The forerunner to the U.S. Public Health Service (USPHS) begins tracking morbidity rates related to illnesses such as smallpox, cholera, yellow fever, and the plague. This process begins in an effort to determine who needs to quarantine and for how long in order to reduce the spread of these contagious diseases. Concurrently, physicians are encouraged to begin documenting illness and death rates among their patients for reporting to state-level public health agencies as they emerge.

The Marine Hospital Service is also authorized by Congress to collect morbidity reports from U.S. consuls overseas, in order to determine how to prevent diseases from entering the United States and spreading.