(WHTM) — Penn Medicine Lancaster General Health Physicians Roseville Pediatrics reports a bump in COVID-19 cases this week. They also saw strep throat, pneumonia, a stomach bug with vomiting and diarrhea, and an increase in wheezing.

Some of the cases of wheezing are known asthmatics having exacerbations with a viral illness, and others with wheezing as a new symptom for them due to lung inflammation reacting to a virus.

Dr. Joan Thode offered the following advice 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 threat or a perceived threat, and the result can be a partial or complete closure of the small airways.

Asthma is a chronic condition of either frequent flares of this inflammation or a more persistent, smoldering inflammation. Asthma technically cannot be formally diagnosed until after age 2, though infants and young toddlers can get wheezing related to specific viral or bacterial lung illnesses. These children 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. This 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.

Any case of wheezing should be evaluated by a physician, because wheezing, regardless of the source, indicates an inhibited airflow through the lungs. 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, and/or inability to eat or drink due to the fast breathing, call your child’s doctor right away.”

UPMC Children’s Community Pediatrics in York and Spring Grove continue to see cases of influenza, stomach bugs, RSV, and sore throats.

Patients who have the flu often start showing symptoms of high fever, chills, watery eyes, body aches, and fatigue. The fevers may last up to five to seven days. A sore throat, runny nose, and cough also develop in the first 24 hours, and the cough can worsen over a period of a week or longer. Influenza is very contagious and spreads through the air, so if you have flu-like symptoms you should try to avoid being in public and around other people, especially babies and the elderly. Call your doctor or medical provider to determine if your child needs to be seen.

Most cases of gastrointestinal viruses start with loss of appetite then frequent vomiting for the first one to three days. Diarrhea has been associated with stomach bugs as well. The stomach pain and loss of appetite can last on and off for up to a week. It is important to rest the stomach for at least 30 minutes after vomiting and only take small sips of fluid, about one to two tablespoons, every five to 10 minutes. Clear fluids like Pedialyte are the best. If the abdominal pain is severe, your child cannot keep sips of fluids down, or your child is urinating less than usual, then they should be evaluated by their doctor or medical provider as soon as possible. Over-the-counter anti-diarrhea medicine is not recommended because this could make the virus stay in the system longer.

Pediatricians at Penn State Health Children’s Hospital are seeing COVID-19, upper respiratory infections, bronchitis and colds.