European foulbrood (EFB) is a severe bacterial disease of honey bee brood often leading to significant declines in colony health and honey production. The dearth of data on this disease in the United States (US) complicates response efforts. In this study, we combine surveillance and molecular epidemiology to investigate prevalence, diversity, and transmission dynamics of Melissococcus plutonius, the causative agent of EFB, in US honey bee colonies. Rates of infection and disease were found to be seasonal, with prevalence peaking in June when over half the colonies screened were infected. Whole genome, single nucleotide polymorphism analysis revealed wide genetic diversity even within a single hive. Operations often had multiple genotypes present which varied from year to year, consistent with high rates of transmission and reinfection. Prevalence and whole genome data provided here will be critical in tracking the efficacy of mitigation efforts and underscore the necessity of additional epidemiological investigations.