In 1892 and the preceding years, Harrisburg's population had enjoyed relatively strong health. Epidemics of deadly disease were rare, and many annual health reports were similar to that of 1892, which stated, "The low death rate (per 1000) not supassed by any city in the Union, the small number of deaths from contagious and infectious diseases...is evidence that our city from a sanitary stand-point, is unsurpassed" (101). Diseases like cholera were still immensely feared, but Harrisburg officials, well aware of the dangers and destruction disease could bring, lauded themselves on taking proper precautions and conducting regular inspections to keep an epidemic from happening. Even so, they still recognized room for improvement and made suggestions regarding sewers (especially near the hospital) and buildings in order to maintain good public health.
By 1894, a short two years later, Harrisburg's health had began to deteriorate. Diseases like smallpox, diphtheria, and scarlet fever reared their ugly heads to the point where a new hospital was built. Patients at this hospital primarily suffered from smallpox. As a result of this outbreak, the officials who put together the 1894 report made further suggestions to improve the city's health, such as procedures regarding the dumping of sewage and the need for a meat, food, and milk inspector (pages 76-83).
This chart, found on page 84 of Harrisburg's 1894 report, shows the number of Harrisburgers afflicted with these deadly diseases. A year later, in the 1895 report, city officials complained that they had difficulty controlling diseases such as these because many people in Harrisburg refused to believe in the contagious nature of them and thus did not take proper precautions to protect themselves (100). Harrisburg citizens had fared better that year than in 1894 when it came to diseases (101, 105), but 1899 proved to be another devastating year. There was only one case of smallpox (and no deaths), 118 cases of diphtheria, and 88 cases of scarlet fever, which was a decrease from the outbreaks of 1894 (1899 report, 175). However, 1899's numbers were still significantly greater than they were in the years after 1894, and there were similar outbreaks the following year. The 1890s, overall, saw an increase of diseases from the previous decade, and despite attempts to improve the city's sanitary conditions, epidemics persisted.