By combining 'on-the-ground' practitioner-based information with geographically broader analysis of ADRS data, we identified an emerging disease situation involving TB lesions in swine. A preliminary epidemiological investigation suggests that likely principal risk sources are related to feed and ground water (1). Analysis of ADRS condemn data suggests that several lower Midwest slaughter facilities in addition to the affected plant used by producers involved in the investigation may have been affected by STB.