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From what I have read about the Washington State epidemic, the number of cases is around 2000, but they are thinking less than 1 in 5 cases is confirmed and reported. The test for pertussis is expensive, so a lot of docs simply listen, guess that it is pertussis and start the antibiotics. So there are a lot more cases than the 2000. What is interesting from a parental standpoint is that Washington has one of highest opt-out rates for vaccines and now has the highest rate for pertussis.