Health Alerts
Last updated: October 6, 2026
Epic Health Alerts use statistical models to identify counties or states experiencing elevated rates of health conditions based on Cosmos data. Alerts are reviewed by the Epic Research team before publication. For details on our detection process and data source, see the Methodology section below.
Rates with an asterisk are from partial weeks.
Number of Alerts by State
Monitoring all 50 states for thousands of conditions. Hover for details.
Alerts By Condition
Thousands of conditions monitored: 15 with a current alert.
Select a condition or multiple conditions below to display areas with alerts for that condition.
Acute Pharyngitis
An inflammation of the throat (pharynx) that causes sore throat, pain with swallowing, and fever. The cause can be an infective organism or other types of irritants. This alert reflects elevated diagnosis rates above expected seasonal levels.
| State | County | Estimated Onset | Cases per 100k (Latest Week) |
|---|---|---|---|
| Alabama | Lamar | 8/17/2026 | 5286.3 |
| Kentucky | Rockcastle | 8/24/2026 | 3281.1 |
| North Dakota | Morton | 8/31/2026 | 1011.8* |
| Oklahoma | Wagoner | 8/17/2026 | 8695.7* |
| Oklahoma | Washington | 8/10/2026 | 5555.6* |
| South Carolina | Sumter | 8/10/2026 | 818.6* |
Acute Tonsillitis
Acute tonsillitis is an inflammation of the tonsils that can be caused by viruses or bacteria. Testing can help determine whether acute tonsillitis is bacterial in origin and requires antibiotic treatment. Most cases are caused by viruses and resolve without specific treatment. Bacterial tonsillitis, most commonly caused by group A streptococcus, accounts for a minority of cases. Acute tonsillitis can be spread through respiratory droplets from coughing, sneezing, or close contact. Symptoms include sore throat, red and swollen tonsils, fever, and difficulty swallowing. This alert indicates an elevated level of acute tonsillitis above expected seasonal levels.
| State | County | Estimated Onset | Cases per 100k (Latest Week) |
|---|---|---|---|
| Ohio | Shelby | 8/31/2026 | 224.2 |
Adenovirus
Adenoviruses are a group of common viruses that most often cause respiratory symptoms like cough, runny nose, sore throat, fever, or less commonly, pneumonia. However, adenoviruses can also present a range of symptoms from conjunctivitis (pink eye) to gastrointestinal symptoms. They spread through respiratory droplets from coughing and sneezing, close personal contact, and touching contaminated surfaces. This alert reflects an elevated rate above expected seasonal levels.
| State | County | Estimated Onset | Cases per 100k (Latest Week) |
|---|---|---|---|
| Florida | Brevard | 9/14/2026 | 252.9* |
Campylobacteriosis
Campylobacteriosis is a common bacterial infection of the digestive tract caused by Campylobacter bacteria and is a frequent cause of gastrointestinal illness. Most people become infected through undercooked poultry or other contaminated food, unpasteurized (raw) milk, untreated water, or contact with infected animals. Symptoms usually begin two to five days after exposure and commonly include diarrhea (sometimes bloody), stomach cramps, fever, and nausea. Part of the observed increase in diagnoses might be related to increased awareness and testing for GI illnesses in recent weeks.
| State | County | Estimated Onset | Cases per 100k (Latest Week) |
|---|---|---|---|
| Kentucky | (State-Wide) | 7/20/2026 | 40.5* |
Croup
A common childhood respiratory infection that causes swelling around the vocal cords, resulting in a distinctive barking cough and noisy breathing. Croup is usually caused by parainfluenza viruses and is most common in fall and winter. This alert reflects elevated diagnosis rates above expected seasonal levels.
| State | County | Estimated Onset | Cases per 100k (Latest Week) |
|---|---|---|---|
| Missouri | Clay | 9/14/2026 | 95.6 |
Cyclosporiasis
Cyclosporiasis is an intestinal illness caused by Cyclospora cayetanensis, a microscopic parasite. People become infected by consuming food or water contaminated with the parasite; it is not spread directly from person to person. The most common symptom is watery diarrhea, which can be prolonged and may come and go over several weeks if untreated.
| State | County | Estimated Onset | Cases per 100k (Latest Week) |
|---|---|---|---|
| Kansas | (State-Wide) | 7/6/2026 | 8.3* |
| Kentucky | (State-Wide) | 6/29/2026 | 16.2* |
| Michigan | (State-Wide) | 6/22/2026 | 24.5* |
| Ohio | (State-Wide) | 6/22/2026 | 20.6* |
Dengue Fever
Dengue fever is a viral illness spread through the bite of dengue-infected mosquitoes; it is not spread directly from person to person. Many infections are mild or cause no symptoms, but when symptoms occur they can include high fever, severe headache, pain behind the eyes, muscle and joint aches, and rash. Some may develop severe dengue, including bleeding from the nose or mouth, persistent vomiting, blood in the stool, and severe abdominal pain, which may result in hospitalization or, in some cases, death.
| State | County | Estimated Onset | Cases per 100k (Latest Week) |
|---|---|---|---|
| Florida | Hillsborough | 8/17/2026 | 19.1* |
Group A Strep
Group A Streptococcus, commonly referred to as strep, is a bacterial infection spread person-to-person through respiratory droplets and direct contact with infected bodily fluids or skin. It causes a range of illnesses, most commonly, strep throat. Less often it can lead to more serious invasive infection such as necrotizing fasciitis and sepsis.
| State | County | Estimated Onset | Cases per 100k (Latest Week) |
|---|---|---|---|
| Indiana | Bartholomew | 8/24/2026 | 38.9 |
Hand, Foot, and Mouth Disease
Hand, foot, and mouth disease is a common and contagious viral illness caused by enteroviruses, most often affecting young children. Symptoms include fever, mouth sores, and a skin rash on the hands and feet. This alert reflects elevated diagnosis rates above expected seasonal levels.
| State | County | Estimated Onset | Cases per 100k (Latest Week) |
|---|---|---|---|
| Iowa | Wapello | 9/21/2026 | 691.7 |
| Indiana | Madison | 9/14/2026 | 105.1 |
| Maryland | Allegany | 9/21/2026 | 161.6 |
Heat Illness
Heat illness is a group of acute conditions that occur when the body's heat gain exceeds its ability to cool itself. It ranges from heat cramps, heat syncope (fainting), and heat exhaustion to heatstroke, a life-threatening medical emergency. Symptoms can include heavy sweating, muscle cramps, dizziness, nausea, headache, and, in severe cases, confusion or loss of consciousness. This alert reflects an elevated rate of visits for heat-related illness in the affected area, more visits than would typically be expected for this location and time of year.
| State | County | Estimated Onset | Cases per 100k (Latest Week) |
|---|---|---|---|
| Illinois | (State-Wide) | 8/31/2026 | 1.9 |
Legionellosis
Legionellosis is a respiratory infection caused by Legionella bacteria. People become infected by breathing in small water droplets containing the bacteria; contaminated droplets can come from water systems that are not well maintained, such as cooling towers, hot tubs, large plumbing systems, or decorative fountains. It is generally not spread from person to person. Its more serious form, Legionnaires' disease, is a type of pneumonia with cough, shortness of breath, fever, muscle aches, and headache. A milder form, Pontiac fever, causes a flu-like illness without pneumonia.
| State | County | Estimated Onset | Cases per 100k (Latest Week) |
|---|---|---|---|
| Florida | (State-Wide) | 9/21/2026 | 10.8* |
Measles
A highly contagious viral illness spread through airborne droplets that causes fever, cough, and a characteristic rash. Measles can lead to serious complications including pneumonia and encephalitis, which may result in hospitalization or, in some cases, death. The MMR vaccine is the best way to prevent measles and its complications, but vaccination rates have recently declined. Elevated rates likely signal gaps in community immunity.
| State | County | Estimated Onset | Cases per 100k (Latest Week) |
|---|---|---|---|
| New York | (State-Wide) | 8/24/2026 | 10.7* |
| Pennsylvania | (State-Wide) | 7/20/2026 | 9.2* |
Salmonellosis
Salmonellosis is an infection caused by Salmonella bacteria that usually affects the intestines. People most often become infected by eating contaminated food such as raw or undercooked poultry, eggs, and meat, unpasteurized milk, or contaminated fruits and vegetables. People can also become infected through contaminated water or through contact with certain animals. Common symptoms are diarrhea, fever, and stomach cramps, which usually begin within 6 hours to 6 days after exposure and resolve within a week. Occasionally, the infection can spread beyond the intestines to cause more serious illness.
| State | County | Estimated Onset | Cases per 100k (Latest Week) |
|---|---|---|---|
| West Virginia | Monongalia | 9/21/2026 | 119.7* |
Strep Throat
Strep throat is a bacterial infection of the throat and tonsils caused by group A Streptococcus. Prompt antibiotic treatment of confirmed strep throat can reduce symptom duration and prevent rare but serious complications. Strep throat spreads through respiratory droplets from coughing or sneezing, or through close contact with an infected person. Symptoms include sudden onset sore throat, fever, red and swollen tonsils, and swollen lymph nodes; cough is typically absent. This alert indicates an elevated level of strep throat above expected seasonal levels.
| State | County | Estimated Onset | Cases per 100k (Latest Week) |
|---|---|---|---|
| Mississippi | Jones | 8/10/2026 | 1117.3* |
| New Mexico | Roosevelt | 8/24/2026 | 2140.7 |
| Texas | Howard | 8/17/2026 | 1153.9* |
Valley Fever
Valley fever, also called Coccidioidomycosis, is a fungal infection caused by Coccidioides, a fungus found in soil primarily in dry regions of the United States. People become infected by breathing in fungal spores from dust or disturbed soil; it is not spread from person to person. Symptoms, when present, often resemble pneumonia or the flu and can include fatigue, cough, fever, chest pain, and muscle or joint aches.
| State | County | Estimated Onset | Cases per 100k (Latest Week) |
|---|---|---|---|
| California | Solano | 8/17/2026 | 65.7 |
Methodology
- Data Source
- Health Alerts are generated based on analysis in Cosmos. For more information, visit About Cosmos.
Health Alerts are based on data from Epic Cosmos participating organizations. They do not reflect complete case counts for a condition but rather evaluate population level trends of disease activity.
- How Conditions Are Identified
- Our detection process monitors diagnosis rates at the county or state level using ICD-10-CM diagnosis codes. A condition is flagged for review when it meets all the following criteria:
Year-over-year increase. The rate of the condition must be higher than it was during the same period in the prior year. This accounts for normal seasonal variation, such as a rise in flu diagnoses during winter, which would not trigger an alert on its own.
Accelerating growth. The share of the condition (the proportion of this diagnosis relative to all patients seen) must be growing at an increasing rate. Specifically, the growth from last month to this month must exceed the growth from two months ago to last month. This ensures the model is responding to conditions that are increasing rapidly, not simply trending gradually upward.
Statistical significance. Conditions that meet the first two criteria are then evaluated using a Farrington improved algorithm, a well-established method in public health surveillance. This model uses three years of historical data to establish expected baseline rates, further adjusting for seasonality and long-term trends, and confirms that the observed increase is statistically significant and not likely due to random variation.
- Clinical Review
- All statistically flagged conditions are reviewed by the Epic Research team, which includes clinicians and data scientists, before being published. This manual review step assesses whether the alert is clinically meaningful and appropriate for public reporting.
- Statewide vs County-level Alerts
- Under most circumstances, alerts will be issued at a county level, rather than at a state level. However, for conditions that have a small number of cases in affected counties, we may issue a statewide alert rather than a county level alert to help preserve patient privacy. We may also issue a statewide alert when a condition meets the alerting criteria when aggregated across the entire state but few or no individual counties meet the alerting criteria.
- Types of Conditions Detected
- The criteria for determining alerts are designed to surface conditions that are both increased from historical rates and accelerating. Alerts are most likely to appear for acute conditions, communicable diseases, and rare or unexpected spikes rather than for chronic conditions or predictable seasonal patterns.
- Update Frequency
- The Epic Research team typically reviews model output on weekdays. New alerts are published as clinically relevant conditions are identified; there is no fixed publication schedule. Alert activity on this page reflects the most recent completed review.
- Column Definitions
- Cases per 100k (Latest Week) — The number of patients with the condition per 100,000 total patients with an encounter in the county during the reporting week.
Estimated Onset — The date the elevated rate first occurred as detected by our model.
