A doctor has warned about an infection that can leave babies struggling to breathe.
Bronchiolitis, which affects the chest, is usually seen in children under two years of age.
But cases are now becoming increasingly more common in older children.
Health chiefs said symptoms of the infection include a runny nose or cough, a temperature, irritablility, and even difficulty breathing.
Cases of bronchiolitis are reportedly on the rise in the UK - in addition to the presence of deadly Strep A.
Dr Murugesan Raja, a GP and clinical lead for respiratory medicine in Greater Manchester’s NHS, has issued a warning to parents about what symptoms to look out for.
Dr Raja told Manchester Evening News : "Symptoms usually start with a runny nose or cough. You should start to think about seeing a GP or calling 111 if they develop a fever, if they are not being their usual self, if they start to feed less, if they are not wetting their nappy enough.
"If you also hear some sounds from the chest or you think the infection has gone to the chest you should try and contact 111.
"If you have a baby that is less than three months old, if their temperature is more than 38 then that’s serious.
"In babies older than three months and less than six months, a temperature above 39 is not a good sign.
"With bronchiolitis if a child has a blue lip or they look pale or if you notice they have pauses in their breathing then that is again a 999 call.
"If they are very irritable and not themselves and working hard to breathe you’d want to call 999 for that. If you think something isn't right with your baby or child, please seek help."
The virus is mild in most cases, and will usually clear within two weeks. But Dr Raja warned there will be some babies who could become severely ill and would need to be treated at hospital.
Because of an increase in cases of Strep A, as well as bronchiolitis, it's important to be able to distinguish the two - as they are treated differently.
He added: "Strep A we are seeing a lot more these days.
"Bacteria infections can be treated with antibiotics so we do need to see children quite quickly.
"With Strep A, we are seeing they are starting with a fever, sore throat and high temperature.
"Usually 12 hours after that, they develop a rash on their body.
"The colour may differ depending on their pigmentation. In white skin, it’s red, but dark brown in others.
"The tongue can become very red and lumpy."
The presence of bronchiolitis and Strep A in the community are putting a strain on NHS services in the area Dr Raja admitted, but he said it's still important for parents to seek medical attention if they think their child is unwell.
He said: "Bronchiolitis and Strep A is definitely putting pressure on hospitals, GPs and A&E attendance but we would of course rather see the children then not, but we want parents to be aware when to contact 111 and when to ring 999 or come to A&E."
The rise in Strep A and other winter viruses are thought to be more prevalent now because of social mixing, One director of public health has said paediatric units 'have never been under so much pressure.'
Scarlet fever cases are also on the rise, much is much earlier in the season than expected.
David Regan, Manchester’s Director of Public Health said: "Speaking to the Royal Manchester Children’s Hospital and other paediatric units, they’ve never been under so much pressure.
"That’s not just because of scarlet fever or invasive Strep, it’s other respiratory illness - flu, it’s a range of things all coming together putting extreme pressure on our hospital systems.
"In Greater Manchester, hospitals work together to make sure children get access to the best service they can, whether that’s at one of our district hospitals, one of our specialist hospitals.
"There are good plans in place to respond to the situation, move children about if necessary from a general and acute bed into more specialist care - we are fortunate to have the resources we have in Greater Manchester."
Although there is little parents can do to prevent their child catching bronchiolitis, getting the flu vaccination can ward off the virus, as well as general hand washing and limiting mixing with people known to be unwell.
Dr Raja said: "We are seeing a combination of viruses in our hospitals including flu, which can cause Bronchiolitis and of course we are seeing Strep A as well.
"I think we are mixing a lot more than the last two years and places are extremely busy. Whether you get on the tram or go to the Christmas markets, you are much more likely to get infected."
