A word of caution has been sounded in the U.S about the rise in cases of pertussis, a highly contagious, bacterial respiratory disease.
There have been 22 cases since January including seven children below one year of age.
More than 3,000 cases of the illness have been diagnosed in Washington State. That's 13 times what they saw by this time last year.
The health district has advised health care providers and parents to receive the vaccine.
If patients come with symptoms, physicians and healthcare providers have been advised to test patients for pertussis.
Adults who care or live with infants have been advised to take the vaccinations.