WellSpan Pediatric Medicine Physicians are starting to see the bugs that we often see when school is in session such as upper respiratory infections, strep throat, and gastroenteritis. Allergies to pollen are still going strong too.

UPMC Pinnacle is seeing a lot of nasal congestion this week caused by viral upper respiratory infections, or the common cold. As summer ends and children spend more time indoors, we start to see respiratory viruses spread more widely. Viral upper respiratory infections or “colds” often start with a runny congested nose. There may be a lot of sneezing and tingling in the nose when this starts. Some people notice headaches, sore throats and a mild cough. There may be a fever, but often there is not.

Seasonal allergies this time of year from ragweed and other grasses may look similar to viral upper respiratory infections, but typically there is a lot more itching with allergies, including itchy eyes, itchy nose and itchy throat.

“Allergies will never cause a fever, even though some people refer to it as hay fever,” Dr. Kathleen Zimmerman said. “There should never be a fever with allergies.”

There is no specific treatment for viral upper respiratory infections. It does help to drink plenty of fluids and get more rest, but most children can continue their normal day. If your child has a worsening cough, headache, or sore throat that stops them from eating, or if their symptoms are not improving after two weeks, then they should see a medical provider.

Penn Medicine Lancaster General Health Physicians Roseville Pediatrics continued to see high rates of anxiety concerns with the start of school.

In the younger age groups, they saw an increase in bacterial conjunctivitis, or pink eye, and viral colds.

As is common with the start of the school year, they have seen a sharp increase in viral illnesses, mostly colds. With some of these viruses, they have seen fevers as well as viral rashes.

Asthma exacerbations and seasonal allergies both increased. Impetigo continues to be seen in all age groups in higher numbers than normally seen.

Dr. Joan Thode offered the following advice about viral “colds” and when to worry:

“A toddler or school-aged child with a normal immune system may have six to 10 colds per year, many clustered in the colder months. It may take a few days for symptoms, such as low energy, low appetite, congestion, cough, chills and/or fever, to resolve.

Here is when to worry about common symptoms:

Congestion that does not improve for 10+ days or seems to improve but then significantly worsens within a seven- to 10-day period without fully going away may indicate a bacterial sinus infection.

A cough that causes distressed breathing (prolonged fast breathing, use of extra muscles of the chest and belly to get air into the lungs, gasping, inability to eat or drink due to breathing effort) should be evaluated by a doctor. A fever in the context of worsening cough, or a fever occurring after the initial fever resolved, also warrants a trip to the doctor to rule out pneumonia.

A fever that lasts five days or longer should be evaluated by a doctor. If your child is truly lethargic — their tone is more limp, they do not respond to you or are very difficult to wake up — seek immediate medical evaluation. An infant younger than 2 months old with a temperature over 100.4 degrees should be evaluated immediately in a hospital setting, as the immune system is immature and less able to fight off infections.

A rash that is non-blanching (the color cannot be pushed out of it with pressure) needs evaluation by a doctor. Any rash that quickly turns from red to bruise-like also should be evaluated, especially if the rash is on the legs or buttocks. While hives themselves are not a medical emergency, it’s important to ensure that the child does not have any signs of swelling in the airway. Seek emergent medical evaluation for these signs: lip or tongue swelling, difficulty swallowing, noises with breathing that are louder than normal, and/or a change in voice.”

Demand continues to be high for the TB test at the CVS MinuteClinic in Lancaster. A nationwide backorder of testing solution aligning with college start times has made for some challenges. Many colleges require testing for incoming freshman and many majors require testing for observation experiences. Students in the teaching and medical field are most likely to need to this test. It requires two visits over 48 to 72 hours. Some insurances cover all or part of TB testing. Call the number on the back of your card for more details.

At the MinuteClinic they’re also diagnosing allergic rhinitis. They say now is the time to start taking over the counter remedies such as antihistamines and steroid nasal sprays. Examples include Claritin, Allegra, Zyrtec and Flonase, Nasacort or Rhinocort. Sneezing, itchy eyes, sore throat, a runny or stuffy nose are all symptoms of allergies.

Back to school vaccines continue into this week as the later group of schools returned after the holiday. Most requested vaccines include Meningitis and Tetanus. We would advise considering other vaccines not required but recommended such as HPV for girls and boys and flu vaccines for all.

This week at the CVS MinuteClinic in York, there continues to be a lot of school vaccines, but they have seen an increase in upper respiratory infections and allergies. I have also seen shingles once, tinea cruris once, and pityriasis rosea once. These are all skin conditions.

Shingles is treated with oral antivirals, over-the-counter pain medciations as needed and follow up as appropriate. It can be contagious until lesions have crusted over.

Tinea Cruris is also known as jock itch. It is treated with over-the-counter or prescription medications depending on severity. Good hygiene and wearing loose, breathable clothing is recommended to allow air to the area.

Pityriasis rosea is non-contagious rash most prominent over the torso and upper arms of patients. It’s typically self-limiting, but can take weeks to resolve. Patients may use hydrocortisone if they experience itching.

This week, pediatricians at Penn State Health and Penn State Health Medical Group are seeing upper respiratory infections, common colds, and some cases of croup. They also are starting to give flu shots.

Geisinger Holy Spirit Primary Care in Cumberland County reports upper respiratory issues, including fevers, coughs, sinus congestion and sore throats. They’re also seeing pink eye, ear infections and poison ivy.