Salmonid whirling disease, caused by the myxosporean parasite Myxobolus cerebralis, was first observed in the United States in 1956 in central Pennsylvania. The parasite was subsequently discovered at several culture facilities throughout the state, and widespread distribution of this parasite via the stocking of subclinically infected brook trout Salvelinus fontinalis, rainbow trout Oncorhynchus mykiss, and brown trout Salmo trutta has been assumed. Although no monitoring of wild populations occurred until the late 1970s, it is a common belief that epizootics of whirling disease, now realized in the Intermountain West, are unlikely to have occurred in Pennsylvania. We conducted a review of historical information and a synoptic survey aimed at identifying factors that may prevent whirling disease outbreak in this region, reasoning that such information might be useful in identifying management strategies for populations affected by this parasite. Here we present data on parasite prevalence, fish populations, stream attributes, and the genetics of Tubifex tubifex (the obligate oligochaete host for the parasite) to evaluate various hypotheses proposed for low whirling disease impact in the region. We did not find clear associations between factors such as stream gradient, the genetics of T. tubifexpopulations, or the composition of resident trout populations and the pattern of M. cerebralis occurrence in Pennsylvania. We suggest that this pattern may be best explained by the association between T. tubifex host populations and point sources of organic enrichment. The potential restriction of T. tubifex populations to locations near sources of organic enrichment may be a factor in explaining why whirling disease has not been observed to cause population declines among wild trout in this region and should be further investigated.