There are several likely reasons why all four died in 1860. Jefferson Township sat in a low-lying agricultural area near waterways and wells, and in the 1850s–1860s rural communities were especially vulnerable to waterborne disease outbreaks including typhoid, dysentery and scarlet fever. According to surviving 1860 mortality records there were multiple deaths from typhoid fever in Jefferson during that same year. This strongly suggests there was infectious disease circulating locally in 1860.

In the years before modern sanitation, a contaminated well could affect an entire extended family or cluster of neighboring farms. Also, Jefferson was connected by roads and trade routes to both Frederick and Harpers Ferry, which increased movement of people and diseases.