What’s Going Around: Croup, coughing, sore throats

Health

UPMC Pinnacle in Camp Hill reports they are seeing croup this week. Croup is a viral upper respiratory infection that causes a very barky cough, hoarse voice, sore throat and usually a fever the first three to five days. The cough with croup is worst in the middle of the night and early morning hours.

The virus that causes croup causes swelling and mucous around the vocal cords. This creates a hoarse voice and the classic croup cough that can sound barky like a dog or seal.

The younger the child is, the more difficulty they have with this cough. In young children, they can have stridor, which is a loud breathing sound from the vocal cords.

The best thing to help the cough is moisture, such as running a cool mist humidifier in the room while they sleep or offering cold or warm clear liquids to drink. If a young child is upset and crying, this will make the stridor worse, so calming them should help. Sometimes sitting in a steamy bathroom can help. If your child appears to be having trouble breathing and none of these things help, you should call your medical provider immediately.

Penn Medicine Lancaster General Health Physicians Roseville Pediatrics saw an increase in coughing. The coughing was mostly related to a sharp increase in viral colds, though we also saw an increase in croup in younger toddlers and babies, as well as allergies and asthma exacerbations in all age groups. Many of these coughs also involved wheezing.

Sore throats continue to be seen in high numbers, though most sore throats were due to post-nasal drainage from viruses. Only about 30 percent were due to strep.

They continue to see a lot of impetigo. Hand, foot and mouth disease was seen in higher numbers and they saw a sharp increase in concussions, with some related to sports and some related to accidents.

Dr. Joan Thode offered the following notes about wheezing:

“Wheezing is a high-pitched, whistle-like sound, either with inhale or exhale, that is related to inflammation in the lungs. Inflammation is caused by the immune system attacking a real or perceived threat, which can result in partial or complete closure of the small airways in the lungs. This inflammation can be due to a virus, asthma or more specific conditions, such as bronchiolitis.

Asthma is a chronic condition of either frequent flares of this inflammation or a more persistent, smoldering inflammation. Though asthma technically cannot be formally diagnosed until after age two, infants and young toddlers can get wheezing related to specific viral or bacterial lung illnesses. Infants and toddlers with wheezing discovered in relation to an infection are not guaranteed to have asthma later in life, though they should be watched a bit more closely.

Bronchiolitis is a virus-induced inflammation of the tiniest of the airways, which typically affects only babies and toddlers. The small airways can swell shut/fill with mucous, which prevents oxygen from getting to the air sacs at the end.

Because wheezing, regardless of the source, indicates inhibited airflow through the lungs, it should be evaluated by a physician. Many, but not all, cases of wheezing can be helped with nebulizer or inhaler treatments, though sometimes other interventions are needed. If you notice sustained fast breathing, using the belly to breathe, having an exaggerated expansion of the ribcage with every breath, called “retractions,” inability to eat or drink due to the fast breathing, and/or any purple or blue color around the mouth or lips, call your child’s doctor right away.

WellSpan Pediatric Medicine physicians across Central Pa. are seeing sore throats, upper respiratory illnesses, sports physicals, ear pain, joint pain and rashes.

The CVS MinuteClinic in York is seeing flu vaccines, physicals, common colds and a few skin conditions that include impetigo.

In Lancaster, they’re seeing the following:

“Acute Pharyngitis (sore throat) – We have seen a number of patients with sore throat. Sore throat can be caused by allergies, postnasal drip, viruses or strep bacteria. Strep is more likely along with fever, body aches, headache and absence of other cold symptoms. We perform a rapid strep test that results in five minutes. If negative but concern remains for strep we send out to a lab to perform a DNA probe which takes one to two days. Antibiotics are only prescribed for positive strep results confirmed by lab tests. Home remedies include salt water gargle, pushing fluids, cold/hot drinks and over-the-counter fever reducer and pain medications.

Cough – Cough can be seen with common cold, viral upper respiratory infection, allergies and bronchitis. A complete physical exam will help determine the cause of the cough and the specific medications that will help. If upon exam lungs are clear and clinical exam confirms lack of bacterial infection treatments can include inhalers, cough medications or allergy medications will be recommended.

MMR vaccine – With recent potential exposures in nearby areas, we may see an increase in request for MMR vaccine or titer status. Some patients may not be fully vaccinated or not have appropriate antibodies. Talk with your doctor to determine if you need to consider lab titers or vaccination. Typically MMR vaccine is given at 12 to 18 months and again at four to years.

Geisinger Holy Spirit Primary Care in Cumberland County reports a stomach virus with vomiting and diarrhea, sore throats, fevers, upper respiratory cough and poison ivy.

Geisinger Holy Spirit Primary Care in Dauphin, Perry and York counties reports sinusitis, bronchitis and ear infections.

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