Whats Going Around: Scarlet fever, flu, strep throat

UPMC Pinnacle’s Heritage Pediatrics in Camp Hill continues to see gastrointestinal viruses, also known as the stomach bug, viral upper respiratory infections and a few cases of influenza. 

They are also seeing a lot of strep throat, and many children are presenting with the classic rash of scarlet fever.

Dr. Kathleen Zimmerman offered the following advice about scarlet fever:

“Scarlet fever is like strep throat, but there is a classic rash on the body and usually a high fever as well as the usual symptoms of strep throat, including red sore throat, swollen tonsils and swollen neck lymph nodes, sometimes headache, abdominal pain and mild vomiting.   The rash is actually not dangerous or contagious and the infection is treated with antibiotics the  same way that strep throat is.  But the rash can be quite noticeable; it is typically referred to as a “sandpaper” rash because there are many tiny red bumps on the skin close together so it feels like sandpaper. 

Usually the redness appears on the face, neck and trunk first, but it can also be on the arms and legs and often in the creases of the groin.  The rash is caused by a skin toxin from the strep bacteria, but the rash does not need any special treatment.  Once antibiotics are started the fever and the sore throat should resolve within 48 hours, but the rash can take days to fade away.  Often as it fades, it is itchy and can cause some faint peeling of the skin.  Lotions can be used to help soothe the itchiness.”

Penn Medicine Lancaster General Health Physicians Roseville Pediatrics saw a continued steady rise of Influenza A.

Strep remained at about 45 percent of the sore throat cases seen. They again saw an increase in gastroenteritis, or the stomach bug, though some cases of vomiting ended up being strep.

Croup decreased, while bronchiolitis increased in infants and toddlers. Walking pneumonia is on the rise. Viral colds remain at the top of the diagnosis list, and more than half of these involved fevers.

Dr. Joan Thode offered the following advice about fevers:

“Fevers are generated by the body as a “battle tactic” of the immune system. The purpose of this “battle tactic” is to increase the temperature of the environment in the body so that it’s harder for the virus or bacteria to survive. Fevers, therefore, are helpful.

The downside is that the person experiencing the fever feels pretty awful. There is no harm in treating a fever with an appropriate dose of acetaminophen (Tylenol) or ibuprofen (Motrin, Advil) to make the child feel better. But it’s also not necessary to treat a fever. It’s best to treat based on how the child looks and feels, NOT the number of degrees of the fever. If a child is willing to drink and stay hydrated and is interactive and alert at 102 degrees, it is not necessary to treat the fever. If, however, the fever makes the child so miserable that they are not willing to drink and are at risk of getting dehydrated, treating the fever is justified.

A sick person may feel hot to the touch, but they will report that they feel cold and have “chills.” There is therefore no need for cool baths. This will likely make the individual feel worse, as they are already feeling cold.

While younger kids have the capacity to spike very high fevers (104-105) in response to certain infections, the temperature will never get to a deadly level–the body will “break” the fever with sweating and other cooling mechanisms. The height of the fever is not what concerns us; it’s how the child looks. A child who is unable to respond and seems more limp than their typical muscle tone is very concerning, even at a “low fever,” while an active alert child with a 105-degree fever and no other respiratory or hydration changes is not as concerning.

When to worry about a fever: it lasts for five or more consecutive days; it causes your child to become less alert and less able to respond to you; any seizure activity with a fever; fevers that go away for a few days but return within the same course of illness. Any fever in a baby younger than 2 months is considered an emergency.”

The CVS MinuteClinics across the Midstate reported the following this week:

Submitted by: Jessica Myers, Nurse Practitioner

“Strep pharyngitis (strep throat)- We have seen many cases of strep throat in adults and children. Some symptoms include fever, headache, sore throat, fatigue and absence of other cold symptoms. Rapid testing in office is available and a confirmatory send out lab may be needed to confirm the diagnosis. If positive testing antibiotics are prescribed. Patients typically improve within 3 doses of medication. OTC fever and pain reducers help reduce inflammation and pain.

Influenza A (flu)- We continue to see flu cases in children and adults. Presenting symptoms include rapid onset of illness, high fever, fatigue, body aches, sore throat and cough. Rapid testing is available. Antiviral medications can be considered on a case by case basis. Prompt treatment is critical. Secondary bacterial infections are common after a flu virus. Flu lasts 10-14 days.

Wellness screenings- We are seeing many patients for screening lipid and glucose levels. Many employers encourage employees to “know their numbers” as a way to reduce chronic illness and complications. Lipid and glucose testing is done in the office with results in 5 minutes. Patients will get more accurate results if fasting 8-12 hours.”

Submitted by: Stacey Basta, Nurse Practitioner

“In York, the top 4 stay the same this week: upper respiratory infections, bronchitis, strep throat and the flu.”

Geisinger Holy Spirit Primary Care in Cumberland County reports upper respiratory issues, such as cough, colds, and sinus congestion, the flu, and a stomach virus with vomiting, diarrhea, and abdominal pain.

Geisinger Holy Spirit Pediatrics in Cumberland and Dauphin counties reports the flu, cold and coughs, strep throat and stomach viruses.

This week,  a lot of viral illnesses are going around Penn State Health. Pediatricians are seeing the flu, upper respiratory viruses, and colds.

WellSpan Pediatric Medicine Physicians are see some cases of croup and respiratory tract infections pop up. They also are reporting influenza A and with it some mild gastrointestinal distress as well as the typical aches, fever, and cough. Many kids are also coming in with sore throats.

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