What’s Going Around: Breathing issues, stomach bugs persist


UPMC Pinnacle’s Heritage Pediatrics reports there has been more coughs with wheezing this week. In many cases, these are due to viruses that causes wheezing and a deep cough, and can result in difficult breathing. In younger children and babies this illness is called bronchiolitis.

Bronchiolitis starts as a typical cold in the first few days with a lot of nasal congestion and nasal discharge and sometimes a fever. Then after a few days to a week, the cough becomes deeper and wheezing begins.

Wheezing can present as fast shallow breathing, a whistling sound with breathing, and coughing spells. If your child is showing any of these signs, call your medical provider.

“Treatment for bronchiolitis is supportive; there is not a medicine that will make it resolve faster,” Dr. Kathleen Zimmerman said. “However, younger children and babies can worsen before they improve, sometimes to the point of respiratory distress. So if you think your child is wheezing, be sure to call your provider immediately.

This week at the CVS MinuteClinic in York, the most prominent types of visits were for viral upper respiratory infections and bronchitis.

This week they did have several cases of strep throat and a few cases of viral gastroenteritis or the stomach bug.

For viral gastroenteritis, most care is supportive. Parents are advised to provide electrolyte replacement fluids, rest, and advance diet from clear liquids up to bland diet, slowly, as tolerated.

No flu was noted this week.  The Centers for Disease Controls reports activity is still relatively low in the area.

WellSpan Pediatric Physicians in York have noticed an uptick in hand foot and mouth disease, strep throat and upper respiratory infections.

In Lancaster County they report continued cases of gastroenteritis.

The best prevention of all of these is great hand hygiene, including washing with soap and water or alcohol-based hand sanitizer, and not sharing cups, utensils, or anything that has been in someone’s mouth.

This week, pediatricians at Penn State Children’s Hospital and Penn State Health Medical Group are seeing a lot of the common cold going around and some cases of bronchitis. They are also seeing a few cases of respiratory infection.

Geisinger Holy Spirit Pediatrics in Cumberland and Dauphin counties reports viral sore throats, headaches with fever, upper respiratory infections and cases of the flu.

Geisinger Holy Spirit Primary Care in Cumberland County reports sore throats, coughs, colds (upper respiratory virus), the flu and strep throat.

Penn Medicine Lancaster General Health Physicians Roseville Pediatrics started to see an increase in strep throat, which came in around 35 percent of sore throats seen, which is an increase from 30 percent last week.

They continued to see more and more bronchiolitis in babies and toddlers. In older toddlers and children, they saw a big increase in pneumonia.

The stomach bug has continued to be seen in low to moderate amounts. Colds continue to be seen in high numbers, and with that, cases of sinusitis and ear infections have persisted, as can be expected.

Though out of season for typical roseola, they have actually seen a small surge this week. Roseola is a viral illness that causes high fevers for three days, after which the fever leaves and the child gets a body-wide, non-itchy, blotchy rash that fades on its own over two or three days.

Dr. Joan Thode offered the following advice about pneumonia:

“Pneumonia is an infection of the cells that make up the airways of the lungs. As a result of this infection-which can be from a virus, bacteria or (more rarely) a fungus-there is inflammation that occurs as a result of the infiltration of the bacteria or virus, as well as additional inflammation from the immune system’s response to the infiltrating microbes.

Because the infection will additionally cause the immune system to react and attack, there will be an increase in thick mucous within the affected airways. This thickened mucous will sometimes completely obstruct the airway and prevent oxygen from reaching the end of the airway, where it can get into the bloodstream. If the pneumonia is severe enough, and enough of the airways are affected, the lungs may be unable to bring in enough oxygen, and the body will compensate by breathing more frequently/quickly. Therefore, rapid breathing is a big sign of concern.

To get rid of some of the accumulated mucous, the lungs will cough, which will sound wet. While most wet coughs will be from post-nasal drip, a persisting wet cough can sometimes be an indicator of pneumonia.

Immune activation to fight off the virus or bacteria causing the pneumonia will often (but not always) involve a fever. A fever is a tool that the immune system uses to make the environment of the body less hospitable to the microbes.

The combination of wet cough, fever and rapid breathing can be seen with a number of different diagnoses, including bronchiolitis, severe viral illnesses and pneumonia. If your child is experiencing any kind of increased work of breathing or rapid breathing, regardless of the presence of other symptoms, they need prompt medical evaluation. Wet cough with fever that persists for a couple days, or a cough that lingers and has a fever start later in the illness course are also reasons to seek medical evaluation.

Treatment for pneumonia often involves antibiotics, as well as additional supportive care, such as oxygen, if needed.”

An important reminder from Roseville:

“As the weather becomes perpetually freezing, it’s typical to break out the puffy coats and jackets to keep our kids warm. But puffy coats are dangerous when worn in a car seat or booster seat, because they prevent the full tightening of the car seat straps or seatbelt against the child’s body. In an accident, the velocity of the child’s body will quickly compress the volume of the coat, and the extra space between the child’s body and the straps will allow for more body movement, increased injuries and possibly even ejection from the seat. It’s best to place your child snugly in the seat in their indoor clothing and lay the coat or a blanket on their lap to keep them warm. When you reach your destination, the coat can be put on once the child is out of the car seat.”

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