This week, pediatricians at Penn State Health Children’s Hospital are looking at COVID-19, influenza, upper respiratory tract virus, common cold and stomach virus.

WellSpan Pediatric Medicine Doctors across the Midstate see asthma, allergies, a stomach virus and upper respiratory tract infections unrelated to COVID-19 or the flu.

CVS MinuteClinic in York reports viral upper respiratory tract infections, pharyngitis and a viral stomach defect with vomiting and diarrhea.

Penn Medicine Lancaster General Health Physicians Roseville Pediatrics reports a lot on flu activity this week, specifically flu A. They saw a small increase in COVID-19 cases and a significant increase in sore throat. Croup cases are also up and they treated an increase in ear infections from viral diseases. Pink eye is on the rise in day care institutions. Finally, they saw an increase in vomiting and diarrhea again. These symptoms were within the framework of enterovirus and adenovirus, where cold symptoms are also involved.

Dr. Joan Thode gave the following advice on fever:

“Fever has been a big part of the presentation of various viruses, especially influenza. Influenza viruses are notorious for causing high-grade fever, and we have seen fever in the range of 102-105 with influenza this week.

The most important thing you can do to help your child through an illness with 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 generally feel better if it is well hydrated. Babies younger than six months should only be hydrated with normally mixed infant formula or breast milk – never with pure water – because of their immature kidneys.

You can see your child breathing a little faster when he has a fever and that is normal. All children will breathe a little faster than their typical baseline when they have a high fever, but you will want to see how much they put into breathing. Comfortable, slightly faster breathing is OK to observe at home, although very rapid (over 50 breaths per minute that continues) breathing or sustained expansion of the chest or abdomen in an excessive manner for more than a minute or two is worrying. It’s about how stressed your child looks while breathing.

Your child may seem tired and have low energy with fever, but they are not at a worrying level of true lethargy until they struggle to wake up and cannot maintain any coherent conversation or reaction due to immediately falling asleep again. To test for true lethargy in older children, ask them a question. If they can answer it correctly, they are attentive. In younger, pre-verbal children, try to get them to engage in a toy or book that they like. If they respond correctly, they are alert. True lethargy is a reason to call your doctor right away.

Any fever that lasts five days in a row should be assessed by a doctor in the office, no matter what your child looks like, as they are likely to need additional tests.

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