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What's Going Around: Respiratory, stomach issues persist this week

UPMC Pinnacle's Heritage Pediatrics reports there are a lot of stomach viruses going around.  Most of these are starting with loss of appetite then frequent vomiting for the first one to three days.  There has been diarrhea associated with this as well.  The stomach pain and loss of appetite can last on and off for up to a week. 

It is important to rest the stomach after vomiting for at least 30 minutes and only take small sips of fluid, one to two tablespoons, every five to 10 minutes.  If the abdominal pain is severe, or if your child cannot keep sips of fluids down, or if they are urinating less than usual, then they should be evaluated by their doctor or medical provider as soon as possible.

The CVS MinuteClinic in York reported they have seen an increased amount of chest colds, including upper respiratory infection and viral bronchitis, and a few cases of strep thorat and sinusitis.  Strep and bacterial sinusitis is treated with antibiotics as well as over-the-counter medications for symptom management. Viral infections are treated to manage symptoms. Viral bronchitis may include use of expectorants, and at times a prescribed rescue inhaler for wheezing. Viral illness typically lasts anywhere from three to 14 days.

"We are still vaccinating, but haven't seen much influenza illness just yet," Nurse Practitioner Stacey Basta said.

WellSpan Pediatric Medicine has seen a spike of community acquired pneumonia and bronchitis in Lancaster County.

Also, WellSpan Urgent Cares in York County locations report a number of patients with nose bleeds as dry heated air in homes can promote nasal dryness and bleeding.

As we are seeing a cold snap, they recommend layer bundling, especially for children, and gloves/mittens and warm hats to help stave off hypothermia and cold-related skin injuries.

Also, it's not at all too late for flu vaccine as we are not out of the woods at all this winter and positive immunization effects can start as short as two weeks post vaccine, WellSpan officials said.

A lot of coughs, colds, and ear infections are going around this week at Penn State Children's Hospital and Penn State Health Medical Group. At the Children's Hospital, providers have also seen a lot of respiratory infections and a few cases of the flu.

Penn Medicine Lancaster General Health Physicians Roseville Pediatrics continued to see a high rate of viral colds, as well as the ear infections that can stem from them.

Bronchiolitis has persisted with 12 cases this week. Croup has been consistent as well, with around 40 cases.

Sore throats have remained mostly viral, with about 30 percent of the cases being strep. They did see an increase in the GI bug, with vomiting and diarrhea occurring for about three to five days.

Unfortunately, they continued to see a lot of asthma exacerbations as well.

Dr. Joan Thode offered the following advice about ear infections:

"Understanding how the ear functions is important to understand how ear infections form.
I like to equate the inner ear to a fountain. The ear consistently creates fluid for its function. A fountain's water will spring out from the top and go through its various spouts and platforms until it empties through the drain at the base of the pool. In much the same way, once the inner ear fluid is used, it continues moving downward through the inner ear until it drains through "drainage pipes" called Eustachian tubes that dump that water into the throat. We simply swallow the fluid along with saliva etc., and it eventually leaves the body.

With an ear infection, the drain pipe gets clogged. Typically, a child has a cold, and the immune system responds by sending soldier cells to the area to destroy the virus. While this gets rid of the virus, it also causes the tissues of the nose, sinuses and throat to become a bit swollen, and the openings of the Eustachian tubes to swell shut. And if the drain is clogged, the water starts to build up in the fountain. With the Eustachian tubes blocked, the inner ear fluid-which will continue to be produced for the function of the ear-starts to accumulate.

This fluid buildup would cause little more than some annoying discomfort if it weren't for bacteria. This is where the infection part comes in. Bacteria naturally populate the lining of the inner ear. While not dangerous, these bacteria are opportunistic, and pooled, built-up ear fluid is the perfect breeding ground. The inner ear starts to become a petri dish.

The immune system quickly discovers and attacks the bacterial overgrowth. Though this is very effective, the large multitude of white blood cells adds to the volume of fluid in the inner ear. All of this volume pushes on the eardrum, a flexible membrane that starts bulging with the pressure of the fluid. This stretches the nerves that run across the eardrum's surface, causing-often severe!-pain.
As for curing an ear infection, the immune system will do that on its own. The clearance of an ear infection largely depends on the resolution of the viral illness and subsequent reopening of the Eustachian tubes. While the immune system of babies younger than 12 months needs a boost from antibiotics to beat the bacteria, the fully functional immune system of older kids just needs time. In this age group, an NSAID medication (ibuprofen) is the best way to treat pain.

Ear infections are not contagious because they are an overgrowth of the bacteria that are fully contained. Reasons to see your doctor include prolonged ear pain, persistent fevers, ear drainage or severe pain that is not lessened by ibuprofen."

Geisinger Holy Spirit Pediatrics in Cumberland and Dauphin counties reported colds, ear infections, sinusitis, upper respiratory infections and strep throat.


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