Results obtained with intradermal (Casoni) and complement-fixation tests (CFT) in cases of suspected hydatid disease in the United Kingdom studied over a period of 10 yr are reported, and a reassessment is made of the reliability of each test for diagnosis and prognosis. Because of a number of disadvantages, the Casoni test is not recommended for diagnosing current infection. It is useful, however, for indicating past or present infection in a community, and in these circumstances a potent antigen, capable of being used diluted, should be employed.

The CFT, properly standardised, is shown to be reliable for diagnosis and prognosis and for these purposes it is the test of choice. Sensitivity of the test is enhanced by chessboard titrations and by these means information is obtained relating to the antigenic complexity of hydatid fluids. Studies of CFT results have confirmed that cysts are found most commonly in the liver where they promote the highest titres. From the number of positive results, the greatest incidence of infection appears to be in the Greater London area, but the highest rate of infection acquired in Britain probably occurs in Wales.


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