Pertussis vaccine wholesale in the developing world at a cost of 15.41 USD per dose as of 2014. Acellular pertussis vaccine (aP) with three or more antigens prevents around 85% of typical whooping cough cases in children. It has higher or similar efficacy to the previously-used whole cell pertussis vaccine, however the efficacy of the acellular vaccine declines faster. Acellular vaccines also cause fewer side effects than whole cell vaccines. Despite widespread vaccination, pertussis has persisted in vaccinated populations and is one of the most common vaccine-preventable diseases. The recent resurgence in pertussis infections is attributed to a combination of waning immunity
Dieterich's disease Dieterich's disease Dieterich’s disease, also known as avascular necrosis of the metacarpal hand, is an extremely rare condition characterized by temporary or permanent loss of blood supply to the metacarpal head of the metacarpal bone, resulting in loss of bone tissue. The five metacarpal bones are long bones located between the carpals of the wrist and phalanges of the fingers. Collectively, the metacarpals are referred to as the "metacarpus." The metacarpals are important in maintaining grip strength and mobility of the fingers. Dieterich's disease is often confused with Mauclaire disease, which is characterized by symmetrical flattening of all metacarpal heads.