What’s Going Around: Hand, foot and mouth, croup

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Penn Medicine Lancaster General Health Physicians Roseville Pedatrics saw a sharp increase in hand, foot and mouth cases.

Strep throat and the stomach bug also increased. Croup also increased slightly, and they continued to see multiple viral illnesses that caused fevers and congestion. They continued to see bacterial pink eye in moderate numbers and seasonal allergies continue to be prevalent.
 
Dr. Joan Thode offered the following advice about hand, foot and mouth disease:

“Hand, foot and mouth disease is caused by one of a handful of viruses, particularly the Coxsackie virus. The rash appears as flat or slightly raised red spots with a small, fluid-filled bubble. It is often accompanied by a fever and decreased appetite and energy for three to seven days.

The rash can be found from head to toe and often appears in clusters on the palms/fingers, soles/toes, lips and buttocks. Fingernails and toenails may appear abnormal or even fall off weeks later. When the lesions occur in the mouth, they will cause a very painful sore throat that may cause your child to be unwilling to eat or drink.

There is no cure, and the virus will run its course in five to seven days. During this time, hydration is the number one goal. Ice water, popsicles, cold smoothies and crushed ice can soothe the throat and maintain hydration. Your child will regain lost calories once feeling better.

Hand, foot and mouth disease is contagious as long as your child has a fever and/or intact bubbles within the rash. The bubbles on the skin contain active viral particles, which will spread the virus if the bubbles open. Once the rash begins to crust over and the fever improves, the immune system has killed the virus, and it no longer can be spread.

The virus can remain on surfaces for long periods of time. Toy-sharing is a major way of spreading the virus, particularly in day-care and school settings. Disinfecting toys and surfaces is a good way to lower the risk of infection, though frequent hand-washing with soap is the best way to prevent the viral spread.

UPMC Pinnacle in Camp Hill is seeing a lot of croup this week.  Croup is a viral upper respiratory infection that causes a very barky cough, hoarse voice, sore throat and usually a fever the first three to five days.  The cough with croup is worst in the middle of the night and early morning hours.
 
The virus that causes croup causes swelling and mucous around the vocal cords. This creates a hoarse voice and the classic croup cough that can sound barky like a dog or seal. 
 
The younger the child is, the more difficulty they have with this cough.  In young children, they can have stridor, which is a loud breathing sound from the vocal cords.
 
The best thing to help the cough is moisture, such as running a cool mist humidifier in the room while they sleep.  Also offering cold or warm clear liquids to drink. If a young child is upset and crying, this will make the stridor worse, so calming them should help.  Sometimes sitting in a steamy bathroom can help.   If your child appears to be having trouble breathing and none of these things help, you should call your medical provider immediately.

WellSpan Pediatric Medicine physicians are reporting lots of allergies and asthma exacerbations as well as viral gastroenteritis and viral upper respiratory tract infections.

The CVS MinuteClinic in Lancaster reports the following this week:

“Allergic rhinitis – Pollens and ragweed levels have been elevated. We have seen an increase in visits for runny nose, congestion, itchy nose and eyes. Treatments can include over-the-counter antihistamines and eye drops. If symptoms are not well managed there are prescription remedies available.
 
Wellness screening – We have seen an increase in patients presenting for biometric screening or wellness exams for employers or insurance. These visits include blood pressure, height, weight, abdominal circumference, glucose and lipid levels. Results are available in minutes and counseling is provided.
 
Vaccine visits – With recent media coverage of the measles outbreak, we have seen an increase in vaccine request for adults who are unvaccinated or undervaccinated. Titers can be ordered to verify antibody levels. Vaccines some adults may need include Hepatitis A which is now a standard childhood vaccine that many adults have not received. At age 50 shingles vaccine is recommended. At age 65 or as directed by your healthcare provider pneumonia vaccine is recommended (Prevnar 13 and Pneumovax 23).”
 
Providers at the CVS MinuteClinic in York report another week with prominently upper respiratory infections and allergies.  There were a couple cases of strep and contact dermatitis.
 
Penn State Children’s Hospital and Penn State Health Medical Group pediatricians are seeing a lot of viral upper respiratory illnesses and some cases of the common cold.

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