Several recommendations were made pertaining to scientific, operational and organizational issues.

Scientific Recommendations

1. Veterinary epidemiologic research is urgently needed to better understand the zoonotic implications of S. japonicum infections with a goal of creating testable control measures in domestic animals. Such studies should include:

a) community studies of the contribution of animal infections to S. japonicum transmission to humans;

b) Concrete studies of manure management and its impact on transmission to animals and humans;

c) studies of water buffalo socio-demographics, economics and the influence of their health on farmerss economic productivity.

2. Immunodiagnostic methods for S. japonicum infection detection in humans and in animals should continue to be developed and epidemiologically tested in a variety of populations with different infection prevalences and intensities.

3. Mathematical models of human transmission of S. japonicum should be developed and elaborated with community data from the different ecozones. Statistical models of animal to human transmission should be developed as more experimental and community data become available. These models should be used as part of the evaluation of the impact of Praziquantel treatment and/or vaccines on infection rates.

4. Vaccine development should continue with both laboratory studies and field tests of vaccine candidates in animals and humans.

5. S. japonicum infection and disease control strategies should continue to be studied through detailed community studies in the different ecozones in China and The Philippines. The cost-effectiveness of control strategies need to be compared including annual or biennial case-finding and treatment, targeted mass treatment, and community mass treatment, and in both humans and animals.

Operational Recommendations

l. National schistosomosis japonica control programs should base their infection surveillance in endemic areas on one stool sample with duplicate slides per resident. Regular training of control program medical technicians should be performed to improve sensitivity of egg detection

Organizational Recommendations

1. A regional network on schistosomosis japonica should be established. The purposes of this network group are to:

a) locate finding opportunities for research on surveillance and control of S. japonica transmission in humans and animals;

b) disseminate information about ongoing research and training opportunities; c) develop standardized protocols for infection and disease surveillance;

d) evaluate current control strategies;

e) share plans for new studies and explore potential for international collaborations.

2. An expert working group on S. japonicum should be established. This expert panel will:

a) develop a range of S. japonicum infection control strategies based on review of existing data;

b) begin the building of formal models on S. japonicum infection and disease;

c) plan new studies to determine relative efficacy and cost of controlling infection vs morbidity in certain endemic areas.

3. The Regional Network should seek relatively small amount of funding to ensure fast communication (e-mail and telefax) between S. japonicum researchers and control authorities in the region, establish a World Wide Web site, an e-mail address, and to plan a meeting in two to thr