What's Going Around: stomach flu, Lyme disease, hand, foot and mouth

This week, pediatricians at Penn State Children's Hospital are seeing a lot of stomach flu, which typically includes vomiting.

At their clinical sites in Lancaster and Cumberland counties, pediatricians and nurses are still seeing hand, foot and mouth disease, sunburn, and bug bites.

Penn Medicine Lancaster General Health Physicians Roseville Pediatrics saw continued high numbers of hand, foot and mouth disease, and an increase in impetigo this week.

They have also seen a couple of lab-confirmed cases of Lyme disease.

Swimmer's ear continues to be seen in high numbers and viral illnesses and fevers continue in moderate amounts.

Most of the sore throat cases Roseville saw this week were viral and not strep throat. Poison ivy and bug bites, as well as molluscum, are still being seen in higher numbers, which is typical in the summer.

Dr. Joan Thode offered the following advice on impetigo:

"Impetigo is an infection of the skin with bacteria in the streptococcal family. It frequently occurs on the face and can look like a red rash, often with a crust on top. The crust often has a yellow color to it, frequently described as 'dried honey.' This rash technically can occur anywhere on the body, though we often see it on the face, frequently at the corners of the nose and mouth. This rash can be painful, though it frequently doesn't bother the child at all.

Other breaks in the skin from things like cuts and scrapes, as well as other rashes like eczema, also can become infected with this bacteria, which can complicate healing.

Any crusting rash, a rash that does not get better after a week or so, or a rash that seems to get progressively redder should be evaluated by a doctor. Impetigo is treated with a topical antibiotic cream and sometimes additional oral antibiotics, depending on the severity of the infection.

Other rashes also can have various forms of crusting, such as fungal infections, psoriasis and eczema, so it's always a good idea to have any kind of 'crusting rash' evaluated."

UPMC Pinnacle's Heritage Pediatrics says they saw an increase in swimmer's ear this week.

Swimmer's ear is an infection in the ear canal that is often triggered by water in the ear from swimming. The water allows bacteria to grow and the skin of the ear canal becomes infected causing pain, redness and swelling of the ear canal. Sometimes the pain is only noticeable when you push on the outside of the ear but as the infection worsens you will see swelling of the opening to the ear canal and a white drainage or debris in the canal. If the infection worsens you may even develop a fever or pain down to the jaw.

There are ear drops over the counter that are meant to prevent swimmers ear, but these drops do not treat an infection. If you are having ear pain, swelling, or draining you should see your medical provider as a prescription antibiotic drop could be needed.

Prevention of swimmers ear is keeping the ear canal dry. After swimming, dry the ear out with a towel and there may be benefit from using a few drops of rubbing alcohol or the over the counter drops after every swim to help dry the water out that is left behind.

CVS MinuteClinic locations across the area reported the following:
Submitted by: Stacey Basta, Nurse Practitioner, MinuteClinic in York

This week we continue to see skin rashes and insect bites. While many bug bites resolve on their own, if you are experiencing excessive redness, swelling, pain or symptoms such as fever, dizziness, tingling in the extremity of the bite, you should be evaluated by your trusted healthcare provider. With the warmer temperatures, many children and adults will take to the pool to cool off.

We did have two cases of CAP (community acquired pneumonia), which is a bacterial infection of the lungs. It is treated with antibiotics and supportive medications, rest and hydration.

Submitted by: Jessica Clabaugh, Nurse Practitioner, MinuteClinic in Lancaster

Many patients are presenting with running noses from seasonal allergies and summer colds. If you suffer from allergies, take your daily antihistamine as instructed to help reduce symptoms. Viral colds can be aggravated by underlying seasonal allergies. These infections can linger up to 10 days. Facial pressure can be improved with nasal sprays. Decongestant products may offer further relief, but use should be avoided for patients who have a history of high blood pressure. Take over the counter pain medications, push fluids, and consider using a humidifier next to your bed at night to help relieve the symptoms of illness.

Poison ivy contact continues to bring many patients into the clinic. Ivy and poison sumac are urushiol oil containing plants. Contact with leaves can cause a skin reaction including red rash within a few days of contact, bumps, patches, streaking, or weeping blisters (blister fluids are not contagious) along with swelling or itching. If you believe you've come in contact with a poisonous plant, immediately rinse skin with water, a specialized poison plant wash, degreasing soap or detergent. Scrub under nails with a brush, and ensure that your pet's fur is also clean to limit spread of the urushiol oil. To reduce itching and blistering apply wet compresses or hydrocortisone cream to the affected areas. An oral antihistamine can also be taken to help relieve itching. Seek medical attention in severe cases where much of the body is covered, or if the rash is on the face or genitals.

Children and adults are presenting with outer ear infections. Outer ear infections affect the canal of the ear, and may follow time spent in water. These infections are usually marked with pain in the outer ear, especially when the ear is pulled or moved. Patients may also report itchiness of the ear, fluid or pus leaking from the ear or difficulty hearing clearly. Treatment of this infection is by prescription ear drops which work to reduce pain and swelling caused by bacteria. 

This week, WellSpan Medical Group providers are seeing an increase in the number of poison ivy cases, in addition to sunburn.
Contact with poisonous plants such as ivy, oak and sumac can be serious. It is recommended that those who may have come into contact with a poisonous plant to immediately wash the skin with warm soapy water. To control itching, use cool moist compresses and consider calamine lotion or hydrocortisone creams to cover the rash. Also, individuals are urged to leave the blisters alone and not to scratch or open them. Opening the blisters can increase the risk of infection. For prevention, wearing long sleeves when outdoors and learning which plants are poisonous can help.
For sunburn prevention, WellSpan Medical Group providers recommend wearing sun-protective clothing, including hats, seeking shade when possible and applying sunscreen with UVA and UVB (broad spectrum) protection with at least SPF 15 before going outdoors.
Geisinger Holy Spirit Primary Care in Dauphin, Perry and York counties reports sore throats, poison ivy, tick bites.

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