Strep Throat

Strep throat is the most common cause of sore throat in both adults and children in the United States. Strep throat is a bacterial infection that can cause sore throat, fever, swollen lymph nodes and other symptoms. Unlike sore throats that are caused by viruses, you need antibiotics to treat strep throat.

If you think you or your child has strep throat, talk to your health care provider right away. Getting diagnosed and treated quickly can reduce the symptoms, make you feel better more quickly, lower the risk of complications and help prevent strep throat from spreading to others.

Who gets strep throat?

People in three groups tend to get strep throat most often:

• Children between the ages of 5 and 15 since they often get exposed at school. Strep throat is uncommon in children younger than age 3.
• Family members and caregivers of school-aged children, including siblings, parents, teachers and caregivers.
• People who are often close to a lot of other people, such as those who live or spend time in households, daycares, schools, colleges and military barracks.

Symptoms of strep throat

Strep throat often has some common symptoms:

• A severe sore throat that makes it painful to swallow.
• Fever that’s often higher than 101°F (38.3°C).
• Tender, swollen lymph nodes (glands) in the neck.
• Red and swollen tonsils that may have white patches or streaks.
• Red spots on the roof of the mouth (petechiae).
• Not feeling well.

Less-common symptoms include:

• Mild to moderate headaches.
• Stomachache, nausea or vomiting especially in children.
• A fine, red rash that feels like sandpaper. This can be a sign of scarlet fever, a form of strep throat.

If you or your child experiences these signs, get medical care promptly.

Causes of strep throat

A type of bacteria called Group A Streptococcus causes strep throat. These bacteria spread easily from person to person through respiratory droplets when an infected person coughs, sneezes or talks. You can inhale these droplets and catch strep throat.

You can also get strep throat by contacting infected saliva or fluids that come out of the nose. That can happen if you share utensils or cups, or touch surfaces that are contaminated with the bacteria.

You can spread strep throat to other people in the two to five days after you are infected and before you start to have symptoms. This is called the incubation period. Once you start taking antibiotics, you won't be contagious after the first 24 to 48 hours. If you don’t take antibiotics, you could be contagious for up to a month.

Strep throat carriers

Some people can have the bacteria that causes strep throat in their throat or on their skin without having any symptoms. They are called asymptomatic carriers. Even though they don't get symptoms, they can still spread the bacteria to other people.

Carriers are more likely to:

• Live or work in close quarters with someone who has strep throat.
• Have a weakened immune system.
• Be young children or adolescents.

If you think that you or someone in your household might be a carrier, talk to your health care provider for advice about reducing the chance that strep throat will spread.

Conditions similar to strep throat

Other health conditions may seem like strep throat:

• Viral infections: Infections like the common cold and the flu can cause symptoms similar to strep throat. They may also cause a cough, which isn’t common with strep throat. Viral infections don't need antibiotic treatment and usually get better on their own with rest and treatment for symptoms.
• Allergies and postnasal drip: These conditions can have symptoms like strep throat but often cause sneezing, watery eyes and nasal congestion as well. Allergies are not contagious – you can treat them by avoiding triggers and taking allergy medications.
• Other bacterial infections: Infections like tonsillitis (an inflammation of the tonsils) could have symptoms similar to strep throat. Tonsillitis usually needs specific treatment, depending on what's causing it.

Diagnosing strep throat

A health care provider will collect a sample from the back of your throat with a throat swab and test it for Group A Streptococcus. A rapid strep test can detect antigens to streptococcus in minutes, so you can start treatment right away.

If you have a negative rapid strep test, your provider may send a sample from your rapid test to a lab for a culture. A culture can show bacteria that a rapid test could miss. Results from a throat culture can take two or three days.

It's important to get an accurate diagnosis from a health care provider. That way, your provider can be sure that you have strep throat and not another condition that might need different treatment.

Treating strep throat

Treating strep throat quickly helps make the illness less severe and can shorten how long symptoms last. It may reduce the risk of complications and help keep it from spreading to other people.

Your provider can prescribe antibiotics, usually penicillin or amoxicillin, to get rid of the bacteria. If you’re allergic to penicillin, your provider may prescribe cephalexin or cefadroxil. Be sure to complete the full course of antibiotics even if you feel better. Most treatments take about 10 days. A penicillin shot may also be an option. 

You can go back to work or school 24 hours after taking your first dose of antibiotics. Tell your provider if you’re not feeling better after 48 hours.

You can still have the bacteria in your body even when you start to feel better. Taking the full treatment course helps get rid of the bacteria and prevent complications. Taking antibiotics as prescribed also helps prevent antibiotic resistance, which is when antibiotics no longer work as well for everyone. That can make infections harder to treat in the future.

You can treat the symptoms of strep throat with over-the-counter (OTC) pain relievers such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin). Throat lozenges or sprays that contain benzocaine or menthol can numb the throat and reduce the urge to cough, making it easier for you to swallow.

You can also drink plenty of fluids, gargle with warm salt water, get plenty of rest and use a humidifier.

Removing the tonsils isn’t recommended as often as it used to be, but it might be something to discuss with your provider if you or your child gets strep throat three or more times a year.

Complications of untreated strep throat

Without treatment, strep throat can lead to complications including:

• Rheumatic fever, which is rare but can affect the heart, joints, skin and brain, especially in children ages 5 to 15. It can lead to long-term heart damage.
• A type of kidney inflammation called post-streptococcal glomerulonephritis, which can lead to temporary or, in rare cases, permanent kidney damage.
• Scarlet fever, a bacterial infection caused by the same germ that causes strep throat. It typically affects children, with a red rash that feels like sandpaper that usually starts on the neck and chest before spreading.
• Ear or sinus infections.
• Pockets of pus (abscesses) around your tonsils.
• Guttate psoriasis, which causes teardrop-shaped spots on your arms, legs and chest. They are usually scaly and red.
• Invasive streptococcal infection, where bacteria can cause severe infections. This can quickly become life-threatening.

How to prevent strep throat from spreading

These steps can help keep strep throat from spreading to other people:

• Try to stay away from people who have strep throat until they have been taking antibiotics for at least 24 hours.
• Don't share personal items like utensils, cups or food with others, especially people who have strep throat.
• Cover your mouth and nose with a tissue or your elbow when you cough or sneeze. 
• Wash your hands with soap and water for at least 20 seconds after coughing, sneezing or caring for someone who is sick. If you don't have soap and water, use hand sanitizer with at least 60% alcohol.
• Try not to touch your eyes, nose or mouth since you can transfer bacteria into your body.
• Clean and disinfect surfaces and objects that people touch frequently.
• Choose healthy foods, exercise regularly and get plenty of sleep. These steps can help support your immune system and help prevent infections.

Getting care

At Banner Health, our providers deliver compassionate, expert care for strep throat and other health conditions. We have an experienced health care team including specialists in infectious diseases who can diagnose and treat strep throat effectively. Visit one of our multiple locations for a personalized treatment plan tailored to your needs.