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Cystic Echinococcosis (CE) is one of the most widespread parasitoses in the Mediterranean Region (MR). This is due to various factors, the most important being the close association between man, sheep and dogs in areas where open farming is practised. Although this disease has been known for several years and many studies have been carried out, nowadays in Italy there are no complete epidemiological data on its diffusion and distribution. The available data show that CE is mainly diffused in those districts where the sheep-dog cycle can be perpetuated, such as central and southern Italy, and the islands. Furthermore, no data are available on biomolecular characterisation of the strains of Echinococcus granulosus in Italy, apart form those in Sardinia, where the G1 (sheep-dog) and G7 (pig-dog) strains were recently isolated. One of the reasons why CE is a problem with no easy solution is undoubtedly the difficulty of making a certain diagnosis in the dog, the principal definitive host of E. granulosus.

During an epidemiological survey carried out for two consecutive years (2001-2002), autochthonous cases of canine leishmaniosis (CanL) were reported in Communes of the Bologna Province (Emilia-Romagna Region, northern Italy), involved in the past (1971-1972) in a severe outbreak of human visceral leishmaniosis (VL). Serological controls, carried out by immunofluorescence antibody test on a sample of owned dogs, detected a mean prevalence of 2.5% in the first year in 4 Communes, and of 11.2% in the second year in only one Commune, where an incidence value of 9.3% was assessed. The autochthonous origin of the infection was confirmed in 11 out of 13 positive animals in the first year and in 5 out of 6 new cases in the second year. In one case the parasitological examinations led to the isolation of leishmaniae characterized as Leishmania infantum zymodeme MON 1. Entomological surveys carried out during two sandfly seasons in one of the areas concerned by the VL outbreak showed the presence of Phlebotomus perfiliewi and, to a lesser extent, of P perniciosus, both proven vectors of L. infantum in Italy. The results obtained seem to suggest the presence of a stable focus of CanL in the territory involved in the previous VL outbreak of 1971-1972, within which the infection in the canine population had been assessed only serologically. Such an epidemiological situation may be seen either as the persistence of an old focus or as a new imported one.

The socio-economic impact of cystic echinococcosis (CE), caused by Echinococcus granulosus, is reviewed with special reference to the following topics: consequences in man and livestock, costs and benefits of control programmes and economic procedures for evaluating control programmes. Examples of some important costs and benefits are given. Many consequences in man and livestock are difficult to evaluate from an economic point of view, because some basic data are difficult to obtain in many countries. However, the socio-economic evaluation of the consequences of CE and of the present and future control actions proves indispensable to best use available resources and possibly tailor control stategies.

Cystic echinococcosis (CE) is an important zoonosis in Italy and in the whole Mediterranean Region, as confirmed by the work by Ettore Biocca, whose contributions to the subject are reported in a summarised annex to the bibliography. The contribution to the understanding and control of CE are presented, with special emphasis on the socio-economic impact, on factors affecting the maintenance of CE in the Mediterranean Region, on the epidemiological situation and control measures, on the present status of epidemiological surveillance, on the control problems in normal and emergency situations, on health education and training. Also, the justifications of combined control programmes are discussed, which may be applied only in situations of peace and well-being.

A new stable focus of canine leishmaniasis (CanL) was identified in a coastal Adriatic area of the Emilia-Romagna Region in Northern Italy. Following the first clinical cases observed starting from 1998, a seroepidemiological survey was carried out on owned dogs from two communes and on animals housed in dog pounds of the Rimini province. Sixteen out of 612 dogs (2.6%) resulted positive to the IFA test. The 16 positive dogs all came from the two communes, with seroprevalences of 3 and 6%, respectively. The autochthonous origin of the infection was confirmed in all the cases. The parasitological investigation led to the isolation and identification of the parasite as Leishmania infantum Zymodeme MON 1. An entomological survey showed that Phlebotomus perniciosus and P. perfiliewi are present in this area and that P. perfiliewi was very abundant in one collection site. The risk of the establishment of a permanent transmission of the infection in the area, previously considered CanL-free, must be analysed in view of further investigations to be extended also to neighbouring areas.

The different aspects of the coexistence of man and animals in towns are discussed. The animals living in urban areas are classified as: a) Pets; b) Synanthropic, appreciated by man: c) Synanthropic, disregarded by man; d) Synanthropic, disliked by man. The detrimental effects are: a) Transmission of diseases; b) Bites, scratches and other lesions; c) Animal wastes; d) Noise; e) Use of feeds, medicines, etc.; f) Abandoned animals. The positive effects are: a) Ecological balance; b) Animals and mental health; c) Other positive aspects. A positive solution of the problem is sought which avoids both the zoomaniac and the zoophobic attitudes.