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What's Going Around: Strep throat, walking pneumonia, asthma issues

This week Penn Medicine Lancaster General Health Physicians Roseville Pediatrics saw an increase in atypical or "walking" pneumonia in school-aged kids and teens.

They have continued to see a lot of viral illnesses, all of which include lots of mucous and some of which have caused sore throats and rashes.

Strep accounted for about 30 percent of the sore throat cases seen this week.

In the rash category, they have continued to see moderate numbers of hand, foot and mouth cases, as well as impetigo.

A sharp increase in the incidence of concussions was seen this week, though there was not a specific trend. Cases were split pretty evenly between high school sports, playground injuries and outdoor play.
Dr. Joan Thode offered the following advice about walking pneumonia:

"Walking pneumonia is the more commonly heard term to describe "atypical pneumonia," which refers to an infectious inflammatory process dispersed throughout the lungs, rather than being localized into a small single area of the lungs. Walking pneumonia is so named because the symptoms tend to be much milder, thus allowing a person to "walk around" with it and not realize. This type of pneumonia is more common in school-aged and teen pediatric populations than in young children and toddlers.

Walking pneumonia and the common cold can have overlapping symptoms of fever,  headache, loss of appetite, and of course, cough.  The cough tends to be much worse with pneumonia than with a cold. The immune system of the lungs will attack the bacterial infection, which causes production of mucous as a defense. The cough with pneumonia will frequently sound "wet," as this increased mucous is being coughed up and cleared. Even after the bacteria has been killed by the immune system and antibiotics, the accumulated mucus in the lungs needs to be cleared, so the cough can sometimes persist for a week after the acute infection is gone.

For walking pneumonia, antibiotics are typically prescribed. The choice of medication and dose will depend on the individual child's exam findings and weight.

Pneumonias are contagious, though it is harder to spread a walking pneumonia than a more "typical" pneumonia."
"All of the providers and staff at Roseville offer our sincerest condolences to the families of those lost and involved in the horrible crash last week in Warwick," Thode also offered. "If your child is a Roseville patient and is having anxiety or grief from that incident, please do not hesitate to reach out to your provider to be set up with our counseling team."

UPMC Pinnacle's Heritage Pediatrics in Camp Hill reports that in addition to viruses causing sore throats, they are also starting to see more strep throat.  

Strep throat typically causes a sudden onset of sore throat, painful swallowing, headache, decreased appetite and sometimes vomiting.  Often there is a fever and sometimes there is a fine red rash on the face and chest and groin as well.  Usually there are not cold symptoms like cough or runny nose, although the nose can feel congested.

Strep throat needs to be treated with an antibiotic, so if your child has these symptoms they should be seen by a medical provider.  There are many viruses that mimic strep, and the only way to know is to get a throat swab performed in the office. Some tests give immediate results and some take a couple of days at a lab. 

The CVS MinuteClinic in York reported they continue to have many patients coming in for flu vaccinations. The Centers for Disease Control recommends it is best to be vaccinated by the end of October.
As for illnesses, they've seen several upper respiratory infections, pharyngitis and ear infections. URIs are managed by treating symptoms with over-the-counter medication, rest and hydration. Pharyngitis, or viral sore throats, are also treated with rest, hydration, pain medications, as well as throat lozenges and honey and lemon as needed.
Bacterial ear infections are treated with pain medications and antibiotics in many cases. Medications to help with other associated symptoms may be helpful, including decongestants and expectorants.

WellSpan Medical Group providers suggest that parents and young people be aware of community illnesses that are spreading among children in schools and childcare locations. Key prevention steps include frequent handwashing, covering coughs, and limiting face touches.  Many illnesses, such as bronchitis and sinusitis, are typically viral in nature and do not require antibiotics. An assessment by your health care provider will help determine if an illness is viral or a bacterial infection, and the proper course of treatment.

It's also time for people to get a flu vaccine. People should get a flu vaccine now, before the flu begins actively spreading in the community. It takes about two weeks after vaccination for antibodies that protect against flu to develop in the body, so make plans to get vaccinated now. Flu shots are currently available at WellSpan Urgent Care locations.

Providers at Penn State Children's Hospital and Penn State Health Medical Group have been seeing a lot of common colds and fevers, upper respiratory tract infections, strep throat, bronchiolitis, and asthma flares this week.

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