What’s Going Around: Seasonal allergies, head lice and tick bites


Penn Medicine Lancaster General Health Physicians Roseville Pediatrics reports that, despite the dreary, cold weather, they have continued to see a rise in seasonal allergy symptoms. Providers have continued to see the common cold as well. Since both cause inflammation that can lead to ear infections, they are seeing those in high numbers as well.

Roseville continued to see sore throats in high numbers, with strep continuing to be diagnosed in around 50 percent of those cases.

There has also been an increase in stomach bug cases.

Only five cases of the flu were detected in the office this week.

Dr. Joan Thode offered the following advice on allergies:

“Despite the cold weather, the plants have been pollenating.

Seasonal allergies occur due to the release of histamine from a subset of the immune system. Histamine is a chemical that aids the immune system in its job. However in the case of seasonal allergies, a high amount of histamine is released into the bloodstream, which causes runny nose; congestion; itchy, watery eyes; and sneezing.

Antihistamine medications work by preventing histamine from bonding to the histamine receptors in the body, which keeps symptoms from occurring. These medications are designed to be taken daily to maintain a constant state of histamine control.

There are also antihistamine eye drops for eye symptoms that persist despite the oral antihistamine. Nasal sprays do not affect histamine but rather calm the immune system reaction in the nose to help decrease congestion related to allergies.

If your child has a known history of seasonal allergies, it’s not too soon to start the antihistamine medication regimen.”

This week, pediatricians at Penn State Children’s Hospital have seen only a handful of flu cases, but a bit of an uptick in cases of the common cold.

At Penn State Health clinical sites in Camp Hill and Elizabethtown, pediatricians and nurses report seeing a lot more patients wheezing and suffering from seasonal allergies and asthma flare-ups, as well as the common cold and strep throat. They are still seeing some cases of upper respiratory virus, as well.

UPMC Pinnacle Health’s Heritage Pediatrics in Camp Hill is seeing high fever viruses and ear infections, in addition to some stomach viruses.

Dr. Kathleen Zimmerman offered the following advice on ear infections:

“We are seeing a lot of ear infections.  Often they present as ear pain that comes on suddenly after a week of stuffy nose or cold symptoms. A true ear infection requires antibiotics because it is caused by bacteria.

But there are many causes of ear pain that are not infection, such as pressure on the ear from sinus and nasal congestion. This could be from a virus, like the common cold, or from allergies. Sometimes ear pain is actually referred pain from a sore throat or from a dental problem.

If your child is complaining of ear pain it is best to have their  medical provider examine them to see what the cause is.  If it is not an ear infection then antibiotics won’t help and should not be used. Your doctor might recommend something else to relieve the pain.”

CVS Health’s MinuteClinics across the Midstate reported the following this week:

Pharyngitis – (aka: sore throat)
15-30% are bacterial with the remaining cases being attributed to viral or allergic causes. A higher fever and absence of cough are more predictive for strep throat (bacterial). A rapid test can be performed with results within 5 minutes. A confirmatory DNA probe is sent if needed with results within 24-48 hours. Bacterial strep throat is treated with antibiotics for 10 days. A child can return to school after 24 hours of therapy and fever free. Viral sore throats are treated with ibuprofen, gargles and supportive care. If allergies are the cause, OTC antihistamines are recommended.
Herpes simplex virus 1/HSV-1 – (:aka: fever blister)
A vesicular(fluid filled) rash on the lip or inside the mouth with a reddened base. They rapidly ulcerate and cause a tingling or burning sensation. HSV-1 is usually acquired in childhood from an adult unknowingly. 0.62-25% of adults can shed virus at any given time so it is widespread. Fever blisters best respond to early treatment. Options include OTC abreva topical medication or prescription antiviral medications. Lesions resolve within 5-10 days and should be monitored for secondary bacterial infection if not improving.
Parvovirus B19 Infection/Erythema Infectiosum- (aka: Fifth Disease)
A “slapped-cheek” appearance is characteristic. The rash spreads to the trunk, buttocks and limbs 1-4 days later and lasts 1-6 weeks. The rash may be itchy. Other symptoms include headache, runny nose, sore throat, and fever. The illness is usually mild and self limited. Peak age is 4-12 years with infections occurring more frequently in late winter to early summer. It is transmitted by the respiratory route. Pregnant women should take precautions against exposure to Fifth Disease particularly in the first trimester to prevent fetal harm.
Conjunctivitis – (aka: “Pink Eye”)
There are several common causes of conjunctivitis or “Pink eye.”  Most commonly, causes include allergens, viruses, and bacteria.  Conjunctivitis can affect patients of all ages, and several cases of bacterial conjunctivitis were noted  this week in both children and adults.  Bacterial conjunctivitis is typically treated with antibiotic eye drops to help speed up the healing process and decrease the spreading of infection.  Individuals can generally return to school/work after being on antibiotic eye drops for 24 hours of antibiotic and symptoms are improving.
Pediculosis Capitis – (aka: Head lice)
Head lice (pediculus humanus capitis) infestations  most commonly affect younger, school aged children (3-12yrs).  It is most common to see outbreaks in places such as daycares, and elementary schools.  Head lice do not fly or jump.  Head lice crawl, and are spread most commonly by direct head to head contact.  If lice is suspected, a child’s hair should be checked for live lice.  If live lice are found, most commonly OTC lice shampoos are recommended, and combined with thorough combing of hair to remove lice and nits.  Hair should be rechecked and treated again about 7-10 days later as needed.  For more resistant cases of lice, prescription medications may be used.  Children can most commonly return to school or daycare after being treated with appropriate topical medications, and hair being thoroughly combed to remove live lice and nits.  Proper cleaning of affected clothing, linens and bedding is advised to prevent re-infestations.
Streptococcal pharyngitis – (aka: strep throat)
There have been several cases of strep throat over the last week.   Strep throat is most common in early Spring and in winter among school aged children.  Common symptoms of strep throat generally include rapid onset of sore throat In the absence of cough and nasal congestion.  Rapid antigen detection tests allow immediate assessment for Group A streptococcal pharyngitis.  For confirmed cases of Group A strep, treatment with antibiotics will likely be recommended to prevent acute rheumatic fever, reduce severity and duration of symptoms, and prevent transmission.  Children with strep, are generally considered no longer contagious after 24 hours of antibiotic therapy. 
Tinea Versicolor – (aka: pityriasis versicolor)
Tinea versicolor (TV) is a superficial fungal infection of the skin that results from a change in certain yeasts, which are normally found in in skin.  TV leads to areas of lighter or darker patches on skin, most commonly the trunk and upper arms.   TV is not due to poor hygiene, nor is it contagious.   Most commonly seen in teenagers and young adults. More common in higher temperatures,  and in those with heavier sweating (athletic activity).  Treated most commonly with topical antifungal medications.  May take several weeks for lighter or darker patches to disappear, and reoccurrence is common.
This week the Harrisburg clinic saw it’s first tick bites of the season. Ticks common to Pennsylvania are carriers of Lyme Disease. Lyme disease, and other tick-borne diseases can result in mild symptoms treatable at home to severe infections requiring hospitalization. If you see a tick on your body use fine-tipped tweezers to grasp the tick as close to the skin’s surface as possible. Pull upward with steady, even pressure. Don’t twist or jerk the tick. Clean the area thoroughly after tick removal. If the tick has been attached to your skin for more than 36 hours present to your provider for prophylactic treatment against Lyme Disease and other complications. If you develop a rash or fever within several weeks of removing a tick, see your provider. Be sure to tell them about your recent tick bite, when the bite occurred, and where you most likely acquired the tick.
For more information on ticks, and how to protect yourself and your family from tick-borne illness visit the CDC website: https://www.cdc.gov/ticks/index.html
The flu has not left the Harrisburg area. This week they saw positive cases of Influenza B in clinic. Unlike a cold, this flu typically presents abruptly with fever, body aches, and a generalized malaise or “hit by a bus” feeling. Present to your provider for evaluation of symptoms. Treatment for influenza includes a prescription antiviral medication along with supportive care to reduce fever and aches as well as to ensure adequate hydration.
There was an increase in the cases of strep throat seen in pediatric patients this week. Strep throat is a bacterial illness and can be differentiated from viral illness using a bacterial swab test. This rapid test can tell patients and providers if the strep bacteria is present within five minutes.  If present, the infection is treated with a course of antibiotics as well as over the counter fever reducer and increase if fluid intake. Students can return to school when fever free for 24 hours.

Geisinger Holy Spirit Primary Care in Dauphin, Perry and York counties reported upper respiratory issues, including sore throat, congestion, cough, and gastrointestinal issues, such as nausea, vomiting, and diarrhea.

This week, WellSpan Medical Group providers are seeing a decrease in strep throat and flu cases.
For strep prevention, WellSpan Medical Group providers also recommend frequent handwashing, as the bacteria can live for a short time on doorknobs, water faucets and other objects. They also recommend not drinking from the same glass or using the same eating utensils as an infected individual. For the flu, WellSpan Medical Group providers urge sick individuals to seek treatment. Early diagnosis may lessen the severity and duration of the illness.
As a reminder, those seeking care for respiratory illnesses – such as the flu -at any WellSpan care site, such as primary or urgent care locations or hospitals, are encouraged to adhere to respiratory etiquette practices. Techniques such as coughing into the inside of your elbow, frequent handwashing with antibacterial soaps for 20 to 30 seconds or using an alcohol-based hand sanitizer, such as Purell, are recommended to help prevent the spread of illness in public and at home.
Additionally, WellSpan providers note that viral gastrointestinal illnesses are common this time of year.  If you or someone in your household are experiencing symptoms of a viral gastrointestinal illness, techniques such as frequent handwashing following bathroom use are recommended. It is also recommended that sick individuals stay home from work or school, to prevent spreading the illness to others. Those affected should also stay hydrated and drink plenty of fluids. If symptoms do not improve after two days, WellSpan Medical Group providers recommend seeking medical care.

This month’s bizarre weather patterns might not just have an impact on your flower beds; medical professionals at Summit Health’s Urgent Care clinics in Cumberland and Franklin counties report a high number of upper respiratory infections, which are most commonly seen in winter months, as well as the start of spring allergy symptoms.

If you suffer from allergies, you know springtime also rushes in sneezing and itchy eyes. Summit ENT Specialist Dr. Anna Grigoryeva shares insight on where you can find relief:
“Allergies happen when your immune system meets something it does not like.  Most commonly people have allergies with pollen, pet dander, dust, mold, bee venom or some foods.According to the Centers for Disease Control, more than 50 million Americans suffer from allergies each year.
Most common reactions are sneezing, coughing and itching.  Reactions can be mildly uncomfortable but can also be life-threatening.

Most people, when they know they have an allergy, just avoid what is bothering them.  Some seasonal allergies, like hay fever, are tough to avoid.

A few small changes can make a big difference.  Wearing sunglasses can help keep pollen out of your eyes.  Wear a mask while working outside and quickly change out of your clothes after going back indoors. Take potted plants out of the home, some potting soil can harbor some triggering molds. Eliminate dust mites from your home by washing your sheets in hot water.

Most of the time, seasonal allergies can be treated with over-the-counter medication.  If symptoms persist, specialists at Summit Ear Nose and Throat can take that treatment farther with allergy testing and treatment.  Providers can order a panel of allergy tests for the most common allergies including grasses, trees, weeds, mold, dander and food.

Treatment includes immunotherapy, which can be a shot or a drop you put under your tongue.  Allergy shots are injections received once a week at the provider’s office. They work by putting a small amount of what you are allergic to in the back of your arm.  The drops are specially formulated for your specific allergies and they can be taken in the comfort of your own home.”

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