Strep Throat: Symptoms, Causes, and Treatment

What is strep throat?

Strep throat (Streptococcal Pharyngitis) is an infection that affects the throat and tonsils and is caused by group A streptococcus otherwise known as Streptococcus pyogenes. This infection can affect people of all ages at any time of the year. However, it is most frequently seen in children during the winter and early spring months.

What are the common symptoms of strep throat?

Most common symptoms:

• Sore throat or pain in the throat which can come on suddenly.
• Painful swallowing.
• Swollen and red tonsils which occasionally also have white patches or streaks.
• Red speckles or spots on the roof of the mouth.
• Fever

Additional, possible symptoms:

• Headache.
• Body aches.
• Generally feeling unwell.
• Rash.
• Abdominal pain/stomachache, nausea with or without vomiting.

Could something else be causing a sore throat?

Yes! Not all sore throats are caused by group A Streptococcus. In fact, many sore throats are caused by viruses and sometimes even drainage from allergies. If your sore throat also has symptoms such as a cough or runny nose, it might suggest that a viral infection is causing the sore throat. If you are also experiencing sneezing, runny nose, and itchy eyes, allergies might be the more likely cause.

When should you contact a healthcare provider?

If you or your child have the signs and symptoms of strep throat outlined above, you should contact your healthcare provider. A simple procedure obtaining a swab of the throat is needed to test for strep throat and can typically be completed in most urgent care, primary care, and express care clinics.

The initial testing for strep throat is a rapid test that can be completed in the office. In some cases due to timing, quality of sample, or bacterial load a false negative rapid test can occur. In these cases, an additional swab can be collected and sent for culture to see if group A streptococcal bacteria grows. This test does take longer, but in some cases can catch a strep throat infection that the rapid strep test missed.

How long should you expect the symptoms of strep throat to last?

Someone who has been in contact with the group A streptococcus bacteria will typically begin feeling ill due to strep throat two to five days after exposure. With prompt diagnosis and appropriate treatment, most patients will begin to feel better within a few days.

If you or your child have been diagnosed with strep throat and do not notice improvement after a couple of days of treatment, you should contact your healthcare provider.

What is the treatment for strep throat?

Strep throat is treated with antibiotics. Antibiotics help to decrease how long the illness lasts, the severity of symptoms, prevent the spread of the bacteria to others, and prevent complications from occurring.

Even though symptoms should improve after 24 hours of antibiotics, you should be sure to complete the entire course of antibiotics as prescribed to ensure the bacterial infection is resolved.

To prevent reinfection, it is important to dispose of the toothbrush after 24 hours’ worth of antibiotic and again after completion of the antibiotic. The group A streptococcus bacteria can live on the toothbrush and cause re-infection if this step of treatment is skipped.

Please be reminded that not everyone with a sore throat needs antibiotics. Sore throats caused by a viral infection or allergies do not require antibiotic treatment.

Can strep throat go away without treatment?

If left untreated, strep throat can cause complications, so it is best that you do not wait for it to go away on its own. For this reason, it is important to call your healthcare provider if you develop the signs and symptoms of strep throat so prompt diagnosis and treatment can be started.

What are the possible complications of strep throat?

If left untreated, though rare, serious complications following a strep throat infection may occur. When the group A streptococcus bacteria spreads to other areas in the body, complications like the ones listed below may occur. This is why it is important to contact your healthcare provider when you notice the signs and symptoms discussed above OR if your symptoms are not improving after a couple of days of treatment for strep throat. Timely diagnosis and treatment of strep throat decreases the risk for complications.

Complications of strep throat include:

• Ear infection.
• Sinus infection.
• Abscess (pockets of infection) of the tonsils or neck.
• Rheumatic fever.
• Post-streptococcal glomerulonephritis.
• Infection in the blood stream (septicemia), Sepsis, shock, and other severe infections.

Can strep throat be spread to others?

Strep throat is very contagious. The bacteria that cause strep throat spreads from one person to another through respiratory droplets, secretions, or saliva. That means that infected persons can spread it to others by talking, coughing, or sneezing (respiratory droplets) or by sharing food and/or drinks with others. If another person breaths in the respiratory droplets which carry the bacteria or touch something that the droplets have landed on and then touch their mouth or nose, they can become ill with strep throat. People can also get strep throat infection after sharing items such as eating utensils, plates, or drinks/drink containers with an infected person.

To prevent the spread and decrease the risk of getting strep throat, it is important to wash your hands often with soap and water for at least 20 seconds, use alcohol-based hand sanitizer when unable to wash with soap and water, put facial tissue in the trash, cover your nose and mouth when sneezing or coughing with your sleeve or elbow if you do not have a tissue, and avoid sharing items such as eating utensils and drinking glasses with others.

When is it safe to return to work, school and/or other activities when you’ve been diagnosed with strep throat?

You should expect to stay home for at least 24 hours after starting the antibiotic treatment and should also wait to return to school/work or other activities until there has been no fever for at least 24 hours without fever-reducing medications.

If your tonsils have been removed, can you still get strep throat?

Strep throat affects the throat and tonsils, so if your tonsils have been removed, the risk is decreased, but not completely eliminated. Without tonsils, you can still get the strep throat infection but your symptoms may not be as severe.

References:

Centers for Disease Control and Prevention. (2023). Strep Throat: All You Need to Know. Accessed April 17, 2023. https://www.cdc.gov/groupastrep/diseases-public/strep-throat.html

Patel, A. (2023). Strep Throat: Symptoms, Causes & Treatments in Kids. Accessed April 17, 2023. https://www.luriechildrens.org/en/blog/faq-what-to-know-about-strep-throat/