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What's Going Around: Stomach bug, pneumonia, eczema

Penn Medicine Lancaster General Health Physicians Roseville Pediatrics saw a continued increase in influenza as well as pneumonia this week.

Viral colds continue to be the largest diagnosis seen, followed closely by sinusitis and ear infections that are secondary to those viruses.

They saw a persistently high number of both croup and bronchiolitis. Strep was about 45 percent of the sore throats seen, an increase in the last week.

Gastroenteritis cases were down overall. Finally, as the air persistently remains dry, they have seen a lot of eczema flares.

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

"Ear infections are infections by the bacteria that normally live inside our body cavities. These bacteria are actually helpful-they take up space so that worse bacteria can't move in. When inflammation of the nasal and throat tissues swells with the immune response to a virus, drainage from the inner ears is obstructed. Mucous and fluid back up, offering additional "real estate" for our native bacteria.
The inner ears produce fluid as part of their function of hearing. This fluid drains out tubes at the bottom of the inner ear into the throat. A viral "cold" will cause the throat to swell a bit due to the immune system's inflammatory response, and the ear drainage tubes swell shut. Without a drainage system, the fluid builds up in the inner ear cavity. Bacteria grow on this stagnant fluid, causing an ear infection. The immune system will send its "soldier cells" to the inner ear to fight that bacteria.

The pain from an ear infection comes from the combination of extra fluid, extra bacteria and lots of immune cells taking up extra space and pushing against the eardrum from the inside. The eardrum bulges as a result of this pressure, stretching the nerve that runs across the surface of the ear, causing it to register pain.

In most cases, antibiotics are not needed to clear an ear infection. As soon as the virus clears, the outflow tubes reopen, allowing the bacteria-laden fluid to drain. Antibiotics are indicated only in babies younger than 12 months or if the infection does not clear in the expected amount of time. In those cases, antibiotics can help the immune system clear the infection a day or two faster. Our goal as clinicians is to relieve the pain, which is best accomplished with ibuprofen. (Please note that ibuprofen can only safely be given to babies over 6 months of age.)"

The CVS MinuteClinic in Lancaster saw the following this week, according to Nurse Practitioner Jessica Myers:

"Bronchitis/Cough- We have seen increased visits for cough complaints. Other symptoms include slight shortness of breath with activity, tightness in chest and disturbed sleep. Most patients do not have a fever which can help differentiate from influenza. Treatments include Mucinex as an expectorant and OTC pain relievers if throat/chest muscles are irritated. Some patients with wheezes benefit from prescription inhalers. Any cough with prolonged fever, severe headache, weakness, fatigue, shortness of breath should be evaluated by a health care professional.

Nasopharyngitis/Common cold- Children are presenting with alternating runny nose and congestion, ear discomfort, no fever and dry cough. Rest, fluids and pain relievers as needed can be used to relieve symptoms. Humidified air, nasal saline, nasal sprays as tolerated are helpful. Symptoms peak at around 3-5 days and improve within 7-10 days.
 
Flu vaccine- We continue to have a steady flow of patients seeking vaccination. It is not too late. Patients reasons for vaccination include sick coworkers/family and upcoming travel. Flu will remain active over the next month and flu strain B typically circulates in spring. It is not uncommon to see a flu case in May."

WellSpan Pediatric Medicine physicians are seeing lots of upper respiratory infections, including some cases that have turned into pneumonia. These viral illnesses can also cause unanticipated fevers that only last about 24 hours, with minimal symptoms other than fatigue.

UPMC Pinnacle's Heritage Pediatrics in Camp Hill is seeing strep throat, croup, RSV bronchiolitis, and flu-like viruses. 
 
They are still seeing a lot of "stomach bug," or acute gastroenteritis, 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," Dr. Kathleen Zimmerman said.  "Clear fluids like Pedialyte are the best. 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.  We do not recommend over the counter anti-diarrhea medicine because this could make the virus stay in the system longer."

Geisinger Holy Spirit Primary Care in Cumberland County reported coughs/colds, strep throat, flu and a stomach bug.

Geisinger Holy Spirit Pediatrics in Cumberland and Dauphin counties reported the flu, stomach bug, strep throat and viral respiratory illnesses


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