A walk through a cemetery -- something many people do as Memorial Day approaches -- offers grim evidence of how often in the past children succumbed to diseases now kept at bay by routine vaccinations. It's impossible to see a lamb headstone guarding an infant's grave and not be grateful for living in an era in which having all your children live to adulthood is the norm, not the exception.

But a whooping cough outbreak in Washington State -- as well as alarming increases in whooping cough in Minnesota and Wisconsin -- serve as sobering reminders that some of these pathogens still lurk in everyday places and are capable of causing serious illness.

Keeping our collective guard up means ensuring that kids get a full set of shots. It also means having adults more vigorously shoulder their responsibility for getting vaccine boosters -- particularly for whooping cough, a bacterial infection that can be spread unknowingly by adults. (Protection provided by childhood immunizations can weaken with age.)

Washington health officials recently declared their 1,284 cases of whooping cough, also known as pertussis, to be an epidemic. Closer to home, health officials are also seeing a disturbing spike.

Nearly 700 cases have been reported so far this year in Minnesota -- more than the number reported for all of 2011. Wisconsin health officials are reporting 1,159 confirmed or probable cases of pertussis as of May 8. That's nearly the number of cases reported for all of last year. No deaths have been reported in Minnesota, but one infant in Wisconsin has died.

Pertussis cases typically wax and wane in three- to five-year cycles. But Minnesota health officials note that the trend here appears to be an "escalating roller coaster," with peak numbers trending higher. "We definitely have the potential to have a huge year again,'' said Kris Ehresmann of the Minnesota Department of Health. "That's why ... we want to make sure we have fully vaccinated adults and adolescents so they can't serve as a reservoir for transmitting the disease.''

Routine medical exams now usually include a push from providers to get a flu shot. The same vigilance is needed for the relatively new pertussis booster -- typically given in a shot that also protects against tetanus and diphtheria -- for adolescents and adults. If providers don't ask, patients should inquire about whether their boosters are up to date, especially if they're going to be around infants.

Babies typically get a set of pertussis shots beginning at 2 months, followed by another at 4 months, then at 6. Until this initial series is complete, they depend on a community "cocoon" of protection provided by immunized individuals. That's why boosters for adults are so important.

Little Everlee Stevenson of Maplewood was 5 weeks old last November when she was diagnosed with pertussis. She spent a month in the hospital. Her mother, Emily Stevenson, recalls watching her baby struggle mightily to breathe during the disease's peak phase. Everlee would turn blue and her heartbeat would drop dangerously low.

Doctors could do little. Antibiotics can reduce the risk of contagion but typically don't shorten the course of illness. "It's such a helpless situation," Emily Stevenson said. "She couldn't eat, she couldn't sleep, she hardly had the energy to even cry.''

Everlee still had a morning cough on Wednesday, but is recovering. Her mother is now speaking out, urging parents to immunize their children and for adults and adolescents to get boosters. Said Emily Stevenson: "We really see how other people's decisions can impact the entire community.''

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