Whooping cough, or pertussis, a highly infectious respiratory disease once considered doomed by science, has struck Washington State this spring with a severity that health officials say could surpass the toll of any year since the 1940s, before a vaccine went into wide use.

Although no deaths have been reported so far this year, the state has declared an epidemic and public health officials say the numbers are staggering: 1,284 cases through early May, the most in at least three decades and 10 times last year’s total at this time, 128.

The response to the epidemic has been hampered by the recession, which has left state and local health departments on the front lines of defense weakened by years of sustained budget cuts…

Did you think Republicans and Blue Dog Dems were going to cut funds for Naval Bases in Washington State?

Skagit county’s top medical officer, Dr. Howard Leibrand, who is also a full-time emergency room physician, said that in the crushing triage of a combined health crisis and budget crisis, he had gone so far as to urge local physicians to stop testing patients to confirm a whooping cough diagnosis.

If the signs are there, he said…doctors should simply treat patients with antibiotics. The pertussis test can cost up to $400 and delay treatment by days. About 14.6 percent of Skagit County residents have no health insurance, according to a state study conducted last year, up from 11.6 percent in 2008…

State health officials estimate that because of incomplete testing and the assumption that many people with mild cases are not seeking medical treatment, perhaps as few as one in five pertussis cases is being recorded and tracked, suggesting that the outbreak is far more widespread than the numbers indicate.

Pertussis was once a dreaded disease of childhood — killing 5,000 to 10,000 Americans a year from the 1920s through the 1940s — but is now a risk mostly to infants, to whom it is fatal in about 1 percent of cases. Most of the victims in Washington, as in previous outbreaks in other states, are between 8 and 12…

The pertussis vaccine is commonly given in childhood, and many states require it for children of school age. But Washington State, according to a federal study last year of kindergarten-age children, had the highest percentage of parents in the nation who voluntarily exempted their children from one or more vaccines, out of fear of side effects or for philosophical reasons…

Or sheer stupidity, ignorance compounded by religious blather.

Ms. Selecky said immunizations were meant to protect not only individuals but also the broader population: the so-called herd immunity threshold. If a large enough segment of the population is unprotected from a disease — generally considered 5 percent to 15 percent, depending on the disease — even people with some degree of immunity through vaccination can have an elevated risk, she said.

I’ve told this tale before – to people too ignorant to know what life in this land was like before widespread availability of vaccines. Every year, at the end of winter, you could look around the urban neighborhood where I grew up and ask – “Who died this winter?”

There would be other school-age kids who died of scarlet fever, measles, diphtheria, whooping cough, German measles – all the ailments these vaccines fight against. Then, we could look forward to summer vacation – and polio.