WellSpan Pediatric Medicine Physicians across the Midstate are seeing stomach bugs and strep throat — although strep cases are declining. They are beginning to see allergy and asthma symptoms increase.

The CVS MinuteClinic in York saw an increase in strep cases, as well as viral upper respiratory infections. They saw fewer COVID and flu cases.

The providers of UPMC Children’s Community Pediatrics across the Midstate reported a lot of stomach bug cases, strep throat and pink eye this week.

Penn Medicine Lancaster General Health Physicians Roseville Pediatrics is still seeing a lot of strep and stomach bug cases.

COVID cases are holding steady, although at relatively low numbers. They are still seeing lots of ear infections, thanks to ongoing back-to-back viral illnesses.

They haven’t seen many flu cases this week. On a side note, they haven’t seen any Influenza Type B yet, although there is typically a spike in that later in the flu season, compared to Type A.

Dr. Joan Thode offered the following advice about strep:

“Strep presentations recently have split between cases of bad sore throats and cases of bad belly pain and vomiting without sore throats. Generally, strep involves a sore throat, headache and belly pain with nausea and sometimes vomiting. More than in prior seasons, though, we are seeing cases of strep present only with nausea and vomiting.

This of course makes it confusing with the GI bug also going around. In general (there are always exceptions in medicine), the GI bug causes vomiting and nausea for one to two days that then improve pretty rapidly and typically transition to loose stool for a few more days. In contrast, strep infection doesn’t cause diarrhea and tends to have a longer course over multiple days unless treated by antibiotics.

Headaches and fevers can occur in both strep and gastroenteritis infections, though it’s more standard with strep (With the GI bug, headaches are due to dehydration from vomiting and diarrhea rather than the virus itself.).

If your child cannot keep anything down, has been vomiting frequently for more than a day or is showing any signs of dehydration (decreased urine output, dry mouth, lacking tears with crying), call their medical provider for guidance, as they will likely need to be evaluated expeditiously.

Medication can be prescribed for extreme nausea or vomiting to help avoid dehydration, but these medications should be avoided for certain ages and cardiac arrhythmias. Over-the-counter anti-diarrheal medications, however, should NEVER be used for gastroenteritis, as they can prolong the viral presence in the gut, worsening the cellular damage and prolonging the diarrhea and discomfort.

Strep should always be treated with an antibiotic to avoid damage to the heart and kidneys, among other complications. Because untreated strep can cause potential long-term organ damage, we doctors need to be on high alert. Given the trends this season, don’t be surprised if your vomiting child gets swabbed for strep despite showing symptoms more consistent with the GI bug. You might just be surprised by a strep diagnosis.”