Everything You Need to Know About Strep Throat, According to a Pediatrician & Mom

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As a pediatrician in a busy New York City pediatrics practice, I’ve treated plenty of children with sore throats. (I’m also the mom of three young boys, so sore throats have been an issue in my house, too!) Many parents assume that a sore throat means strep throat, but here’s the thing:  In school-aged children with sore throats only three out of ten will actually have strep throat. More often, children with sore throats have viral infections. So, as a parent, you may have lots of questions about how to treat a sore throat and when to seek medical attention. You may wonder: What is strep throat? How do children get it? Does it need to be treated? For answers to all of these questions and more, check out my guide.

What is strep throat?

Strep throat is a bacterial infection of the back of the throat.

Who is most likely to get strep throat?

It’s most common in children between the ages of 5 and 15. It’s unlikely that children under age 2 will get strep throat, unless they have older siblings or have been exposed to the infection.

 

What are the symptoms of strep throat?

The most common symptoms are fever and sore throat. Other symptoms include:

  • Headache
  • Abdominal pain
  • Decreased appetite
  • Fussiness
  • Swollen glands
  • Pain with swallowing

Scarlet fever, a version of strep throat, can cause a red, raised, rough-feeling rash on the abdomen, chest, and back. While the condition sounds scary, it is really strep throat with a rash and it’s treated with antibiotics, just like any other case of strep throat.

How is strep throat diagnosed?

Doctors can test for strep throat by running a soft cotton swab along the back of a patient’s throat. Preliminary results from what’s called a rapid fire test will come back in about five minutes. If those results are positive, the diagnosis is confirmed and your child will require antibiotics. If it is negative it is unlikely that your child has strep throat; however, since the rapid strep test is not perfect and can miss some cases of strep throat, the doctor will send the throat culture out to a lab to confirm the diagnosis.

Is there a way to tell the difference between a viral sore throat and strep throat?

The only way to tell for sure is to have a throat culture done by your child’s pediatrician. However, there are physical symptoms that can help parents to distinguish between the two. Sore throats accompanied by runny nose, cough, red eyes, ulcers in the mouth, or hoarseness tend to be caused by a virus. Signs of strep throat are sudden, severe throat pain, fever greater than 101, swollen glands in the neck, and severe pain with swallowing (although it is possible for children to have strep throat without a fever).

How is strep throat treated?

Strep throat is treated with antibiotics. Children may get symptomatic improvement without antibiotics, however, strep throat needs to be treated with antibiotics so that it doesn’t turn into rheumatic fever, which can cause heart damage. Medications such as acetaminophen and ibuprofen (in children older than 6 months) can help keep your child’s pain under control, so that he can stay hydrated. Soothing foods like popsicles, jello, and cool liquids can also help. You should also change toothbrushes after your child has been on the antibiotics for 72 hours and before the completion of antibiotics. Children with recurrent strep throat infections (generally more than six in a year) are typically referred to an ear, nose, and throat specialist and may have their tonsils removed; however, this procedure isn’t commonly performed today.

When should you take your child to the pediatrician?

If you are concerned that your child has strep throat, you should always see a doctor, especially if your child has any of these symptoms:

  • Sore throat accompanied by fever that is lasting greater than 48 hours
  • Severe sore throat accompanied by swollen glands
  • Sore throat accompanied by a rash
  • Strep throat that hasn’t improved within 72 hours of antibiotic treatment

When can children with strep throat go back to school?

Children must be on antibiotics for at least 24 hours and be fever-free for the same length of time before they can go back to class.

Is there any way to prevent strep throat?

Strep throat is spread through contact with secretions (nasal or saliva) of someone who has the infection. Symptoms will usually develop within two to five days of exposure. The best way to prevent strep throat is to have your child wash her hands frequently and avoid sharing utensils, cups, towels, and so on with others. Also, teach her not to touch her face, since germs can be spread from her hands to her mouth, eyes, and nose through which they can easily enter the body.

More advice from Dr. Blanchard:

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