Germany is a federal republic with 16 states subdivided into 440 counties. As in many countries the local (county) health departments (total number: 425) are the primary recipients of infectious disease notifications made by physicians and laboratories. Local health departments verify the incoming notifications and assess the need for public health action. Local health departments use one of five software products on the market to classify the case reports according to the national edition of case definitions and to report these cases electronically to the state health department. From there the report is being forwarded to the Robert Koch Institute (RKI), the federal institution in charge of national infectious disease surveillance in Germany [11] .