What’s Going Around: Pneumonia, flu, COVID, colds

UPMC Children’s Community Pediatrics is seeing hand foot and mouth, the flu and viral upper respiratory infections this week.

This week, pediatricians at Penn State Health Children’s Hospital continue to see a lot of colds, stomach bugs and upper respiratory viruses. They are seeing COVID, some RSV, and a few cases of pneumonia.

Penn Medicine Lancaster General Health Physicians Roseville Pediatrics reports ongoing cases of pneumonia, many from mycoplasma. Enterovirus continues to be seen in high numbers. It’s causing vomiting, belly pain, fever, headache, sore throat, congestion, and sometimes ends with diarrhea. They are also seeing a lot of other colds, but so far have not detected any flu cases. Strep throat cases have held steady in moderate numbers. They have also seen an increase in asthma exacerbations and fall allergies are still in full swing.

Dr. Joane Thode is offering the following advice on differentiating lung sounds:

“Wheezing is a high-pitched whistle-like sound, either with inhale or exhale, that is related to inflammation in the lungs. Inflammation is caused by the immune system attacking a threat or a perceived threat, and the result can be partial or complete closure of the small airways.

Asthma is a chronic condition of either frequent flares of this inflammation or a more persistent smoldering inflammation. Asthma technically cannot be formally diagnosed until after the age of 2 years, though infants and young toddlers can get wheezing related to specific viral or bacterial lung illnesses. Infants and toddlers with wheezing discovered in relation to an infection are not guaranteed to have asthma later in life, though they should be watched a bit more closely.

Bronchiolitis is a virus-induced inflammation of the tiniest of the airways. This typically affects only babies and toddlers. The issue with bronchiolitis is that the small airways can swell shut/fill with mucous, which prevents oxygen from getting to the air sacs at the end.

Any case of wheezing should be evaluated by a physician, because wheezing, regardless of the source, indicates inhibited air flow through the lungs. Many, but not all cases of wheezing can be helped with nebulizer or inhaler treatments, though sometimes other interventions are needed. If you notice sustained fast breathing, using the belly to breathe, having an exaggerated expansion of the rib cage with every breath, called retractions, inability to eat or drink due to the fast breathing, and/or any purple or blue color around the mouth or lips, call your child’s doctor right away.

A chest rattle is not a wheeze; a rattle typically indicates post nasal drainage creeping down the back of the throat that then is moved by the inhale and exhale of the child. They usually clear this rattle, at least temporarily, with a hearty cough. A rattle in the absence of retractions, wheezing, or increased effort of breathing can be observed at home, though as soon as a child demonstrates wheezing, an impending sense of doom, or increased effort and/or retractions, they need to be medically evaluated.”

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