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What's Going Around: Stomach bugs, mono, strep throat

UPMC Pinnacle's Heritage Pediatrics in Camp Hill noted there are 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."

Geisinger Holy Spirit Primary Care in Cumberland County reports coughs, colds, sore throats, strep throat, and allergy symptoms, including sneezing, and itchy, watery eyes.
Geisinger Holy Spirit Primary Care in Dauphin, Perry and York counties reports sinus issues and coughs.

This week Penn Medicine Lancaster General Health Physicians Roseville Pediatrics reports a persistence of strep throat and an increase in the stomach bug.

They also saw an increase in viral diarrhea without vomiting. They said it is not as consistent with the classic stomach bug, but still most likely viral.

They report a moderate amount of colds and ear infections and said seasonal allergies are understandably still pretty high.

They are seeing a rise in hand, foot and mouth disease and croup.

As pollen counts climb, providers also are seeing an increase in asthma exacerbations in asthma sufferers.

Dr. Joan Thode offered the following advice about the stomach bug:

"The formal name of the GI bug is gastroenteritis, which is a somewhat generic term to indicate inflammation throughout the GI tract, which leads to vomiting and diarrhea. A large number of viruses can cause these symptoms.

While the virus often starts with vomiting and ends with diarrhea, the opposite could be the case. The diarrhea occurs when the cells of the intestines become injured and therefore absorb less water, sugar and nutrients. Once the virus is gone, the cells lining the intestines must be replaced, which can take up to a week, especially in younger kids, before the diarrhea subsides.

The primary goal for a child with acute gastroenteritis 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. Children of any age who cannot keep any fluids down due to vomiting and/or are showing signs of dehydration, including less urine output, fewer tears, dry mouth, cracked lips, should be evaluated by their doctor sooner rather than later."

CVS MinuteClinic locations across the Midstate reported the following:

Lancaster:
Submitted by: Jessica Myers, Nurse Practitioner
 
"This week we have seen a case of mononucleosis which is commonly seen in children and college students. Symptoms mimic other viral illnesses with fatigue, sore throat and fever over 7-10 days. Swollen glands in the neck are noticeable. Testing is performed with a small blood sample. Treatment is supportive care with fluids, fever reducers like Tylenol and Advil and rest. Sports activity is limited for 4 weeks due to reduce risk of spleen rupture. Treatment is provided in the home setting with most recovering within 4 weeks. Fatigue may persist for months.

Otitis externa was a diagnosed across all ages this week. Symptoms include pain, itching and discharge from the ear. The canal appears red and may have drainage or debris inside. Antibiotic ear drops are administered to treat infection and swelling of the canal. No restriction from school or work is needed if fever free. Symptoms improve rapidly with treatment. Risk factors for otitis externa include swimming, hot and humid weather, and eczema.

We have seen a few rashes in children. Impetigo is a contagious bacterial infection of the skin. It is most frequently found on the face or the site of a minor injury, such as a bug bite, or skin abrasion. The rash will be red with honey-colored crusts. Treatment includes topical antibiotic ointment or an oral antibiotic. The rash will clear within seven to 10 days of therapy. Take precaution to cover the wound and not share personal items. Having a current eczema outbreak can be predisposing."

Harrisburg:

Submitted by: Jessica Clabaugh, Nurse Practitioner

"Patients are presenting with nausea and diarrhea lasting two to four days. Most stomach bugs we see in clinic are self-limited and caused by viruses. Routine antibiotics are not recommended for most individuals with non-severe, watery diarrhea. Focus of treatment is rehydration, preferably oral. If you have diarrhea, focus on consuming electrolyte solutions that will help your body hang on to the fluids that you need. Contact your healthcare provider if you have diarrhea that lasts for more than three days or is accompanied by high fever, blood in the stool, or so much vomiting that you cannot keep liquids down and you pass very little urine.

Pennsylvania, and many other states are currently affected by an E. coli outbreak linked to romaine lettuce. Indicators of E. coli infections usually present 3-4 days after eating or drinking something that contains the bacteria, but illness can present anywhere from 1 to 10 days after exposure. Symptoms vary for each person, but often include severe stomach cramps, diarrhea,often bloody, and vomiting. At this time, it is the recommendation from the CDC to not buy or eat romaine lettuce at a grocery store or restaurant unless you can confirm it is not from the Yuma, Arizona, growing region.

Many patients are still presenting with sinus pain and pressure. For some individuals, these symptoms mark the return of spring allergies, and treatments such as oral histamines help to reduce the severity of the sniffles. Sinusitis infections can also cause facial pressure and discomfort. Eighty percent of sinus infections are viral in nature. They usually peak between days three and six of illness and symptoms taper by day 10 or 12. Yellow or green nasal discharge is a normal finding viral illness, and coughing is your body's way of clearing this mucous from passages. Increased fluids and humidifying air at night can help to keep secretions thin. Additionally, over the counter treatments such as pain relievers, and a cough suppressant used at night can help to lessen the severity of symptoms during your illness. Present to your health provider for severe sinus pain with fever, or if symptoms persist longer than 10 days.

For the third week in a row, strep is still affecting many patients in Harrisburg.  If you or your child has a sharp sore throat with fever that presents suddenly, present to your provider for rapid testing. If found to be positive, treatment includes pain relievers and an antibiotic. Other culprits causing sore throats in our community include viral illnesses and allergies with post nasal drip."

This week, WellSpan Medical Group providers are seeing an increase in seasonal allergy cases, while observing a number of strep throat cases.​​​​​​​

WellSpan providers believe that the cooler weather delayed allergy symptoms for some, until now. For those with mild seasonal allergies, WellSpan Medical Group providers say low-drowsy, over-the-counter antihistamines can help. They urge users to follow label instructions.

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.

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.

Penn State Health is still seeing some lingering flu cases in the Children's Hospital as well as a clinical site in Camp Hill. Pediatricians are seeing a lot of kids with the common cold. They are also seeing seasonal allergies, and some spring sports injuries as well.


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