In 1803, a devastating Yellow Fever epidemic swept through Alexandria, sickening over 1,000 residents and resulting in approximately 197 deaths. At the height of the outbreak, horse and donkey carts moved through the town daily to collect the dead from the previous 24 hours. The overwhelming number of deaths taxed Alexandria’s small burial grounds beyond capacity and led to mass burials. The experience exposed serious weaknesses in the town’s burial infrastructure, setting the stage for major public health reforms the following year.