Strep throat

Overview

Strep throat is a bacterial infection that causes a sore, scratchy throat. It is caused by a type of bacteria called group A Streptococcus.

Yes, especially in school-age children and during the winter and early spring.

Strep throat can affect people of any age, but it happens most often in children aged 5 to 15. Adults can also get it, especially if they have close contact with children.

Symptoms

Common symptoms

• Sore throat that comes on quickly
• Pain when swallowing
• Fever over 38°C (100.4°F)
• Red and swollen tonsils, sometimes with white patches or streaks of pus
• Tiny red spots on the roof of the mouth
• Swollen, tender lymph nodes in the neck

Symptoms in children

• Same common symptoms as above
• Headache
• Stomach pain
• Nausea or vomiting

Symptoms in older adults

• May have a less severe sore throat
• Sometimes only vague symptoms like fatigue or body aches
• Fever may be lower than in younger people

Causes

Main causes

• Infection with group A Streptococcus bacteria (Streptococcus pyogenes).
• The bacteria spread through tiny droplets when an infected person coughs, sneezes, or talks.
• You can also catch it by touching a surface with the bacteria and then touching your mouth or nose.

Risk factors

• Close contact with someone who has strep throat, such as living in the same house.
• Being in crowded settings like schools, daycares, or military barracks.
• Age: children aged 5 to 15 are at higher risk.
• Season: more common in late fall, winter, and early spring.

When to see a doctor

See a doctor urgently if:

• If you or your child has trouble breathing or swallowing.
• If the fever is very high (above 39°C / 102.2°F) and does not come down with over-the-counter medicine.
• If you see signs of dehydration.

Book a routine appointment if:

• If a sore throat lasts more than 48 hours without a runny nose or cough (which suggests a virus instead).
• If you have a fever plus a very red throat or white patches on the tonsils.
• If someone else in your family is diagnosed with strep throat and you develop symptoms.

Diagnosis

A doctor or nurse will ask about your symptoms and look at your throat, tonsils, and neck. They may use a soft cotton swab to take a sample from the back of your throat. This only takes a few seconds and may feel uncomfortable but is not painful.

Tests that may be done

• Rapid strep test: Results come back in about 5 to 10 minutes. It can tell if the bacteria are likely present.
• Throat culture: The swab sample is sent to a lab and grown for 1–2 days. This is more accurate and can confirm the diagnosis if the rapid test is negative.

What to expect at your appointment

The doctor will explain the results and what treatment is needed. A positive rapid test or culture means you have strep throat. A negative test usually means a virus is causing the sore throat. If the rapid test is negative but symptoms strongly suggest strep, the doctor may send the sample for a culture to be sure.

Treatment

Strep throat is treated with antibiotics to kill the bacteria, ease symptoms faster, and prevent rare complications. It is important to take the full course exactly as prescribed, even if you start feeling better.

Self-care at home

• Get plenty of rest to help your body fight the infection.
• Drink warm liquids like tea with honey (for adults) or cold liquids like ice pops to soothe the throat.
• Gargle with warm salt water (half a teaspoon of salt in a cup of warm water) several times a day for pain relief.
• Use a cool-mist humidifier in your room to keep the air moist and reduce throat irritation.

Medical treatments

Doctors usually prescribe an antibiotic. You will need to take it by mouth, often for 10 days. Even if you feel better after a few days, finish all the medicine to make sure the infection is completely gone. Do not stop early unless your doctor tells you to. Over-the-counter pain relievers like ibuprofen or acetaminophen can help with fever and pain – always follow the package directions and ask your pharmacist if you are unsure.

When is surgery considered?

Surgery is very rarely needed for strep throat itself. If a child or adult has very frequent and severe tonsillitis (which can be caused by strep), a doctor may discuss removing the tonsils (tonsillectomy). This is done only after carefully weighing the benefits and risks.

Living with this condition

Stay home from school, work, or daycare until you have been on antibiotics for at least 24 hours and your fever is gone without using fever-reducing medicine. This helps prevent spreading the infection to others.

Lifestyle tips

• Wash your hands often with soap and water, especially after coughing or sneezing.
• Do not share eating utensils, cups, or toothbrushes until you are fully recovered.
• Cover your mouth and nose with a tissue or your elbow when coughing or sneezing.

Diet and exercise

While you have a sore throat, eat soft, easy-to-swallow foods like yogurt, applesauce, mashed potatoes, and soup. Cold foods like ice cream or smoothies can also feel soothing. Drink plenty of fluids to stay hydrated. Avoid spicy, acidic, or rough foods that can irritate your throat. Rest until you feel better, then gradually return to your normal activities. Listen to your body.

Mental health and emotional wellbeing

Having a painful sore throat can make you feel frustrated or down, especially if it keeps you from your usual routine. This is normal. Most people feel better within a few days of starting treatment. If you feel very worried or sad that lasts beyond the illness, talk to your doctor.

Prevention

You can reduce your risk by washing your hands often, not sharing personal items, and staying away from people who are sick. If someone in your home has strep throat, clean shared surfaces like doorknobs and countertops regularly.

Vaccines

There is no vaccine available to prevent strep throat.

Screening programmes

Routine screening for strep throat is not recommended for the general public. Testing is only done when someone has symptoms and needs diagnosis.

Complications

If left untreated

• Rheumatic fever – an inflammatory condition that can affect the heart, joints, brain, and skin.
• Post-streptococcal glomerulonephritis – a kidney disease that can cause blood in the urine and swelling.
• Peritonsillar abscess – a pocket of pus behind the tonsils that may require drainage.

Long-term outlook

With proper antibiotic treatment, nearly all people with strep throat recover completely without any long-term problems. Symptoms usually improve within 1–2 days, and the risk of complications becomes very small. It is important to finish your antibiotics even if you feel better. If you have any concerns, your healthcare provider can give you personalized advice.

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