The cold and flu aren’t the only things you need to worry about this winter. Washington County Public Health’s Lynn Fisher says whooping cough starts like a cold, but then becomes more severe after a few weeks, with symptoms including violent fits of coughing.

Also known as pertussis, the illness was given the name due to the distinct whooping sound common that follows a series of coughs in those older than six months.

In 2012, the Center for Disease Control saw a 400% increase in whooping cough cases. Beginning this school year, Iowa began requiring students entering the 7th grade receive the Tdap, which includes the pertussis vaccine.