[The Elba triad: harara, light dermatoses, leishmaniasis. The ecological background]

A report is given on a travel to Elba, the largest island of the Tuscany archepelago (Italy) and a holiday place preferred by German speaking tourists. In the last years some cases of visceral leishmaniasis and oriental sores, respectively, were introduced to Germany from this island. The geoecological background of this development was investigated. Reproduction and spread of the most abundant sandfly species Phlebotomus (Laroussius) perniciosus favour ruinous buildings, actually used as animal shelters sometimes in the immediate vicinity of new tourist bungalows. A typical allergic response upon sandfly bites occurs in almost all of the newcomers. This skin irritation is wellknown as urticaria multiformis endemica of Harara. Local people and tourists connect this itching disorder with certain types of sun trauma and do not take notice of their real etiology. Cortisone treatment in severe cases may facilitate the start of simultaneously transmitted leishmaniasis. The possible epidemiological role, which the dog travelling to southern countries in connection with leishmaniasis plays, is considered.