(WHTM) — WellSpan Pediatric Medicine Physicians across the Midstate are seeing upper respiratory illnesses, asthma attacks, and stomach bugs.

Penn Medicine Lancaster General Health Physicians Roseville Pediatrics reports a lot of blisters this week. They are seeing many cases of hand, foot, and mouth disease and bullous impetigo. Both cause blisters, but in different patterns and with different treatments.

They are still seeing some COVID cases. They noticed a consistent increase in strep throat cases and a lot of allergies.

Bronchiolitis has also been on the steady rise, mainly from RSV.

Dr. Joan Thode offered the following advice:

“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. Don’t worry, they will grow back! 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 and cold smoothies are ways of soothing the throat and maintaining hydration. 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 virus no longer can be spread.

“Bullous impetigo is a bacterial skin infection that also causes blisters, though these tend to be more sporadic, not as consistently in clusters, and do not tend to cluster on the hands or feet. These lesions will typically pop sooner and leave a raw-appearing base in the imprint of the blister. These tend to be painful and can sometimes appear wet or waxy until healed. These lesions do not appear in the mouth and will not cause fingernails to fall off. The treatment is typically oral antibiotics. Fevers are not common. The main concern to watch for is infection of the open-appearing bases of the lesions, which would cause the surrounding skin to become red, puffy and painful.

“We have NOT seen any cases of monkeypox, but in that case, there are painful blisters that often occur in conjunction with large, painful, swollen lymph nodes and a body-wide syndrome of fatigue and feeling sick.

“If you’re not sure what rash your child has, if pain from blisters is causing them to avoid drinking and they are showing signs of dehydration, or if you’re worried about skin infection on the blister sites, seek evaluation with a doctor.”