What's Going Around: COVID, hand, foot and mouth

The CVS MinuteClinic in York reports a few cases of COVID and viral upper respiratory infections this week.

This week, pediatricians at Penn State Health are seeing a lot of summer colds, hand, foot and mouth, viral stomach bugs and they're continuing to see COVID cases creep up.

This week, the providers of UPMC Children's Community Pediatrics in York and Spring Grove are seeing hand, foot and mouth disease. They are also seeing cases of COVID-19 and strep.

Penn Medicine Lancaster General Health Physicians Roseville Pediatrics reports an increase in mono and croup this week. They also saw viral illnesses with a cough and an ongoing high number of hand, foot and mouth cases.

Dr. Joan Thode offered the following advice about viral coughing:

"As we all know, viral upper respiratory infections create a lot of nasal mucous. The anatomy of the nose naturally drains the mucous down the back of the throat and into the esophagus to the stomach and eventually out of the body.

The cough occurs as that descending mucous triggers the nerves at the top of the airway. These nerves respond as if the child is about to choke on food and immediately cause a protective cough to push the mucous away from the top of the trachea and away from the lungs. The blast of air through the thick mucous causes the cough to sound wet.

Viral coughs tend to occur after the start of nasal drainage and persist after the virus is done, due to the continued drainage of the accumulated mucous in the nose. At night, when a child lies down for sleep, gravity causes the mucous to pool in the back of the throat, and this wet cough can sound even worse. Coughing "fits" are more likely at night or early morning because the mucous has had enough time overnight to accumulate a larger volume in the back of the throat, requiring a lot more coughing to clear.

Unfortunately, there is no way to speed up this drainage process. The wet cough following a "cold" will typically not cause high rates of breathing or significant retractions, as the lungs' ability to get oxygen is not affected by postnasal drainage. Thus, the child may have a similar sounding wet cough to a peer with bronchiolitis, but they are much less likely to have true respiratory distress."