What’s Going Around: Hand, foot and mouth, bronchiolitis, COVID-19 and influenza


UPMC Children’s Community Pediatrics in York and Spring Grove reports hand, foot and mouth and RSV bronchiolitis.

The Coxsackie virus, also known as hand, foot and mouth, can start with a fever, sometimes a high fever up to 105, for three to five days. Then tiny blisters start to show up , typically around the mouth, on the hands and feet, and often in the diaper area. Blisters also develop on the back of the mouth or throat and sometimes on the tongue. This causes a sore throat. Many children drool and refuse to drink or eat. Hand foot and mouth virus is very contagious. If you see a rash like this on your child or if they are not drinking well or saying they have a sore throat, call your medical provider. There is no treatment for hand foot and mouth. It will resolve on its own after about seven days. However, your child should not go to school while they have the fever or rash. It is important to make sure your child is drinking enough fluids to stay hydrated. If you feel they are not, call your doctor’s office for guidance on pain control and signs of dehydration.

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Bronchiolitis starts as a typical cold 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. 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 their provider immediately.

Penn Medicine Lancaster General Health Physicians Roseville Pediatrics also reports a sharp increase in hand, foot and mouth and continued high rates of bronchiolitis.

COVID-19 cases on the slow rise. Strep throat cases are rising quickly. They are also treating viral illnesses that are not diagnosed as COVID.

Rashes, including poison ivy and impetigo, are continuing in moderate numbers.

Dr. Joan Thode offered the following advice about hand, foot and mouth:

“It’s a misnomer as the lesions of this virus can and do occur anywhere from head to toe, not just on hands, feet and mouth.

It tends to concentrate in areas of increased friction, which often include the hands, feet, lips, and buttocks. Lesions often start as small red bumps and then can progress into bubble-appearing lesions.

In kids, the lesions do not typically hurt unless they occur in the mouth or throat. Then it causes a severe sore throat that can make the child less likely to want to eat. In this situation, it’s most important to maintain the child’s hydration

The skin lesions on the hands and feet of teens and adults is acutely painful

Kids are contagious a few days prior to the lesions developing and until they are fever-free for 24 hours. The lesions that are bubbled also contain virus within the fluid and can be spread.

It’s a virus that causes this condition, so it typically lasts three to seven days.

As with any virus, it’s important to maintain hydration, offer comfort measures, and call the doctor for evaluation if the fever lasts 5 consecutive days.”

WellSpan Pediatric Medicine Physicians across the Midstate are seeing COVID-19 cases in patients who are mild to moderately ill, rashes, a few positive influenza cases, lots of sports physicals for the school year, and some children with RSV.

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