Strep throat is a common illness, especially in children between the ages of 5 and 15. This throat infection is caused by group A streptococcus bacteria and is most frequently diagnosed during the late fall, winter, and early spring. Symptoms can include a red and painful throat that begins suddenly, a fever above 101ºF, and white patches on the tonsils or in the throat. Its symptoms usually include a very sore throat, stomach pain in the lower abdomen and high fever. The neck glands may also be swollen, and a person with strep throat may feel ill, weak, and/or achy. The infection itself signifies the presence of large amounts of strep bacteria in the throat and needs to be treated with antibiotics in order to be cured. Treatment typically involves antibiotics, such as penicillin.
Strep throat, though common today and easily treated, was once one of the most devastating illnesses a person could get. It frequently progressed to either rheumatic or scarlet fever, which could cause lengthy illness, damage to the heart and even death. Until the discovery of antibiotics, strep throat remained complicated and difficult to treat, and like pneumonia was indicated in a number of childhood deaths.
The ability to treat strep throat with antibiotics is often ignored, and people may adopt a wait and see approach to treating the condition. This is definitely not advised. If a person has a sore throat, high fever, and stomach pain or stomach upset that persists for more than a day, strep throat should definitely be considered. If the streptococcus bacteria are responsible for the infection the condition will not get better on its own.
The test for strep throat is a fairly simple one. Until recently, doctors had to take a swab from the back of the throat and wait 24-48 hours to detect the presence of thriving strep cells. Today, most physicians have rapid strep diagnosis, which allows a patient to get a diagnosis in about five minutes. When strep is present, antibiotic treatment can begin immediately.
People with strep throat usually begin to feel better after a few days of treatment, but it's important to finish all antibiotics prescribed. Failing to finish the prescribed amount can cause the bacteria to reassert itself, resulting in strep throat symptoms emerging again. Occasionally, one form of antibiotic does not adequately kill strep throat. If symptoms disappear and then reappear a few days later, it's important to check with a physician about possibly changing to a different antibiotic medication.
Strep throat is most common among children and teens, and most contagious when the greatest number of symptoms present. A person with strep, even on antibiotic treatment can remain contagious for up to 21 days. Normally, the infected person, when not symptomatic, can protect others by not sharing food and observing good handwashing hygiene. Risk of contagion to others decreases sharply after a person's symptoms have disappeared and he or she has been on antibiotics for a couple of days.
For parents, strep throat in a child should mean keeping the child at home from daycare, preschool or regular school until a few days after antibiotic treatment has begun and symptoms have cleared. Continued presence of symptoms means greater likelihood of passing the illness to other children. Sometimes children will also have cold or viral symptoms concurrently with strep throat, which makes them more contagious to others. In general, following a doctor's advice on when a child should return to school is good practice.
Not all fevers and sore throats mean you or your child have strep throat. Lots of viral infections include sore throats and fevers. When this fever persists beyond a day or two, strep throat may be a possible cause. Fortunately, it has never been easier to diagnose strep throat than it is today.
Strep throat is a throat infection caused by group A streptococcus bacteria (GAS for short). The scientific name for these bacteria is Streptococcus pyogenes. This type of bacteria is commonly found in the throat and on the skin of healthy people. Although many people may carry these bacteria and show no symptoms of illness. If the bacteria do cause an infection, it often results in relatively mild illnesses such as strep throat, impetigo, scarlet fever, or cellulitis, to name a few.
Occasionally, group A streptococcus can cause severe and even life-threatening illnesses. This happens when bacteria get into parts of the body where bacteria are not usually found. This can include places such as the blood (bacteremia), lungs (pneumonia), or the fat layer under the skin (necrotizing fasciitis). These infections are sometimes called invasive GAS infections. However, it is rare for people with strep throat to develop invasive GAS infections.
Up to 30 percent of throat infections diagnosed in children between the ages of 5 and 15 are the result of strep throat. Adults and infants can also get strep throat, although it is less common. Up to 10 percent of adults who seek medical care for a sore throat are diagnosed with strep throat.
Although common, strep throat is not the most likely reason for a sore throat. Up to 50 percent of sore throats are caused by an infection with a virus.
Strep throat is contagious. However, most people do not get group A strep infections from casual contact with others. Instead, the bacteria are transmitted through contact with infected throat mucus, nasal discharge, or saliva.
This can happen when an infected person sneezes or coughs, and infected droplets spray into the air. The infected mucus can land in another person's nose, throat, or eyes, and enter their body.
Strep bacteria can also spread by touching a surface or object that has infectious fluids on it. When the person then touches their mouth, nose, or eyes, the bacteria can be spread. It takes about two to four days after contact with the bacteria for a person to develop strep throat symptoms.
Main article: Strep Throat Symptoms
In general, signs and symptoms of strep throat include:
Throat pain
A fever above 101ºF (38.3ºC)
Difficulty swallowing
Red and swollen tonsils, sometimes with white patches or streaks of pus
Tiny red spots on the soft or hard palate — the area at the back of the roof of the mouth
Swollen, tender lymph glands (nodes) in your neck
Fever
Headache
Rash
Stomachache and sometimes vomiting, especially in younger children
Fatigue
It's possible for you or your child to have many of these signs and symptoms, but not have strep throat. The cause of these signs and symptoms could be a viral infection or some other kind of illness. That's why your doctor generally tests specifically for strep throat.
It's also possible to have the bacteria that can cause strep in your throat without having a sore throat. Some people are carriers of strep, which means they can pass the bacteria on to others, but the bacteria are not currently making them sick.
Read more about Strap Throat Symptoms, Dangers and Complications
If you think you might have strep throat, you should visit your healthcare provider. If you are diagnosed with strep throat, antibiotic treatment is important for a couple of reasons, including:
Untreated strep throat can result in serious complications (see Strep Throat Complications)
It is a contagious illness.
With treatment, these situations are largely eliminated.
To diagnose strep throat, your healthcare provider will do a throat swab, which takes a sample of fluids from the back of the throat. This sample will be used for a throat culture, or a rapid strep test. These tests look for signs of the bacteria that cause strep throat.
If you have strep throat, a healthcare provider may recommend an antibiotic such as penicillin or amoxicillin. After taking antibiotics for 24 hours, you are no longer contagious. Treatment for strep throat should also include drinking lots of fluids and getting plenty of rest. If your symptoms do not improve within a few days, contact your healthcare provider.
A number of medications are available to cure strep throat, relieve its symptoms and prevent its spread.
If you or your child has strep throat, your doctor will likely prescribe an oral antibiotic such as:
Penicillin. This drug may be given by injection in some cases — such as if you have a young child who is having a hard time swallowing or is vomiting from strep throat.
Amoxicillin. This drug is in the same family as penicillin, but is often a preferred option for children because it tastes better and is available as a chewable tablet.
If you or your child is allergic to penicillin, your doctor likely may prescribe:
A cephalosporin such as cephalexin (Keflex)
Erythromycin
Azithromycin (Zithromax)
These antibiotics reduce the duration and severity of symptoms, as well as the risk of complications and the likelihood that infection will spread to classmates or family members.
Once treatment begins, you or your child should start feeling better in just a day or two. Call your doctor if you or your child doesn't feel better after taking antibiotics for 48 hours.
If children on antibiotic therapy feel well and don't have a fever, they often can return to school or child care when they're no longer contagious — usually 24 hours after beginning treatment. But be sure to finish the entire course of medicine. Stopping medication early may lead to recurrences and serious complications, such as rheumatic fever or kidney inflammation.
In addition to antibiotics, your doctor may suggest over-the-counter medications to relieve throat pain and reduce fever, such as:
Ibuprofen (Advil, Motrin, others)
Acetaminophen (Tylenol, others)
Because of the risk of Reye's syndrome, a potentially life-threatening illness, don't give aspirin to young children and teenagers. Be careful with acetaminophen, too. Taken in large doses, it can cause liver problems. Read and follow label directions. Talk to your doctor or pharmacist if you have questions.
In most cases, antibiotics will quickly wipe out the bacteria causing the infection. In the meantime, try these tips to relieve symptoms of strep throat:
Get plenty of rest. Sleep helps your body fight infection. If you have strep throat, stay home from work if you can. If your child is ill, keep him or her at home until there's no sign of fever and he or she feels better and has completed a minimum of 24 hours of antibiotic therapy.
Pain Medications. Over-the-counter (OTC) pain relievers can be used to help treat throat pain and fever. This includes acetaminophen (Tylenol) or NSAIDs, such as ibuprofen (Motrin) or naproxen (Aleve). Aspirin products should not be used in children under the age of 18.
Drink plenty of water. Keeping a sore throat lubricated and moist eases swallowing. Drinking plenty of water also helps prevent dehydration.
Eat soothing foods. Foods that are easy on a sore throat include broths, soups, applesauce, cooked cereal, mashed potatoes, soft fruits, yogurt and soft-cooked eggs. You may even want to puree foods in the blender to make them easier to swallow. Very cold foods such as sherbet, frozen yogurt or frozen fruit pops also may be soothing. Avoid spicy foods or acidic foods such as orange juice.
Gargle with warm salt water. For older children and adults, gargling several times a day can help relieve throat pain. Mix 1/4 teaspoon (1.2 milliliters) of table salt in 8 ounces (237 milliliters) of warm water. Be sure to tell your child to spit out the liquid after gargling.
Use a humidifier. Adding moisture to the air can help ease discomfort. Moisture keeps mucous membranes in your throat from becoming dry and even more irritated. Choose a cool-mist humidifier and clean it daily, because bacteria and molds can flourish in some humidifiers. Saline nasal sprays also help to keep mucous membranes moist.
Stay away from irritants. Cigarette smoke can irritate a sore throat and increase the likelihood of infections such as tonsillitis. In addition, avoid fumes from paint or cleaning products, which can be irritating to your throat and lungs.
Plan low-key activities for a sick child. If your child tests positive for strep throat, he or she should take antibiotics for at least 24 hours before returning to school or child care. When staying home with your child, plan some low-key activities that you both can enjoy.
Practicing good personal hygiene can help prevent strep throat.
Proper hand cleaning is the best way to prevent this and many other types of infections. Clean your hands regularly, and teach your children how to clean their hands properly.
To properly wash your hands, scrub them briskly for at least 15 seconds with soap and water. Pay special attention to the fingernails, between the fingers, and the wrists. After washing, dry them with a disposable towel. When you don't have access to soap and water, carry a small bottle of hand sanitizer containing at least 62 percent alcohol.
Other ways to help prevent the spread of strep throat and reinfecting yourself include:
Do not share eating or drinking utensils, especially with a person who has strep throat.
Throwing out your toothbrush as soon as you feel sick. Replace it again when you are well. You can also clean your toothbrush well before using it again. Bacteria can collect on the bristles and reinfect you.
Do not touch your eyes, mouth, or nose after direct contact with some infected with strep bacteria.
Cover the nose and mouth when sneezing or coughing. Use the inside of the elbow to cover the nose and mouth to contain the spread of infectious fluids and prevent contaminating the hands.
For those diagnosed with strep throat, stay at home from school, day care, or work for at least 24 hours after antibiotics are started.
It is possible that a sore throat is strep or something more serious. People with throat pain should contact their healthcare provider if they have any of the following symptoms:
Temperature higher than 101ºF (38.3ºC)
Swelling in the neck or tongue
Difficulty breathing, swallowing, or opening the mouth
Drooling
Difficulty talking
Stiff neck.