Dear Don,

It looks like you may have had some cucumber beetles in your pumpkin patch which has spread Bacterial wilt in the patch. Just to be sure, I'll send some information on a variety of diseases that can affect cucurbits here:

Cucumber, Squash, Melon & Other Cucurbit Diseases | Home & Garden Information Center (clemson.edu)

Here is additional information on  bacterial wilt. Sadly, it is a common problem, best dealt with by dealing with the cucumber beetles earlier in the season.

Bacterial wilt of cucurbits | UMN Extension

rutgers also has a good factsheet on diseases:

E310: Diagnosing and Managing Important Cucurbit Diseases in the Home Garden (Rutgers NJAES)

Additionally, here is some information on growing pumpkins:

Growing Pumpkins in a Home Garden | University of Maryland Extension (umd.edu)

I hope you find the information helpful.  I often have this same problem in my own garden. Some years are better than others but those beetles can certainly do a lot of damage.

I sprayed twice with neem oil. Should I be spraying more often or use something stronger?

Dear Don, 

Neem oil can be used but may not be as effective depending on when it is applied. There are a variety of Pest Management optiions available in this factsheet. Personally, I have had best results with pesticide sprays which include the chemicals listed in the factsheet. When using any insecticides, follow all the label instructions for safe use.

Cucumber beetles in home gardens | UMN Extension

Additionally, you may see squash bug damage in pumpkins. This factsheet may  be helpful for that problem. Sometimes both bugs arrive to disrupt your garden.

Squash Bug (psu.edu)

Happy gardening,