Illinois health officials released a warning Monday as whooping cough cases in the state rose to their highest levels in two decades.

January through November, South Dakota has confirmed 258 cases of pertussis, also known as whooping cough. The five-year median is 34 cases. This year South Dakota is experiencing 659% more than usual.

The latest data from the Centers for Disease Control and Prevention is reporting that fewer children are getting vaccinated. Coverage declined to less than 93% for all reported vaccines.

And a lot of times the kids who have that cough it’s usually that type of cough that takes your breath away sometimes they’ll cough until they vomit,” said Noland. The in