What’s Going Around: COVID-19, RSV, bronchiolitis, strep throat, hand, foot and mouth

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Close-up of doctor with stethoscope

Penn Medicine Lancaster General Health Physicians Roseville Pediatrics saw a lot of fevers, viral illnesses, COVID-19, hand, foot and mouth, bronchiolitis, a stomach bug and strep throat.

Dr. Joan Thode offered the following advice about fevers:

“It’s easy to panic when your child has a high fever. In pediatrics, it’s more about the way the child looks than how high the fever number is. A pediatrician will be a lot more concerned about a child with a 102 fever who is having trouble staying awake than with a child with a 104.8 fever who is alert and able to drink fluids.

When concerned about a fever, remember to LOOK, LISTEN, ASK, and HYDRATE

LOOK: The first thing to do when your child has a fever is to see if your child is having trouble breathing. All kids will breathe a little bit faster than their typical baseline when they have a high fever, but you want to see how much effort they are putting into breathing. It’s about how stressed your child looks while breathing.

LISTEN: Is your child making any consistent noises or gasping sounds when they inhale or exhale? Is their cry nice and strong or more weak and hoarse? Noisy breathing or change in their cry is concerning in the context of increased breathing effort. Persisting respiratory distress is a reason to call your physician

ASK: In older kids, ask them a question. If they can answer it appropriately, they are alert. In younger pre-verbal kids, try to have them engage in a toy or book that they like. If they respond appropriately, they are alert. They may appear fatigued and have low energy, but they are not at a concerning level of true lethargy until they struggle to wake up and cannot maintain any coherent conversation or response due to their immediately falling back asleep. True lethargy is a reason to call your physician right away

HYDRATE: The most important thing that you can do to help your child through an illness with a fever is to give them water. The higher temperature causes evaporation of water from the skin surface, and with the typically low appetite and faster breathing can cause some dehydration. Your child will feel better overall if well hydrated. Babies younger than 6 months should be hydrated only with formula or breastmilk, never with pure water. Inability to maintain hydration and a decrease in urine output is a reason to contact your doctor for evaluation

A fever does not need to be treated. We often treat them not to protect the body from the heat, but rather to make the child feel a bit better and thereby be more willing to drink water and stay hydrated. The body will not cook itself to a deadly level, but rather it is using the higher temperature to make it harder for a virus or bacteria to survive (thus helping the immune system win the battle). The aim during a fever is hydration and comfort for your child.

All fevers lasting 5 consecutive days should be evaluated by a physician in the office and likely additional testing.”

WellSpan Pediatric Medicine Physicians across the Midstate are seeing acute asthma attacks, bronchiolitis causing congestion and difficulty breathing in infants, croup and viral respiratory illnesses, including RSV, influenza, and COVID-19.

This week, pediatricians at Penn State Health Children’s Hospital and Penn State Health Medical Group locations in Cumberland County are seeing COVID, RSV, colds, strep throat and hand, foot and mouth disease.

The CVS MinuteClinic in York saw viral upper respiratory infections and COVID-19 this week.

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