What’s Going Around: Stomach bug, croup, seasonal allergies, COVID-19

What's Going Around

WellSpan pediatric medicine physicians across Central Pa. are seeing mild COVID-19 cases, mild asthma exacerbations, seasonal allergies and viral upper respiratory illnesses.

UPMC Children’s Community Pediatrics in York and Spring Grove are seeing seasonal allergies and stomach bugs going around. Most of these stomach bug cases are starting with loss of appetite then frequent vomiting for the first one to three days. Diarrhea has been associated with this 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 after vomiting for at least 30 minutes and only take small sips of fluid, one to two tablespoons, every five to 10 minutes. Clear fluids like Pedialyte are the best. If the abdominal pain is severe or if your child cannot keep sips of fluids down OR if they are urinating less than usual, then they should be evaluated by their doctor or medical provider as soon as possible. They do not recommend over the counter anti-diarrhea medicine because this could make the virus stay in the system longer.

The CVS MinuteClinic in York saw viral infections that were negative for COVID-19, seasonal allergies, and contact dermatitis.

Penn Medicine Lancaster General Health Physicians Roseville Pediatrics reports a huge increase in croup this week. There was also a moderate increase in ear infections, a stomach bug, some cases of COVID-19, and an increase in strep throat, seasonal allergies and tick bites.

Dr. Joan Thode offered the following advice about croup:

“Croup references the harsh, barky cough that’s caused by one of a few viruses that cause inflammation of the muscles in the vocal cords. This causes the child to breathe through a much smaller hole, which can give the sense of not being able to get the air in. This sensation will often cause the child to try to take larger and deeper breaths, thus pulling the air faster through the small space and vibrating the vocal cords, creating a voice-like sound called stridor when they inhale. The cough of croup is also very voice-like and barky because the fast bursts of air of a cough are being pushed between the closed vocal cords, causing them to vibrate. The classic cough of croup sounds like a seal bark.

Croup does not always need to be treated. If the child can remain calm and keep their breathing under control, observation and supportive care during the viral symptoms are all that is needed. But if the croup is severe and the breathing space between the vocal cords is very small, steroids are sometimes needed to acutely relieve the inflammation and open the space between the cords.

Interestingly, warm, moist air and cold, dry air can sometimes also relieve some of the inflammation at the vocal cords. We therefore suggest that a child with croup be taken into a steamy bathroom or have their face positioned at the door of the freezer, or outside on a cold winter night, to help relieve the symptoms of breathlessness and stridor.

Croup is most often experienced by kids younger than six. Older kids tend not to get croup because the diameter of their airway increases as they grow and isn’t as affected by inflammation at the level of the cords. However, rarely older children can get this condition as well, known as spasmodic croup. It is treated the same way, with supportive care and sometimes steroids.

Croup notoriously worsens at night, so if your child is showing some signs of hoarse voice, barky cough, or stridor during the day, it’s recommended that you have them evaluated or at least make your pediatrician aware. It’s also important to know what number to call to speak with your child’s doctor after the office closes for the evening.”

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