Background: In May 2003 the Soest County Health Department was informed of an unusually large number of patients hospitalized with atypical pneumonia.

End of May 2003 the health department of Soest (HDS), Germany, was notified by a local hospital of an increase of patients with atypical pneumonia. An outbreak investigation was conducted to identify the etiologic agent, extent and source. The first case-control study (case-base design) was conducted to see whether attending a farmers' market where a sheep was lambing, was positively correlated with disease or whether another source was possible. It was conducted with clinical cases registered in the town of Soest and population-based controls from the same town regardless the disease status. In a second case-control study risk factors in the farmers' market were investigated. Therefore only cases and controls from Soest that had attended the farmers market were enrolled. The infectious agent Coxiella burnetii was detected by laboratory testing of patients and the ewe. 299 outbreak-associated cases were reported nation-wide with the majority of cases from the district of Soest. Exploratory interviews led to the hypothesis that a sheep that had given birth to a lamb during a farmers' market on May 4 could be the source. Blood samples confirmed the diagnosis. In the first case-control study, visitors to the farmers' market were 210 times (95%CI=22-3601) more likely than non-visitors to develop Q fever. In the second case-control study the time spend at the gate (OR=17, 95%CI=3,0-112,54) and close distance to the sheep (OR=5, 95%CI=1,17-22,34) were significantly associated with illness. The outbreak was associated with close proximity to a sheep that had given birth to a lamb. We recommend that pregnant ewes in the latter third of their pregnancy are banned from display in the public and that sheep that have close contact with the public are tested for Coxiella burnetii. P2.42: Interactive web based presentation of infectious disease notification data in Lower-SaxonyHolger Scharlach*, Johannes Dreesman * Corresponding Author: Niedersächsisches Landesgesundheitsamt, Hannover email: holger.scharlach@nlga.niedersachsen.deIn Lower-Saxony the analysis of notification data according to the infection protection law is based on two pillars: One pillar is the weekly data analysis in order to identify clusters and locally non detectable outbreaks in the sense of an early warning system. The second pillar is a yearly reporting system for obtaining an overall picture and identifying long-term trends. For spatial-temporal visualization of these infectious disease data an interactive, web based tool was developed. The presentation is based on the weekly case counts and incidence rates for the 12 most important pathogens. The screen is divided into two panels. One panel shows the yearly incidence rates of the 46 districts and district-free towns by means of a choropleth map. The other panel gives either textual information on the selected disease or shows a time series of the weekly case numbers and a histogram of the age distribution. If a district is interactively selected from the map, this district's time series is dynamically...