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Is 2014 turning into a bad year for whooping cough?

A school nurse prepares a vaccine against whooping cough before giving it to students at Mark Twain Middle School in Los Angeles.

The city of Long Beach and the counties of Orange, Riverside and Ventura are all reporting a spike in cases of pertussis, or whooping cough, so far this year. The state health department says it is too soon to tell whether the surge indicates that this will be a particularly bad year for the disease.

On Tuesday Long Beach said it has had 43 cases reported so far in 2014 -- that's more than the number of cases in the previous three years combined.

Orange County has had 32 reported cases to date in 2014. By this time in 2013, it had 12, and at this point in 2012, it had 11.

RELATED: Measles cases have officials worried about vaccine refusers

Riverside County has 39 reported cases so far this year. At this point in 2013, it had eight reported cases, and at this point in 2012 it had 11. In January, one infant died of pertussis in the county.

Ventura County has 28 reported cases to date in 2014. That compares with four at this point in 2013, and 11 at this point in 2013.

The California Department of Public Health says cases of whooping cough have been increasing across the state since the middle of last year.

RELATED: Check out the 2013-14 vaccination rate at your child's elementary school

Whooping cough peaks every three to five years, and California’s last major outbreak was in 2010. But James Watt, chief of the division of communicable disease control at the Department of Public Health, says it’s too early to know if this is the beginning of the state’s next big wave.

"It is concerning that we’re seeing higher levels of disease than we saw a year or so ago, but it’s always challenging to predict what will happen with infectious diseases," Watt said.

Watt said the state would continue to monitor whooping cough, which is highly contagious. In the meantime, he encourages vaccination, especially for pregnant women and infants. 

There is a minority of parents who refuse to vaccinate their children, out of the mistaken belief that vaccines cause autism, or out of fear that vaccines might cause other health problems. Researchers say vaccine refusal did play a role in California's 2010 pertussis outbreak, which claimed 10 lives.