What’s Going Around: Stomach bug, hand, foot and mouth, Lyme disease


Penn Medicine Lancaster General Health Physicians Roseville Pediatrics continued to see fair amounts of croup and strep.

Hand, foot and mouth disease increased, as did the stomach bug. They saw a sharp increase in several rashes, including poison ivy, molluscum, insect bites, ringworm, infected hair follicles and finger/toenails.

They also have had an increase in evaluations for circular rashes with concern raised for potential Lyme disease, treating three cases this week alone.

Roseville has not seen any measles in their office this week.

Dr. Joane Thode offered the following advice about Lyme disease:

“Although Lyme disease is seen in higher prevalence in Pennsylvania, the overall risk of contracting Lyme disease after a tick bite is 3 percent. Deer ticks can only transmit Lyme disease after becoming engorged, or attached to a human host for 36 to 48 hours. That is why it is so important to do tick checks and remove ticks quickly.

If a tick was removed after 36 hours of attachment, was engorged and was probable to be a deer tick, your child may receive a dose of an antibiotic called Doxycycline to prevent infection with Lyme disease. This dose must be started within 72 hours of the tick’s removal to be effective.

If a tick wasn’t noticed, it will fall off on its own after becoming engorged. In the following one to two months, the child may have a red, spreading rash at the site of the bite. This rash will sometimes have some central clearing, making it the classic bullseye rash, but it also can be an expanding circular red rash without the central clearing. The rash will not be raised or have any scaling skin associated with it. It typically does not hurt. Any expanding painful rash needs to be evaluated by a doctor to ensure that it isn’t an infection called cellulitis.

Any bullseye rash or painless expanding rash should be evaluated by a doctor. There are treatments to completely kill the Lyme organisms. Treatment will be started for the rash, but if your child has joint pain or swelling, or non-specific flu-like symptoms without a history of a rash or known tick bite, a blood test can evaluate if your child has Lyme disease.”

WellSpan Pediatric Medicine Physicians are seeing gastroenteritis, specifically in older infants and toddlers; six months to three years of age. They’re also seeing cases of asthma exacerbations and many well child visits for camp physicals and school physicals, as it is that time of the year.

This week, pediatricians at Penn State Children’s Hospital and Penn State Health Medical Group have been seeing some cases of Lyme disease. Pediatricians recommend adding a tick check into daily routines. Ticks need over 24 hours of attachment to transmit Lyme disease, so adding a check before bed or at bath time can decrease the risk of Lyme disease. Also going around are other bug bites and contact dermatitis.

Geisinger Holy Spirit Pediatrics in Cumberland and Dauphin counties reports fever, summer colds, a stomach virus, bug bites, and hand, foot and mouth disease.

The CVS MinuteClinic in York reported the following this week:

“We have seen numerous cases of poison ivy dermatitis. The oil of the plant can cause a severe allergic reaction with redness, itching, and blistering skin. It is possible to develop a superimposed bacterial infection. Try to limit scratching. Poison is not contagious, only areas that came in contact with the oil will erupt in a rash. Burning poison ivy and inhaling the smoke can be dangerous. Topical treatments include hydrocortisone or prescription topical steroids, over-the-counter antihistamines and prescription steroids in severe cases. Oatmeal lotion or soaks can be soothing. Use a mild soap like Dove unscented.

Allergies continue to be high in the area. After spending time outdoors patients complain of itching eyes, swelling around eyes and clear/watery discharge. Treatments include over-the-counter anti-histamine and eye drops like Zaditor or Naphcon A. Also using Natural tears to rinse the allergen from the eye is soothing. If failing to improve or becomes stuck shut with green/yellow crusts and drainage follow up at a health care provider for evaluation of the eye to rule out bacterial conjunctivitis or pink eye.”

–Submitted by Jessica Myers, MSN, CRNP, FNP-BC

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