What Is Strep Throat?

Strep throat (pharyngitis) is an infection of the throat and tonsils caused by the bacteria group A Streptococcus. Strep throat is highly contagious and is spread in ways like sneezing, coughing, and sharing utensils with someone who has the infection.

Although anyone can get strep throat, it is most common in children ages 5-15. Children under the age of 3 rarely get strep throat.

People with strep throat often experience a sore throat that comes on suddenly along with a fever. If you suspect you have strep throat, you may notice your tonsils are red and swollen. Your tonsils may also have pus on them.

Although complications from strep throat can occur, they are rare. Antibiotics are the most common treatment for strep throat, helping to clear the infection within a matter of days.

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Strep Throat Symptoms 

Suddenly experiencing a sore throat is one of the most common and tell-tale symptoms of strep throat.

Other symptoms of strep throat include:

• Fever
• Severe pain when swallowing
• Swollen and tender lymph nodes in the neck, just under the jaw
• Headache
• Nausea
• Vomiting

Examining the throat may reveal other signs of strep throat, such as swollen and red tonsils as well as white patches of pus on the tonsils.

What Causes Strep Throat? 

Group A Streptococcus (GAS) bacteria cause strep throat. Group A strep bacteria are quite common and can cause many types of infection—strep throat is one of those infections.

Strep throat is highly contagious. Group A strep bacteria typically live in the nose and throat and are spread to other people through respiratory droplets.

When someone infected with strep throat talks, sneezes, or coughs near you, you may inhale infected droplets that can cause infection.

Other than breathing in infected respiratory droplets, you can also develop strep throat after touching your mouth or nose after touching something that has infected droplets or by sharing utensils or drinking out of the same glass as someone with strep throat.

Risk Factors

Children ages 3-15 are most likely to develop strep throat. Parents and other adults who are around children are also more likely to develop strep throat as well.

Being in certain environments can increase your risk of strep throat. Since strep throat is highly contagious, attending school or living and working in a care facility where people are near one another for long periods of time can raise the risk of exposure to the bacteria.

Cases of strep throat also tend to increase in the winter and early spring months.

How Is Strep Throat Diagnosed?  

To diagnose strep throat, your healthcare provider will take a medical history, ask about your symptoms, and perform an exam. During the exam they will look at your throat, feel your neck area for swollen lymph nodes, and look for other signs of strep throat.

If your healthcare provider suspects you have strep throat, they will perform a rapid strep test. For this, the provider will swab your throat and test the swab. The results come back quickly, within a few minutes. If strep bacteria are detected, the test is positive and you will be diagnosed with strep throat.

If the test is negative, but the healthcare provider still thinks you may have strep throat, they might perform a throat culture. This test also involves a swab of the throat but can take longer for results, about a day or two. After the throat is swabbed, the test material is placed in a culture where the bacteria can grow. The throat culture is more accurate at picking up infections that a rapid test could miss.

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Treatments for Strep Throat  

The goal of treatment for strep throat is to shorten the duration of symptoms, shorten the time you can infect others, and prevent any complications. Antibiotics are the first step of treatment for strep throat caused by Group A strep.

The most commonly prescribed antibiotics to treat strep throat are penicillin and amoxicillin. These medications are typically prescribed in 10-day courses to ensure that the bacteria are eliminated. If you are allergic to these types of antibiotics, your healthcare provider can prescribe a different antibiotic.

If you are prescribed an antibiotic, it is important to finish the full prescription even if you are feeling better. Not finishing the prescription may mean that not all the bacteria have been killed and may cause the bacteria to resist future antibiotic treatment.

Not everyone may need an antibiotic. If you test positive for strep throat but don't have any symptoms, a healthcare provider might nor prescribe you an antibiotic because you are less likely to not only spread the bacteria to other people, but also to develop complications.

Other treatments for strep throat can help with symptoms. Tylenol (acetaminophen) or non-steroidal anti-inflammatory drugs like Advil (ibuprofen) can help relieve the pain of the sore throat and reduce fever. You might find that gargling with salt water can help reduce throat pain and swelling. Cold liquids may also bring pain relief.

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How to Prevent Strep Throat

The best way to prevent strep throat is to practice good hygiene. This includes washing your hands with soap and water frequently. If you know that someone close to you has strep throat, avoid direct contact and do not share utensils with them.

If you can't avoid direct contact with someone who has strep throat, then make sure to avoid touching your mouth or eyes after using an object that person might have touched.

If you have strep throat, you can try to prevent it from spreading to others. You should stay home until your fever has cleared and you've taken antibiotics for at least 12 hours. You should also practice good hygiene, especially by washing your hands after you cough or sneeze.

Comorbid Conditions   

Although rare, if left untreated, strep throat can cause serious complications. If any of these complications develop, you would need to address both the Group A strep bacteria causing the strep throat and the secondary condition that has since developed.

One condition you can develop if strep throat is not properly treated is acute rheumatic fever. Acute rheumatic fever is an immune response that can lead to inflammation of the heart, joints, brain, and skin. 

It's also possible for children to develop pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) if strep throat is left untreated. A child with PANDAS may experience abrupt changes to behavior and movements. This can include new or worsening symptoms of obsessive-compulsive disorder or tics.

Living With Strep Throat 

While the pain of strep throat can be quite intense, it does not last a long time once treatment begins. People with strep throat should start to feel better within a day or two of starting antibiotics. The quicker you can get a diagnosis and start antibiotics, the faster you will start to recover.

It possible to develop complications like sinus and ear infections after having strep throat. But with proper treatment, it is rare to develop serious complications from strep throat.

As with most illnesses, rest and fluids can help your body fight the infection. To help relieve the pain, you can take over-the-counter pain relievers or try at-home remedies like gargling salt water.

If you have strep throat, stay home from school or work until your fever breaks and only after you've taken antibiotics for 12 hours. Make sure you practice good hygiene. If you are in close contact with someone who has strep throat, try to prevent catching it by washing your hands often.