If you or your child suddenly feel a fiery, stabbing pain in the throat that makes swallowing difficult and unpleasant, you may have a case of strep throat.
This respiratory illness is more prevalent in children than adults, but it can affect anyone at any age. While it’s more likely to occur in the winter, strep throat can strike throughout the year.
Read on for everything you need to know about strep throat.
Key Takeaways:
- Strep throat is a type of bacterial infection that commonly appears in children, but it can occur in adults as well.
- Symptoms can include a sore throat, inflamed tonsils, swollen lymph nodes and painful swallowing.
- Health care professionals may use a rapid strep test or throat culture to diagnose strep, and treatment involves a round of antibiotics.
- You should seek diagnosis and treatment as soon as possible to avoid complications.
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What Is Strep Throat?
Strep throat is an infection caused by a type of bacteria called group A streptococcus, or GAS for short.
This common – but serious – ailment resulted in an estimated 27,300 cases in 2022, according to the Centers for Disease Control and Prevention data.
What Are the Symptoms of Strep Throat?
Many viruses can trigger a sore throat, so it’s not always obvious when you have strep.
Common signs and symptoms to look out for include:
1. Sore throat
The condition's hallmark symptom is a very sore throat, medically known as pharyngitis. It typically starts suddenly and can be intense. This throat pain is sometimes one-sided and may be accompanied by a bulging appearance in the throat or neck along with a stiff neck.
2. Painful swallowing
Because the tissues in the throat become inflamed and swollen, this can make swallowing difficult and very painful.
3. Absence of cough
With a common cold caused by a viral infection, you'll typically have a cough. But with strep throat, this is less likely, making a strep infection more identifiable.
4. Absence of other flu-like symptoms
Nasal congestion, runny nose and diarrhea are more commonly associated with viruses than a strep infection and are likely to be absent during a strep infection.
5. Red or swollen tonsils
The tonsils, which are two lymph nodes located on either side of the back of your throat, are part of your immune system and the first line of defense when there's an infection in the throat. If you have strep, your tonsils may also show white patches or streaks of pus.
6. Tiny red spots
Small red spots may be visible along the back of the roof of the mouth.
7. Swollen lymph nodes
The lymph nodes on either side of your neck may show signs of battling an infection in your throat by swelling and becoming tender.
8. Headache or abdominal pain
Headache and stomach pain are common with strep throat. While it's less common in adults than children, you may also experience nausea or vomiting.
9. Fever and/or chills
Pain and fever without a cough may signal a strep infection.
10. Stridor and voice changes
Some people experience a thick, muffled voice, called a hot potato voice, or stridor – a high-pitched respiratory sound that develops when the throat tightens or an upper airway is obstructed. Wheezing, chest tightness and shortness of breath can also occur as inflammation in the airways causes swelling and narrowing of the airways.
Is Strep Throat Contagious?
Yes, strep throat is contagious.
The infection is typically passed through respiratory droplets when a person with the virus coughs, sneezes or talks. The bacteria can survive on surfaces – such as door knobs, counters, utensils, cell phones, keyboards and toilet handles – and can spread when a person comes in contact with a contaminated item.
As with other upper airway infections, patients are most contagious in the early stages of the infection.
“It can take anywhere from two to five days to start showing symptoms once exposed,” explains Dr. Barbara Bawer, assistant clinical professor in the department of family and community medicine at the Ohio State University Wexner Medical Center in Columbus. "If a person is not taking antibiotics, they can stay contagious for two to three weeks.”
Starting a course of antibiotics usually curtails contagiousness within 24 to 48 hours.
How Is Strep Throat Diagnosed?
To diagnose strep throat, you need to visit your primary care provider or an urgent care clinic for timely assessment, which will include a rapid strep test or throat culture. Both types of tests require using a swab to collect mucus from inside the throat for testing.
“The culture takes longer but can sometimes catch strep infections missed by the rapid swab test,” Bawer notes.
How Is Strep Throat Treated?
If you or your child test positive, the infection needs to be treated with antibiotics to prevent complications. A 10-day course of penicillin or amoxicillin are the most commonly used treatments. If you're allergic to penicillin, your provider may prescribe a Z-pack (azithromycin) or another antibiotic.
Make sure you complete the entire course of treatment as directed by your doctor. Stopping the medication early can lead to a rebound infection and the development of drug-resistant strains that are much harder to treat.
If you don’t feel better quickly and your sore throat persists, you may have a viral infection, which can typically take about a week to clear up.
“Most cases of pharyngitis are due to respiratory viruses, which do not respond to antibiotics,” says Dr. David Weiss, an internal medicine physician with the Torrance Memorial Medical Center in California.
How Can I Soothe Strep Throat Pain?
When strep is correctly diagnosed and treated, relief usually comes quickly.
"Most people with strep throat notice they feel significantly better within one to two days of starting antibiotics,” says Dr. Rajsree Nambudripad, an integrative medicine specialist with Providence St. Jude Medical Center in Orange County, California.
However, while antibiotics usually work quickly, you may need some relief before they start to take effect.
To make symptoms less painful, experts recommend:
- Staying hydrated. Drink plenty of liquids, especially if fever is present, to prevent dehydration. Avoid orange juice, grapefruit juice, lemonade or other acidic beverages, which can irritate a sore throat. Instead, opt for soups, sweetened tea or hot chocolate, which can be more soothing.
- Taking over-the-counter medications. OTC medications – like acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) – can help bring down fever and reduce pain. Make sure to follow the package directions on how much to take and when.
Your primary care provider or pediatrician is your best source of information on when you can return to normal activities.
“Most kids can go back to school when they’ve taken antibiotics for at least 24 hours and no longer have a fever,” says Dr. Amanda Salter, a pediatrician in the Children’s Hospital of Orange County Primary Care Network in California.
How Serious Is Strep Throat?
Left untreated, strep throat can lead to significant complications.
“The danger with strep throat is that the infection can spread to local soft tissues, potentially causing an abscess, as well as spreading to the sinuses and middle ear,” Weiss explains.
In some rare instances, it can lead to meningitis and bacteremia when it spreads to the blood.
Other complications can include:
Bawer recommends reserving a visit to the emergency department for more severe cases that include:
- An inability to swallow or breathe
- Joint pain
- Rash
- Abdominal pain, usually with nausea and vomiting
- A fever lasting more than two days while you're on antibiotics
How Can I Prevent the Spread of Strep Throat?
Even if you're not certain whether someone else has an active strep infection, you should always try to limit contact with sneezes, coughs and other fluids that may transmit strep and other common viruses and illness-causing bacteria.
Remember the following:
- Wash up. Regular handwashing with soap and water is one of the most effective ways to prevent the spread of bacteria.
- Cover up. Covering the mouth and nose when coughing or sneezing can help prevent respiratory droplets from spreading to others.
- Avoid others. Individuals diagnosed with strep throat should avoid close contact with others until they have completed at least 24 hours of antibiotic treatment and are fever-free.
- Use disinfectants. Regular cleaning and disinfection of frequently touched surfaces can help prevent the spread of bacteria in shared spaces.
- Start fresh. Give your child a new toothbrush after their antibiotic treatment starts and they’re no longer contagious.
- Seek care. Receiving prompt medical attention for symptoms of strep throat can help prevent complications and reduce the risk of spreading the infection to others.
