What’s Going Around: Strep, COVID, colds

This week, pediatricians at Penn State Health Children’s Hospital are seeing an uptick in COVID cases and upper respiratory viruses. They are also seeing some colds and strep throat.

WellSpan Pediatric Medicine Physicians across the Midstate are seeing non-COVID respiratory infections and diarrhea. They’re also seeing a lot of back-to-school updates like general checkups and immunizations.

Penn Medicine Lancaster General Health Physicians Roseville Pediatrics reports strep throat, a couple cases of COVID, colds, ear infections and moderate cases of the stomach bug.

Dr. Joan Thode offered the following advice about congestion as kids head back to school.

“Viral illnesses are a common issue for kids and teens. The average number of colds for a toddler or school-aged child with a normal immune system ranges from six to 10 per year. Many of these are clustered in the colder months.

The good news is that even in babies and toddlers, the immune system is fully able to fight and kill off a virus. The bad news is that it can take a few days for the immune system to wage battle, and during that time, the child may have low energy, low appetite, congestion, cough, chills and/or a fever.

Congestion is the most typical symptom of viruses that cause a cold” and it’s a combination of the virus invading our mucosal tissues – the shiny, slimy lining of our nose, mouth, and sinuses – as well as our immune system’s response to the virus. The result of the invasion and the body’s defense mechanisms, like thickening mucous and increasing blood flow to the location, create lots of snot. The presence of the immune cells will turn the mucous various colors, from white to yellow to green. The color of the mucous therefore does not indicate a worse infection or a bacterial infectio, only the presence of the immune system.

Thick mucous can be annoying, but the concern is about the timing and not about the mucous appearance. In a typical viral course, the immune system will battle and beat the virus in three to five days on average. During this time, the mucous and congestion/runny nose will increase. After that time, if the immune system has beaten the virus, the child’s energy will increase, but so will the drainage of the mucous down the back of the throat as the body starts clearing the mucous from the nose by sending it down the esophagus and eventually out of the body. This drainage process can last three to seven additional days during which time the child may frequently clear their throat or cough, though the nasal congestion should be getting progressively better during the day. Laying down at night may still cause a lot of congestion due to position making it hard to drain the mucous as efficiently. Sinus pressure is common during this time period and does not consistently indicate a sinus infection.

When to worry? We worry after the congestion has lasted without improvement for 10 or more days, or when the congestion seems to improve but then significantly worsens within a seven to 10 day period of time without fully going away. In these cases, the concern is that the mucous has remained stagnant in the sinuses long enough that the bacteria that naturally lives in our sinuses to grow on the mucous and create a bacterial sinus infection. This process takes time to occur, which is why clinicians do not suspect a formal sinus infection before 10 days. Sinus infections can have associated fevers, though frequently do not.”

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