":[{"name":"Department of Anatomy University of Otago  Dunedin New Zealand"},{"name":"School of Social Sciences University of Otago  Dunedin New Zealand"},{"name":"Department of Archaeology Max Planck Institute for the Science of Human History  Jena Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6027-8915","authenticated-orcid":false,"given":"Hiep H.","family":"Trinh","sequence":"additional","affiliation":[{"name":"Institute of Archaeology  Hanoi Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tran T.","family":"Minh","sequence":"additional","affiliation":[{"name":"Institute of Archaeology  Hanoi Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nguyen T.","family":"Mai Huong","sequence":"additional","affiliation":[{"name":"Institute of Archaeology  Hanoi Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lan Cuong","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Institute of Archaeology  Hanoi Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5453-7987","authenticated-orcid":false,"given":"Hirofumi","family":"Matsumura","sequence":"additional","affiliation":[{"name":"School of Health Sciences Sapporo Medical University  Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nghia T.","family":"Huu","sequence":"additional","affiliation":[{"name":"Institute of Archaeology  Hanoi Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5804-2145","authenticated-orcid":false,"given":"Marc F.","family":"Oxenham","sequence":"additional","affiliation":[{"name":"School of Archaeology and Anthropology The Australian National University  Canberra Australia"},{"name":"Department of Archaeology University of Aberdeen  Scotland UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,11,9]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-199207000-00034"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/oa.2475"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijpp.2014.07.003"},{"key":"e_1_2_10_5_1","volume-title":"Paleopathology at the origins of agriculture","author":"Armelagos G. 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