The providers at UPMC Children’s Community Pediatrics in York and Spring Grove are continuing to see strep throat, RSV, flu and hand, foot and mouth. They are also seeing coxsackievirus this week.

The CVS MinuteClinic in York reports COVID, viral upper respiratory infections, viral bronchitis and some poison oak and poison ivy rashes.

WellSpan Pediatric Medicine Physicians across the Midstate are seeing RSV, flu and strep throat.

Penn Medicine Lancaster General Health Physicians Roseville Pediatrics reports a big increase in enterovirus, which has caused prolonged wet coughs, long-lasting fevers, sometimes five to six days, stomach upset and dehydration. It also sometimes leads to secondary pneumonia in older kids.

Strep cases remain moderate and they continued to see cases of croup and COVID.

Dr. Joan Thode offered the following advice about fevers:

“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 they are having trouble breathing. All kids will breathe a little bit faster and deeper than their typical baseline when they have a high fever, but you want to see how much effort they are putting into breathing. Comfortable, slightly faster breathing is OK to observe at home, though very rapid, over 50 breaths per minute that persists, breathing or persistent expanding of their chest or belly in an exaggerated way for more than a minute or two is concerning. 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 a change in their cry is concerning in the context of increased breathing effort. Persisting respiratory distress is a reason to call your physician.

ASK: Ask older kids 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 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 immediately falling back asleep. In infants, if their muscle tone is more floppy than their typical baseline when well, this is another highly concerning sign that needs evaluation right away. True lethargy is a reason to call your physician right away.

HYDRATE: The most important thing 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, due to their immature kidneys. Inability to maintain hydration and a decrease in urine output is a reason to contact your doctor for evaluation.

You’ll notice that medicating a fever is not on the list. 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 therefore more willing to drink water and stay hydrated. The aim during a fever is hydration and comfort for your child.

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