What’s Going Around: COVID-19, croup, bronchiolitis, RSV, influenza

What's Going Around

Penn Medicine Lancaster General Health Physicians Roseville Pediatrics is seeing croup, hand, foot and mouth disease, COVID-19 and many other viral infections with mucous and coughing.

They’re also seeing seasonal allergies, bronchiolitis and a stomach bug.

Dr. Joan Thode offered the following advice about mucous and coughing:

“Once a virus is causing symptoms of runny nose, congestion, fatigue, cough and sore throat, it takes the immune system three to five days to battle and kill off the virus. During that process, not only is the virus creating mucous in the nasal passages, but the immune system’s efforts are creating mucous as a defense mechanism. The mucous drains pretty slowly and clears the nasal system either out the front of the nose or down the back of the throat. Post-nasal drainage is what causes babies, toddlers, and kids to cough and cough and cough.

The cough and the wet sound to the cough increase at night as gravity causes the mucous to pool in the horizontally lying child rather than consistently drain in small amounts. This is why the cough is typically a lot worse at night. The post-nasal drainage and cough can slowly taper over seven to 10 days after the other cold symptoms resolve. This is known as a protracted cough. As long as the initial active heavy nasal drainage improves after four to seven days and the protracted cough continues to slowly improve without causing fevers or increased work of breathing, it’s okay to watch it for a week or two.

Can we differentiate a cough from a cold from a cough specific to COVID-19? Unfortunately, no. For this diagnosis and for care planning for household members, a child with a cough and cold symptoms warrants testing, ideally on day three to four of illness if the child is not in any distress.

Reasons to bring your child to medical evaluation include: five consecutive days of fever; respiratory distress or increased work of breathing; fevers that come back before the cold symptoms have fully improved; cough that does not improve after about two weeks; nasal drainage that returns after getting almost all better.”

WellSpan Pediatric Medicine physicians across the Midstate are seeing acute asthma attacks, bronchiolitis causing congestion and difficulty breathing in infants, strep throat, and viral respiratory illnesses such as RSV, influenza and COVID-19.

The CVS MinuteClinic in York also treated patients for viral upper respiratory infections this week.

This week UPMC Children’s Community Pediatrics in York and Spring Grove are seeing a number of viral illnesses, including RSV, upper respiratory tract infections, and influenza. Providers continue to see cases of strep throat as well. Influenza and strep throat are very contagious. They recommend that children stay out of school for at least one or two days after the fever is completely gone.

Symptoms of viral illnesses may include sore throat, nasal congestion, runny nose, sneezing, cough, and often a fever. If the fever is not easily reduced with over-the-counter fever reducers, OR if the fevers go on and off for more than three days, then you should see your doctor or medical provider.  If your child’s cough or symptoms are worsening and they are less playful and eating less, they should also be seen. 

As mentioned above, influenza is very contagious and spreads through the air. If you have flu-like symptoms you should try to avoid being in public and around other people, especially babies and the elderly.  

Like other viral illnesses, flu symptoms often include a high fever. However, patients with flu frequently experience chills, watery eyes, body aches, and fatigue as well, as well as longer fevers lasting five to seven days. A sore throat, runny nose, and cough also develops in the first 24 hours, and the cough can worsen over a period of a week or longer.  

The best way to prevent influenza is the flu vaccine. Although it may not work 100% of the time, it does reduce the chances of getting the flu and of having dangerous flu complications. Call your doctor to see if you qualify for treatment or if you need to be seen. 

Strep throat is also very contagious, and it needs to be treated with an antibiotic. 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, chest, and groin as well. If your child has these symptoms, they should be seen by a medical provider. 

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