What's Going Around: stomach virus, strep throat, hand, foot and mouth

UPMC Pinnacle's Heritage Pediatrics in Camp Hill reports that this past week there were still a lot of stomach viruses going around.  They often start with a high fever and stomach pain.  Then vomiting is frequent for the first 24 hours.  After that, diarrhea may start.  The stomach pain is prominent and 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 every few minutes," Dr. Kathleen Zimmerman said.  "If you cannot keep sips down or if you are noticing less urinating, then you need to be evaluated or call your doctor about possible dehydration."

Penn Medicine Lancaster General Health Physicians Roseville Pediatrics saw an increase in diarrhea, some within the context of gastroenteritis and vomiting, some cases just diarrhea. They also saw an increase in strep throat.

Hand, foot and mouth virus continues to be a very common diagnosis, especially among the toddler age group. 
They have also seen some pink eye, which has been a combination of viral and bacterial cases, in addition to continued skin infections and nailbed infections, similar to last week.
Dr. Joan Thode offered the following advice about diarrhea:

"Whether it's from a virus or a bacteria, the cells of the intestines can become injured and therefore absorb less water, sugar and nutrients. The result is loose stool, which will resolve once the virus is gone and the cells lining the intestines have a chance to be replaced (This can take up to a week, especially in younger kids.). Very often, this can cause a transient lactose intolerance, which can last one to two weeks before resolving on its own.

The primary goal for a child with acute gastroenteritis (a virus that can cause both vomiting and diarrhea) is hydration. Water is the most ideal hydration in children over 12 months. Babies younger than 12 months still have immature kidneys, so hydration efforts should be coordinated with your child's doctor. Electrolyte solutions like Pedialyte can be used for vomiting or diarrhea, keeping in mind that water should be the primary form of rehydration. While your child's doctor may prescribe a medication that reduces vomiting, anti-diarrheal medications are not advised, as they cause the infection to stay in the intestines longer.

Bloody diarrhea should always be evaluated by a doctor. In young babies, this could be an indication of an allergy to milk protein, but in toddlers and older kids, it's more likely a bacteria. Specific tests and treatments require evaluation in the office, which also allows your child's provider to evaluate for related issues or other potential causes. Diarrhea that occurs soon after international travel or after camping should also be evaluated promptly."

Geisinger Holy Spirit Pediatrics in Cumberland and Dauphin counties reported hand, foot and mouth disease as well as issues with vomiting and diarrhea.

CVS MinuteClinic locations across the Midstate report the following:

Submitted by: Jessica Myers, Nurse Practitioner, MinuteClinic in Lancaster
This week in Lancaster we continue to see students coming in for sports physicals. Summer training camps and practices are starting, and physicals must be within the last year for participation. Minute Clinic also provides physical exams for camps including boy scouts. We currently have a promotional discount until September in effect.
We saw a few cases of strep throat this week, as well as viral pharyngitis. Strep throat is caused by a bacteria and requires antibiotics for treatment. If you have a sore throat with fever, swollen glands, and absence of cough these symptoms could be strep throat. A viral sore throat can present in a similar fashion but will resolve within three to four days without antibiotics.
Lastly, we have been seeing many patients coming in for Tuberculosis testing, a screening procedure done for employees in certain fields such as healthcare, child care, or working in schools. Tuberculosis testing is a quick way to detect if a person has had contact with Tuberculosis, a bacterial infection that causes serious respiratory illness. The illness can be "latent" and not show symptoms which is why testing is done prior to employment for these special populations.
Submitted by: Stacey Basta, Nurse Practitioner, MinuteClinic in York
This week we have seen a number of skin rashes: Insect bites, fungal infections and allergic reactions from contact with plants like poison ivy. Prevention is the key when dealing with summertime skin aliments such as long sleeves and gloves when gardening or hiking. There are many over the counter preparations available to treat skin issues, but please see your trusted healthcare provider for symptoms that do not respond or are in conjunction with fevers, joint or muscle pains or a vague feeling of being unwell.
Colds and upper respiratory infections don't take a vacation in the summer. Good hand washing, covering your mouth when you sneeze or cough, increasing fluids and rest are all important tips to remember no matter the season.

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