(WHTM) — This week, the providers of UPMC Children’s Community Pediatrics in York and Spring Grove are seeing more cases of COVID-19 as well as upper respiratory infections.

WellSpan Pediatric Medicine Physicians across the Midstate are seeing viral upper respiratory infections, COVID-19, bug bites, and poison ivy.

The CVS MinuteClinic in York reports COVID and viral upper respiratory infections this week.

Penn Medicine Lancaster General Health Physicians Roseville Pediatrics reports COVID-19, fevers, coughs, swimmer’s ear, tick bites, roseola, adenovirus, and croup this week.

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Dr. Joan Thode offered the following advice about fevers and what to do when your child wakes up in the middle of the night with a fever:

“It’s easy to panic when our child has a high fever. In pediatrics, it’s more about the way the child looks than how high the fever number is. A pediatrician will be a lot more concerned about a child with a 102-degree fever who is having trouble staying awake than a child with a 104.8-degree fever who is alert and able to drink fluids.

“When concerned about a fever, remember to LOOK, LISTEN, ASK, and HYDRATE.

“LOOK: See if your child is having trouble breathing. All kids will breathe a little bit faster than their typical baseline when they have a high fever, but you want to see how much effort they are putting into breathing. Comfortable, slightly faster breathing is OK to observe at home, though very rapid breathing — over 50 breaths per minute — that persists or persistent expanding of the chest or belly in an exaggerated way for more than a minute or two is concerning. It’s about how stressed your child looks while breathing.

“LISTEN: Is your child making any consistent noises or gasping sounds when they inhale or exhale? Is their cry nice and strong, or more weak and hoarse? Noisy breathing or change in their cry is concerning in the context of increased breathing effort. Persisting respiratory distress is a reason to call your physician.

“ASK: In older kids, ask them a question. If they can answer it appropriately, they are alert. In younger, pre-verbal kids, try to have them engage in a toy or book that they like. If they respond appropriately, they are alert. They may appear fatigued and have low energy, but they are not at a concerning level of true lethargy until they struggle to wake up and cannot maintain any coherent conversation or response due to immediately falling back asleep. True lethargy is a reason to call your physician right away.

“HYDRATE: The most important way to help your child through an illness with a fever is to give them water. Babies younger than 6 months should be hydrated only with formula or breastmilk, never with pure water. The higher temperature causes evaporation of water from the skin surface, and, with the typically low appetite and faster breathing, can cause some dehydration. Your child will feel better overall if they are well-hydrated. Inability to maintain hydration and a decrease in urine output is a reason to contact your doctor for evaluation.

“You’ll notice that medicating a fever is not on the list. A fever does not need to be treated. We often treat them not to protect the body from the heat but rather to make the child feel a bit better and therefore more willing to drink water and stay hydrated. The aim during a fever is hydration and comfort for your child. All fevers lasting five consecutive days should be evaluated by a physician in the office and likely additional testing.”