What’s Going Around: Flu, COVID-19, stomach bug

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This week, pediatricians at Penn State Health Children’s Hospital are seeing COVID-19, the flu, upper respiratory viruses, common colds and stomach viruses.

WellSpan Pediatric Medicine Physicians across the Midstate are seeing asthma, allergies, a stomach virus and upper respiratory tract infections that are not related to COVID-19 or the flu.

The CVS MinuteClinic in York reports viral upper respiratory infections, pharyngitis and a viral stomach bug with vomiting and diarrhea.

Penn Medicine Lancaster General Health Physicians Roseville Pediatrics reports a lot of flu activity this week, specifically influenza A. They saw a small increase in COVID-19 cases and a significant increase in strep throat. Croup cases are also up and they treated an increase in ear infections from viral illnesses. Pink eye is on the rise in daycare settings. Finally, they saw an increase in vomiting and diarrhea again. These syptoms were within the context of enterovirus and adenovirus, where there are also cold symptoms involved.

Dr. Joan Thode offered the following advice on fevers:

“Fevers have been a big part of the presentations of various viruses, especially flu. Influenza virus is notorious for causing high spiking fevers, and we have seen fevers in the 102-105 range with flu this week.

The most important thing you can do to help your child through an illness with fever is to give them water. The higher temperature causes evaporation of water from the skin surface, and with the typically low appetite and faster breathing can cause some dehydration. Your child will feel better overall if well-hydrated. Babies younger than six months should be hydrated only with normally-mixed formula or breastmilk—never with pure water—due to the immaturity of their kidneys.

You may see your child breathing a bit faster when they have a fever, and this is normal. All kids will breathe a little bit faster than their typical baseline when they have a high fever, but you want to see how much effort they are putting into breathing. Comfortable, slightly faster breathing is OK to observe at home, though very rapid (over 50 breaths per minute that persists) breathing or persistent expanding of the chest or belly in an exaggerated way for more than a minute or two is concerning. It’s about how stressed your child looks while breathing.

Your child may appear tired and have low energy with a fever, but they are not at a concerning level of true lethargy until they struggle to wake up and cannot maintain any coherent conversation or response due to immediately falling back asleep. To test for true lethargy in older kids, ask them a question. If they can answer it appropriately, they are alert. In younger, pre-verbal kids, try to have them engage in a toy or book that they like. If they respond appropriately, they are alert. True lethargy is a reason to call your physician right away.

All fevers lasting five consecutive days should be evaluated by a physician in the office, regardless of how your child appears, as they will likely need additional testing.

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