What’s Going Around: COVID, strep, hand, foot and mouth

WellSpan Pediatric Medicine Physicians are seeing COVID, upper respiratory infections and continued pneumonia cases this week. They’re also seeing diarrhea in toddlers.

This week, pediatricians at Penn State Health Children’s Hospital are seeing a surge in COVID cases and an uptick in upper respiratory viruses. They are also seeing a lot of colds and some stomach bugs.

UPMC Children’s Community Pediatrics are seeing viral illnesses that are not positive for COVID or flu. Symptoms include fever, congestion and cough.

Penn Medicine Lancaster General Health Physicians Roseville Pediatrics saw an increase in COVID cases this week. They also saw a bump in strep throat and hand, foot and mouth cases. They say enterovirus made a comeback this week, causing fever, sore throat and congestion. They are still seeing patients with mycoplasma, and as some fields are getting cut in Lancaster County, they have seen an increase in fall seasonal allergy symptoms.

Dr. Joan Thode offered the following advice about sore throats:

“Herpangina is a term meaning sores in the throat and mouth. These are typically very painful and can make kids not want to eat or drink to avoid the pain of swallowing. This painful issue can be caused by a variety of viruses, including hand, foot and mouth, as well as enterovirus. We have been seeing a lot of hand, foot and mouth as well as an increase in enterovirus this week.

Hand, foot, and mouth disease is caused by one of a handful of viruses, particularly the Coxsackie virus. The rash appears as flat or slightly raised red spots with a small, fluid-filled bubble. It is often accompanied by a fever and decreased appetite and energy for three to seven days.

The rash can be found from head to toe, and often appears in clusters on the palms, fingers, soles, toes, lips and buttocks. Fingernails and toenails may appear abnormal or even fall off weeks later. Don’t worry, they will grow back! When the lesions occur in the mouth, they will cause a very painful sore throat that may cause your child to be unwilling to eat or drink.

There is no cure, and the virus will run its course in five to seven days. During this time, hydration is the number one goal. Ice water, popsicles, cold smoothies and crushed ice are ways of soothing the throat and maintaining hydration. Your child will regain lost calories once feeling better.

Hand, foot, and mouth disease is contagious as long as your child has a fever and/or has intact bubbles within the rash. The bubbles on the skin contain active viral particles in them, which will spread the virus if the bubbles open. The virus is generally spread by getting the virus in the mouth after touching an infected surface. Once the rash begins to crust over and the fever improves, the immune system has killed the virus and it no longer can be spread.

Coxsackie virus can remain on surfaces for long periods of time. Toy-sharing is a major way of spreading the virus, particularly in daycare and school settings. Disinfecting toys and surfaces is a good way to lower the risk of infection, though frequent hand washing with soap is the best way to prevent the viral spread.

Enterovirus is a particularly mean virus that can cause an array of symptoms that can include congestion, runny nose, sore throat with mouth sores, nausea and vomiting, belly pain, extreme fatigue, cough, muscle soreness or general achiness, headaches and fever. Neck stiffness can occur and can mimic meningitis. In asthmatics, enterovirus can cause wheezing and asthma attacks with tight chest and difficulty breathing.

As with all viruses, treatment includes methods to support the patient through the illness, as antibiotics do not work against viruses. The course of acute enterovirus can last from four to seven days, sometimes with a gradual recovery. The main treatments are pain relief and hydration. Ibuprofen and acetaminophen are the mainstays of comfort treatment, and hydration is the primary goal. The mouth sores can make hydration difficult as the pain makes kids want to avoid swallowing. Chilling water and providing low-acidity cold or frozen treats like slushies can help prevent dehydration from a sore throat.

Enterovirus is spread via droplets from one patient to another, such as when coughing or sneezing. The virus can also survive on surfaces that have been touched by someone who coughed into their hand. Frequent hand washing and disinfecting of toys is important for protecting younger kids as best as possible.”

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