GREENSBORO, N.C. — Sun, sand...and a side of germs seem to be washing summer illnesses ashore faster than high tide in a hurricane.
This summer season has offered little reprieve to families, who, for three years, have navigated the emotionally-draining and physically-trying roller coaster of the COVID pandemic, flu season, stomach bugs and a slew of respiratory ailments.
"What we're seeing a lot of is adenovirus, strep (throat) and Hand, Foot and Mouth (Disease)," affirmed Suresh Nagappan, MD, the medical director for Cone Health's children's unit and UNC Medical School campus in Greensboro.
Nagappan, also a father of two, joined the Good Morning Show to elaborate on the slew of summer sicknesses pediatricians across the country are reporting this summer.
Hand, Foot and Mouth
The CDC has declared Hand, Foot and Mouth Disease (HFMD) an endemic in Asia, and Nagappan can attest, firsthand, to its high contagion across central North Carolina.
"Hand, Foot and Mouth is very, very common. (In) kids under five, we see it all the time. What we want to look for, as parents, is bumps, blisters on your hands or feet – it can be sort of a reddish color -- and bumps and blisters in the mouth. You can have a fever with it. Oftentimes, kids are fussy, and oftentimes they don’t want to eat or drink because those sores hurt," he explained.
Because HFMD is a virus, there is no antibiotic pediatricians prescribe. While pain relievers (if children are of age to take them) can provide some relief, Nagappan emphasized the key to healing is hydration.
"One tip I did with my kids is I use a straw, because if they’ve got those sores in the front of the mouth, you get that liquid behind it with the straw," he said.
Nagappan said while adults can catch the virus, it is uncommon, and the virus spreads more commonly through saliva than surfaces.
Adenovirus
While HFMD is generally mild, and the sores clear up within a few weeks, adenoviruses can turn a summer vacation into a pediatric ER stay.
Adenoviruses, as defined by the CDC, are "common viruses that typically cause mild cold- or flu-like illness."
Nagappan said, "Adenovirus and the flu, and honestly a lot of viruses, are very similar. You can see a lot of those symptoms of cough, runny nose, fever, muscle aches. With adenovirus, a couple things that are a little distinctive are red eyes – you can get a little conjunctivitis or a pink eye – and two, it’s a little more common to have those GI stomach symptoms – diarrhea, vomiting."
The next step, he explained, depends on changes in symptoms and trust in intuition.
"The time to go to the emergency room is when your child’s really not acting right. You use your sixth sense – you know they’re off. Trust your gut. That’s the time to go to the emergency room. But, for the most part, just like with all the other viruses, fluid, rest, all the stuff Mom told you to do, that’s still the best advice," he said.
RSV
That best advice, however, can be hard to come by in the moment, when dealing with one of the most serious pediatric illnesses -- Respiratory Syncytial Virus (RSV). The mere sound of the characteristic rapid breathing and raspy cough can freeze parents with debilitating fear. While the virus can present as a mild cold for adults and older children, it can be deadly to infants and seniors with weakened immune systems.
The typical "winter" virus manifested outside of its norms in the summer of 2022, as COVID precautions eased, leaving many children more vulnerable to germs.
"Last year, RSV was the worst we’ve ever seen it. It was really terrible, and we had a lot of kids in the hospital. So this year, this is a great year for fighting RSV. There are actually three things that are out there," Nagappan explained.
He referenced the previously-approved RSV vaccine for adults older than 60, as well as the vaccine for pregnant women. The newest option is Beyfortus, an antibody shot manufactured by Astrazeneca and Sanofi, which gained FDA approval earlier in July and is awaiting final CDC clearance.
"It works different from the vaccine; it’s still a shot, but instead of spurring your own immune system to make antibodies, you’re actually getting the antibodies. It’s still in the very beginning (stages), and we’re hoping it’ll be available this year. It’s hard to know for sure."