What’s Going Around: Back-to-school anxiety, sore throats, stomach bug


Penn Medicine Lancaster General Health Physicians Roseville Pediatrics saw an increase in croup cases among younger kids and toddlers.

They continued to see vomiting and diarrhea, some cases within the context of gastroenteritis, or a stomach bug, and some within the context of enterovirus.

Strep continues to be seen in around 30 percent of sore throat cases, with viral causes making up the majority of the remaining 70 percent.

Skin infections, including impetigo, have increased.

Dr. Joan Thode offered the following advice about croup:

“Croup is caused by one of a few different viruses. The muscles that attach to the vocal cords become swollen and less functional due to the virus. As a result, the child will cough through a smaller space between the vocal cords, and that burst of air causes the vocal cords to vibrate, giving the cough a very voice-like, barky sound quality.

Typically with croup, the vocal cords are able to still open enough that the child can get adequate air. However, in severe cases, inflammation can cause the child to breathe through a much smaller hole, which can give the sense of not being able to “get the air in.” This sensation will often cause the child to try to take faster and deeper breaths, creating a voice-like sound called “stridor.” The presence of stridor is a reason to seek medical attention right away.

Croup does not always need to be treated. If the child can remain calm and keep their breathing under control, observation and supportive care during the viral symptoms are all that is needed. But if the croup is severe and the breathing space between the vocal cords is very small, steroids are sometimes needed to acutely relieve the inflammation and open the space between the cords.

Interestingly, warm, moist air and cold, dry air sometimes also can relieve some of the inflammation at the vocal cords. We therefore suggest that a child with stridor and croup be taken into a steamy bathroom or have their face positioned at the door of the freezer (or outside on a cold winter night) to help relieve the symptoms of breathlessness and stridor.

Croup is most common in kids younger than six years old. Older kids tend not to get croup because the diameter of their airway increases as they grow. The viruses may cause older kids to get a little hoarse, though they typically lack the bark cough and stridor. However, rarely older children can get this condition as well, known as “spasmodic croup.” It is treated the same way, with supportive care and sometimes steroids.”

UPMC Pinnacle in Camp Hill is seeing a lot of children with symptoms of anxiety as school has started.

Dr. Kathleen Zimmerman offered the following observations:

“The start of school year is exciting but can also cause stress in children for a few reasons.

  1. Separation Anxiety: children often spend more time with their parents in the summer (longer nights, more time at home or on vacation). The transition back to school can make them feel homesick.
  2. Worry about grades and homework.
  3. Worry about who their friends will be, worry about bullies, or worried they may have a “mean” teacher.

It’s important for parents to recognize the signs of stress and anxiety because everyone can act differently. Some children will act out and be irritable. Some may seem more quiet or distracted. Many children will have physical symptoms such as belly pain or headaches or fatigue.

Parents should talk to their child before school starts to open the door for conversation about their worries. Often just talking about it makes them feel better.

Parents should avoid keeping their child home from school, even if they have some minor symptoms. Once children miss school for anxiety, it is often much harder to get them to go back to school.

Write out a schedule with your child for the week and and plan something for them to look forward to after the school day.

For most children, once they’ve been in school for a few weeks, they build confidence and familiarity with their routine and the anxiety lessens. If your child does not seem to improve or if they are refusing to go to school, see their doctor as soon as possible. The sooner school anxiety is managed the quicker it will resolve.”

Geisinger Holy Spirit Primary Care in Cumberland County reports coughs, colds, sore throats, ear infections, pink eye and rashes such as poison ivy.

Geisinger Holy Spirit Pediatrics in Cumberland County reports coughs, sore throats and some fevers.

WellSpan Pediatric Medicine physicians across the Midstate are seeing an increase in roseola and stomach bug cases.

There’s not a lot of illnesses going around at Penn State Children’s Hospital and Penn State Health Medical Group this week. Pediatricians have seen a few cases of the common cold and respiratory viruses, but otherwise have been busy with back-to-school wellness checkups.

The CVS MinuteClinic in Lancaster reports the following this week:

“Immunization visits are rising each day as we approach the first day of school at many schools and colleges. We are seeing many visits for meningitis vaccines. Most universities require Meningitis ACWY, we also recommend getting meningitis B which is required by some universities. We are also seeing many visits for measles, mumps and rubella vaccine with increase community awareness and outbreaks.

Skin conditions- In summer we see various skin rashes and conditions. Poison ivy is common which occasionally requires prescription therapy if widespread or involving the face. We see ringworm which thrives in moist warm areas and yeast infections involving skin folds. Both can be treated with over-the-counter products first and evaluated by a health care provider if fails to improve or worsens.”

In York, the MinuteClinic has seen mostly physicals, vaccines, the start of flu vaccines and a few illness such as sinus and ear infections.

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