A Rotorua doctors' surgery is seeing between 40 and 50 sick kids a day as winter illnesses strike the city.
Doctors' surgeries are busy, and schools are seeing more youngsters absent as the dreaded winter bugs strike, with medical officials warning the worst is yet to come.
Bay of Plenty medical officer of health Phil Shoemack said fewer people had been diagnosed with influenza this winter compared with previous years but warned sicknesses would get worse.
"We are expecting a significant further increase in the next few months."
He said the flu peak usually happened later in winter and it hadn't happened yet.
Dr Harry Pert from Ranolf Medical Centre said it had been busier than they'd usually expect over winter, a combination around parents being more vigilant with sore throats and an increase in the number of children with croup.
He said they were seeing many people with the common colds and coughs, but had only seen a few cases of influenza.
Dr Pert said he didn't think the cases were more severe, they were just seeing more of them. They were seeing about 40-50 children a day, compared with "a handful" daily in summer.
An awareness of strep throat and the risk of rheumatic fever if left untreated meant more parents were taking children to doctors with a sore throat. Many turned up who otherwise would not have done so, he said. Other symptoms included runny noses, fevers and coughs.
Dr Pert said there was an increase in children with croup, which could be treated with a single dose of steroids so they liked to see children with the symptoms - which include a barking cough - early.
He said hygiene practices like good hand washing, effective nose blowing and safe coughing habits could help prevent the spread, and said it wasn't too late for people to get the influenza vaccination if they hadn't already.
Central Health practice manager Alison Chapman said they had reached the busy time, however she didn't think it was busier than other winters.
She said the practice would remain busy with winter illnesses through until August.
St Mary's Catholic School receptionist Maggie Dalton said she'd noticed an increase in pupils away sick.
"The winter bugs are definitely coming home to roost now."
She said yesterday there were about 20 children away from the roll of about 400.
Lakes District Health Board spokeswoman Shan Tapsell said there had been more people turning up to the emergency department with respiratory problems but they hadn't yet had a "significant increase" in people with cold and flu symptoms, like previous years.
She said people with winter-type illnesses tended to go to family doctors first but if they didn't get treatment early enough, they could need a hospital stay.
The hospital expected to see increased numbers of unwell people during the winter months and said bed numbers could be "quite tight" in winter months but so far they had sufficient beds, Ms Tapsell said.