(WHTM) — WellSpan Pediatric Medicine Physicians across the Midstate are seeing RSV, asthma exacerbations, and other viruses that are not RSV, flu, or COVID.

This week, pediatricians at Penn State Health continue to see a high volume of patients with respiratory illnesses, including RSV, COVID, and the flu. They are also seeing stomach bugs, common colds, and strep throat.

The CVS MinuteClinic in York is seeing viral upper respiratory infections and COVID.

Penn Medicine Lancaster General Health Physicians Roseville Pediatrics is seeing a lot of fevers, viruses, and bronchiolitis from RSV.

They’re also seeing flu cases slowly rise. COVID cases are low but steady. They are also seeing ear infections and asthma exacerbations.

Dr. Joan Thode offered the following advice about RSV:

“RSV, or Rhino Syncytial Virus, is not a new or novel virus. We see it surface every year. In most patients, babies included, it causes the common cold with runny nose, congestion, cough, fever and lower energy for a few days. In some babies and toddlers, RSV, as well as a handful of other viruses, can cause an inflammatory lung condition known as bronchiolitis.

“Bronchiolitis is inflammation of the bronchioles, the tiniest of the airways of the lungs. If these littlest airways fill with mucous, oxygen can’t get from the inhaled air to the air sacs at the end. The air sacs are where oxygen is transferred to the blood, so if the air can’t get there, the body could have an oxygen deficit. The brain will start to compensate by getting more oxygen despite decreased usable air sacs by breathing deeper and breathing faster.

“Babies and toddlers breathe deeper by engaging the muscles of their neck and ribcage to pull the ribs apart forcefully, creating a vacuum effect that sucks more air into the lungs. This will cause their ribs to pull out in a pronounced way, their neck to suck in around their collarbones, and sometimes head bobbing as if they are doing crunches. These motions are known as ‘retractions.’ The rate of breathing will be consistently faster in this context as well. If you see your child exhibiting these symptoms of ‘increased work of breathing,’ you can infer they are compensating for a lack of oxygen, and they should be promptly evaluated by a physician.

“So yes, bronchiolitis can be scary, but thankfully, the odds that your baby with bronchiolitis will end up in the hospital with oxygen are pretty low. Because the lungs have millions of these air sacs, most babies and toddlers affected will be able to compensate by using the ones that aren’t swollen shut. They will they have a wet cough but not the signs of increased work of breathing.

“So is it necessary to test for RSV if your little one has a cough or runny nose, or even a fever? No. Here’s why: 1. Physicians don’t provide treatment based on the knowledge of RSV. They provide treatment based on the level of oxygen in the bloodstream. If a toddler or baby is exhibiting retractions or fast breathing, the type of virus causing the issue is irrelevant—our job is to get that baby some oxygen. 2. RSV infection by no means guarantees bronchiolitis, and even if your child did develop bronchiolitis, chances are they will not need oxygen. Our advice as pediatricians is always the same for every common cold virus: Watch the effort of breathing.

“All babies with bronchiolitis will have a wet-sounding cough, but signs to watch for that indicate a more serious issue with breathing include sustained fast breathing, using the belly to breathe, having an exaggerated expansion of the ribcage with every breath, inability to eat or drink due to the fast breathing, and any purple or blue color around the mouth or lips. It’s always important to have your child examined by their doctor for any concerns with breathing.”