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What's Going Around: Measles concerns, heat-related illnesses

Penn Medicine Lancaster General Health Physicians Roseville Pediatrics continued to see a rise in strep throat cases.
 
They also have continued to see a lot of viral illnesses, including those that cause fever, runny nose, ear infections, cough and rash.
 
They continued seeing a decent number of swimmer's ear cases and lots of hand, foot and mouth virus.
A stomach bug was seen in lower numbers.
 
Dr. Joan Thode offered the following advise about measles:
 
There has been a lot of concern raised about a measles case so close to home (Hershey). Many of the symptoms of measles can mimic the typical symptoms of viruses, but there are important differences to know.
 
Both the common cold and measles can cause runny nose and pink eye, though in measles, everything is very watery-the runny nose is very copious, and the eyes are very red, with lots of tearing (more so than the typical cold). Both colds and measles can cause fever, but in the case of measles, the fevers are high (103- to 105-degree range, generally).
 
Colds can cause a bit of a sore throat and some throat redness, though the throat redness in measles is very red. Additionally, measles will cause whitish spots or plaques in the mouth, typically on the inside of the cheeks.
 
The rashes of measles vs. the common cold are very different. Rashes following non-measles viral illnesses typically are lacy, flat and start on the belly/chest/back and sometimes will spread to the tops of the legs and arms. The measles rash is much more pinpoint in nature, starts only at the top of the forehead, and steadily descends downward over the face, chest and then the belly and legs/arms. The small, raised spots of the measles rash will start to blend together into coalesced raised red patches on the body. Whereas the rash of a cold virus will typically erupt after the virus is gone and the child is feeling better, the measles rash occurs while the patient is the sickest, often erupting just after the watery pink eye starts.
 
The common cold will typically leave the body in a week. Measles leaves its victims much sicker, and it will cause pneumonia, encephalitis (swelling of the brain), and serious pneumonia in about 30 percent of cases. Pneumonia, as well as encephalitis, can easily cause death, especially in a child.
What do you do if you think your child has measles? Call your doctor, but PLEASE STAY OUTSIDE! The potential measles case should be evaluated outside or in the car to avoid sickening unvaccinated or under-protected kids in the waiting room.
 
Measles spreads by droplets that are so fine that they hang in the air for up to two hours. Anyone who walks into this space and inhales these droplets has a 90 percent chance of  getting measles unless they are vaccinated against it.
 
Please vaccinate your kids with the MMR. The first of the two-dose series will provide about 70 percent immunity, whereas the second should give 100 percent immunity."
 
UPMC Pinnacle's Heritage Pediatrics is seeing more cases of poison ivy dermatitis this week.
 
Poison ivy is a three leaved, vine like plant that spreads among trees, bushes, and gardens.  Many people are allergic to this plant and develop a rash after coming in contact with it. It can take anywhere from one to 14 days to develop the rash.
 
The rash starts as red itchy skin bumps or blisters or sometimes swollen areas. More areas or blisters develop as time goes on. This is because different contacted areas on the skin may take a little longer to develop the rash. This is not because people spread the rash on themselves.
 
A common myth is that poison ivy is contagious. Allergic rashes are never contagious. The only way to develop the rash is to come in contact with the plant or with the plant oils that may have transferred onto clothing or gloves.
 
Treatment of poison ivy can sometimes be controlled with topical over the counter creams and itch relief medications or antihistamines. However, if the rash covers large areas of the body, or is on the face or near the eyes, you may need a prescription medication to give quicker relief.  Call your medical provider for guidance.
 
With high school sports back in action along with the extreme heat and humidity the region is experiencing, WellSpan Medical Group providers are seeing outdoor activity-related injuries such as sprains and strains, as well as heat-related illnesses.
 
WellSpan providers recommend having drinking water available for all outdoor activities; keeping cool or limiting time outdoors during extremely hot or humid days; and for those who participate in sports, to consider a sports drink to help replace electrolytes. However, those with diabetes should keep a close eye on the sport drink's sugar content.
 
Heat-related illnesses are often caused or made worse by dehydration and fatigue. Exercising during hot weather and working outdoors increases the risk for experiencing a heat-related illness. Drinking alcohol also increases your risk of dehydration. Home treatment is usually all that is needed to treat mild heat-related illnesses, such as heat cramps. However, more serious issues, such as heat exhaustion and heatstroke, need immediate medical treatment and in some cases can be life-threatening.
 
CVS MinuteClinic locations across the Midstate reported the following this week:
 
Lancaster:
Submitted by: Jessica Myers, Nurse Practitioner, MinuteClinic in Lancaster
 
Molloscum contagiosum is a common viral skin infection found in children. It is a self-limiting condition that will clear in three to 12 months. Symptoms include flesh colored bumps, often on the trunk, extremities and face. Cover lesions to prevent spread. Avoid scratching, sharing towels and clothing. Topical prescription treatments are available if not improving.
 
We have seen an increase of visits for insect bites. An insect bite can cause significant localized swelling and discomfort. Apply ice for pain and swelling. Over-the-counter hydrocortisone creams can be used for itching. Taking an over-the-counter antihistamine, such as Zyrtec, Allegra or Claritin, is also recommended for symptom management. You should monitor for signs of infection, including increasing redness, streaking, change in drainage, and fever. Prevention is key. Avoid being outdoors at dusk and wear light layers on exposed skin.
 
Tinea versicolor is a common skin condition in teens and young adults. Symptoms include small scaled lesions that do not tan. Sometimes itching is present. It is caused by yeast and worsened by hot weather. Treatment includes topical anti-fungals like clotrimazole (Lotrimin) twice daily for two to four weeks. Prescription remedies are available if it's widespread or resistant to treatment. Retreating each spring is helpful to prevent recurrence.
 
York:
Submitted by: Stacey Basta, Nurse Practitioner, MinuteClinic in York
 
This week in the York Minuteclinic, we continue with predominantly physicals, vaccines and screenings in preparation for most children's return to school.
 
There have been a few cases of pharyngitis, with most being viral and one attributed to strep throat. There were also cases allergic rhinitis, or allergies, and upper respiratory infections with cough. All upper respiratory infection cases were treated with over-the-counter medications to help with symptoms.  Allergy patients were advised appropriately, but most respond well to oral antihistamines or nasal steroids. The strep throat patient was treated with oral antibiotics.
 
We also have flu vaccines and are encouraging patients to get vaccinated!
 
Geisinger Holy Spirit Primary Care in Cumberland County reports sore throats, coughs, colds and rashes.
 
Geisinger Holy Spirit Primary Care in Dauphin and York counties reports rashes and poison.
 
While they have not seen any additional suspected cases of measles, pediatricians at Penn State Children's Hospital are getting a lot of questions about measles from parents this week.  This comes after a measles exposure in the area of their emergency department. For more information, click here.
 
Pediatricians there want parents to know that the best way to prevent measles is to make sure they and their children are vaccinated. The vaccine is safe and effective. Pediatricians also say if kids develop a high fever with a rash and are worried about measles, parents should contact their doctors office.

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