Experiencing a sore throat is a common discomfort, often sparking questions about its cause. While various culprits like the common cold, flu, COVID-19, or allergies exist, strep throat is another potential cause, particularly prevalent during late autumn, winter, and early spring. Understanding how strep throat is contracted, its symptoms, and preventative measures is crucial for managing this bacterial infection effectively.
Strep throat, medically known as streptococcal pharyngitis, is a significant health concern, leading to approximately 5.2 million outpatient visits annually in the United States. It also accounts for 2.8 million antibiotic prescriptions each year among non-Medicare patients, according to the Centers for Disease Control and Prevention. While it can affect anyone, strep throat is most frequently diagnosed in children aged 5 to 15 years, and is less common in children under 3. Group A strep pharyngitis cases typically peak during the winter and spring seasons in the U.S.
To shed light on this common ailment, we consulted with medical experts, Dr. Whitney Hardy, a family physician and associate medical director for primary care at Ochsner Health, and Dr. Nikita Patel, a pediatrician also at Ochsner Health. Their insights from the “What Doctors Wish Patients Knew” series offer valuable information on how strep throat spreads and what you need to know to protect yourself and your family.
Understanding How Strep Throat Spreads: It’s a Bacterial Infection
“Strep throat is a bacterial infection affecting the throat and tonsils,” explains Dr. Hardy. “The key differentiator between strep throat and other sore throat causes, which are usually viral, is the involvement of strep bacteria.”
Dr. Patel elaborates, “A specific bacterium, group A Streptococcus, is responsible for a range of symptoms. It causes the typical sore throat symptoms we recognize as strep throat.” This clarifies that strep throat isn’t just any sore throat; it’s specifically caused by this bacterial infection.
How Contagious is Strep Throat and How Do You Catch It?
Strep throat is highly contagious, primarily spreading through respiratory droplets. Dr. Hardy points out, “The incubation period of strep throat is a key factor. In the two-to-five-day window before symptoms fully manifest, an individual can still be contagious.” This means you can spread strep throat even before you realize you are sick.
Dr. Patel details the transmission process: “When someone with strep throat coughs or sneezes without properly covering their mouth, or doesn’t wash their hands effectively, they release particles from the back of their throat. These droplets can spread the bacteria.” She further adds, “Strep bacteria can also temporarily live on surfaces, contributing to indirect transmission.” This highlights the importance of hygiene and preventative measures in controlling the spread of strep throat.
Recognizing Strep Throat Symptoms: What to Look For
Understanding the symptoms of strep throat is crucial for early detection. “Strep throat can manifest differently based on age,” Dr. Patel notes. “In individuals over 3 years old, common symptoms include fever, sore throat, and fatigue.”
She further explains, “Headaches and abdominal pain can also occur. Visually, you might notice redness at the back of the throat where the tonsils are. Sometimes, white patches of exudates, resembling pus or streaks, are present.” Dr. Hardy adds, “In severe cases, swelling in the neck glands can also be observed.”
A key distinguishing factor is the absence of cough in typical strep throat cases. Dr. Hardy clarifies, “One of the criteria we use to differentiate strep from viral sore throats is the presence of a cough. Usually, strep throat does not involve a cough or phlegm production. If a cough is present, it’s more likely a viral illness, as strep throat primarily affects the upper respiratory tract.”
However, symptoms can vary in younger children. Dr. Patel mentions, “In children younger than 3, strep throat is less typical and may not present with the classic sore throat. Instead, it might manifest as congestion and fatigue.” This underscores the need for careful observation and medical consultation, especially in young children.
Diagnosis: Confirming Strep Throat
To confirm strep throat, medical testing is necessary. Dr. Patel outlines the common tests available: “The most common tests are rapid antigen tests, usually done with swabs. These might involve two swabs to collect a sample from the back of the throat or tonsils.”
Dr. Hardy elaborates on the rapid strep test, “We administer rapid tests in the office, and results are available within about 15 minutes.” She also mentions another option, “The rapid molecular test is gaining popularity. It’s more accurate and often requires only a single swab sample. While slightly more expensive, it generally eliminates the need for a follow-up throat culture.”
Dr. Patel explains the purpose of the two-pronged rapid test: “The initial rapid test may sometimes yield a false negative. In such cases, a throat culture is sent to check for bacterial growth, providing a more definitive diagnosis.”
Treatment and Recovery: Antibiotics are Essential
Since strep throat is a bacterial infection, antibiotics are crucial for treatment. Dr. Hardy emphasizes, “Strep throat is unlikely to resolve on its own without antibiotics.” Commonly prescribed antibiotics include amoxicillin and penicillin.
Dr. Hardy explains the treatment duration, “Typically, antibiotics are prescribed for about 10 days to ensure complete eradication of the bacteria. Contagiousness significantly decreases within 24 to 48 hours after starting antibiotics.”
While symptom relief may occur quickly, Dr. Hardy advises, “Even if you or your child feel better after the first dose, it’s vital to complete the entire course of antibiotics as prescribed to fully clear the infection and prevent complications.”
Preventing Strep Throat and Reinfection
While antibiotics treat strep throat, prevention is key to avoiding infection and reinfection. Dr. Hardy acknowledges, “Unfortunately, reinfection is possible.” She explains, “Sometimes, strep bacteria can persist in the tonsils even after treatment, making someone a carrier. Stress on the immune system can reactivate the bacteria.”
Dr. Patel adds, “Recurrent strep throat episodes might warrant consultation with an ear, nose, and throat specialist.”
Both doctors stress basic hygiene practices for prevention. Dr. Hardy recommends, “Handwashing is fundamental. Cover coughs and sneezes, avoid sharing drinks and utensils, and limit contact with others when sick.”
Dr. Hardy also advises on environmental hygiene, “Regularly clean frequently touched surfaces like light switches and countertops with disinfectant wipes or soap and water.” Dr. Patel suggests, “After starting strep throat treatment, consider replacing toothbrushes and washing items like stuffed animals that the infected person sleeps with.”
Home Care and Hydration During Strep Throat
While antibiotics address the infection, home care can alleviate symptoms. Dr. Hardy suggests, “Avoid hot or spicy foods and smoky environments. Opt for a soft, bland diet.” She also recommends “warm saltwater gargles and hot tea with honey for soothing the throat. Over-the-counter pain relievers like Tylenol or ibuprofen can help manage fever and pain.”
Hydration is particularly important, especially for children. Dr. Patel advises, “Ensure children stay hydrated. Difficulty swallowing or pain while drinking fluids could indicate severe throat pain requiring medical attention.” She suggests, “Colder fluids or Pedialyte popsicles can be helpful for hydration and numbing the throat.”
Recognizing and Addressing Complications
It’s important to be aware of potential complications from strep throat, especially if untreated or improperly treated. Dr. Patel mentions, “Complications include abscesses around or within the tonsils, which can be extremely painful and require more than oral antibiotics.”
She also notes rare but serious complications: “Post-streptococcal glomerulonephritis, affecting kidney function, and rheumatic fever, which can affect the heart, joints, brain, and skin, are potential risks if strep throat is not properly managed.” Rheumatic fever can develop weeks after a strep infection.
Conclusion: Proactive Measures Against Strep Throat
Understanding how you get strep throat empowers you to take proactive steps for prevention and early management. By practicing good hygiene, recognizing symptoms, seeking timely medical diagnosis and treatment, and ensuring proper home care, you can effectively minimize the impact of strep throat on yourself and your community. If you suspect you or your child has strep throat, consult a healthcare professional for prompt diagnosis and appropriate treatment to prevent complications and ensure a swift recovery.
