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15-20% of children are strep carriers - they may test positive for strep with no symptoms at all.

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1. When a child has a sore throat, in general, there is a 37 percent chance that it is strep (Group A Strep, aka, Streptococcus pyogenes)

2. Fifteen-20 percent of kids WITH NO SYMPTOMS AT ALL will be POSITIVE FOR STREP if tested. This means 15-20 perecent of kids are strep "carriers." A tiny amount of strep lives in their throat all the time, and it doesn't make them sick. Let that sink in a moment. Think about all the unnecessary antibiotics kids are getting!

3. The most common symptoms of strep throat are a sore throat, fever and swollen glands in the neck. I also see kids get nauseous, have stomach aches and headaches. It's odd - sometimes their only signs are fever and vomiting or nausea and a headache.

4. Sometimes, strep comes with a rash. We then call it "Scarlet Fever" and it is no more dangerous than just plain strep throat. Someone just gave it a cool name and then we get to feel like we are living in that computer game "Oregon Trail."

5. Most people look at the back of the throat to see if their kiddo has strep. I don't look there - that's typically where drainage from the nose causes bumps and other changes. When I look for strep, I look at the tonsils and the ROOF of the mouth - the arch over that dangly thing (the uvula) to see if there are dark red spots.

6. If your child has congestion, coughing, a runny nose, watery eyes and/or diarrhea, she most likely doesn't have strep. Chances are it's just a cold or some allergies - and postnasal snot drip is the most common cause of sore throats in my office.

7. Strep is passed from kids to kid through "large respiratory droplets." Yum. This means kissing, sharing drinks or food, or a sneeze or a cough either lands directly on another kid's hand which then they put that hand in their mouth, nose, or eyes. Or, the drops land on a surface and another child touches it and touches their face somehow.

8. If you are a strep carrier, you don't have much strep in your throat. It's enough to catch on a strep swab, but not enough to fly out of your kid's mouth and onto things and people (ew). Also, these bacteria aren't as "mean" as typical strep bacteria are. So you aren't really very contagious at all. And with 15-20 percent of kids being carriers, many of us live with them on a daily basis and are just fine.

9. I always talk with incredulous parents in the office about how "the strep came right back" after finishing antibiotics. They finished treatment and then the fever and sore throat hit again, and the test is positive again. I call these kids "strep bounce-backs" and it's more common than you think. It doesn't mean anything went wrong, and there are lots of explanations. Sometimes there are a lot of kids in the class passing it back and forth, and getting treated at different times. Sometimes, it is because the bacteria is hiding deep inside the tonsil folds and the antibiotic had a hard time reaching it. Changing up the antibiotic, or just repeating a course, can help it go away.

10. You can get over strep on your own, without antibiotics. Isn't that amazing? Our immune systems are awesome. BUT, we like to treat strep with antibiotics anyway. Why? Because it makes you feel better sooner. It makes you less contagious to others (you are no longer contagious 12 hours after the first dose of Amoxicillin). And it can prevent the VERY rare complications we see with strep - when strep attacks the heart (acute rheumatic fever).

Hope this helps you to better understand strep!
Get to know Diane Arnaout, M.D.
" Dr. Diane Arnaout is a pediatrician at the Cook Children's Forest Park practice. If you would like to see her at Forest Park, call 817-336-3800 or clic k h ere for an appointment. Dr. Diane has been a Cook Children's physician since 2011.

She got her undergraduate degree at Texas A&M University, went to medical school at the UT Health Science Center in San Antonio, and completed her pediatric residency in the Texas Medical Center at UT Health Science Center in Houston.

She is board-certified by the American Board of Pediatrics. She has two small kids, whom she credits as being her toughest (and best) teachers. She loves being a pediatrician and loves to teach parents all about their childrens' health daily, both in-person and online."

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1. When a child has a sore throat, in general, there is a 37 percent chance that it is strep (Group A Strep, aka, Streptococcus pyogenes) 2. Fifteen-20 percent of kids WITH NO SYMPTOMS AT ALL will be POSITIVE FOR STREP if tested. This means 15-20 perecent of kids are strep "carriers."

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Maclyn McCarty (1911-2005) is credited for many discoveries regarding streptococcus bacterium.

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Antibiotic resistance is an increasing problem in the United States. This can be especially threatening in treating Strep Throat, as there are antibiotics used to treat the infection that are seeing trends in resistance.

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1. Frequently wash your hands
2. Cover your mouth with a tissue or your elbow when sneezing or coughing.
3. Do not share drinks or eating utensils with others.

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Antibiotics are used to treat Strep Throat. The most common antibiotics of choice are Penicillin and Amoxicillin (CDC,n.d.). However, Azithromycin and Erythromycin are also frequently used antibiotics to treat Strep Throat in individuals with penicillin allergies.

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To conduct a strep test, a cotton swab is brushed against the throat to collect a sample. A test is then ran on the swab sample to detect the presence of the streptococcus bacteria.

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1. Fever
2. Sore throat
3. Swollen tonsils with white patches
4. Swollen lymph nodes
5. Red spots on roof of mouth

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Strep Throat is a contagious bacterial infection caused by Streptococcus bacterium (Mayo Clinic, 2020). It causes inflammation, scratchiness, soreness, and irritation to the throat and tonsils.

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Overview

Strep throat is a bacterial infection that can make your throat feel sore and scratchy. Strep throat accounts for only a small portion of sore throats.

If untreated, strep throat can cause complications, such as kidney inflammation or rheumatic fever. Rheumatic fever can lead to painful and inflamed joints, a specific type of rash, or heart valve damage.

Strep throat is most common in children, but it affects people of all ages. If you or your child has signs or symptoms of strep throat, see your doctor for prompt testing and treatment.

Symptoms

Signs and symptoms of strep throat can include:

Throat pain that usually comes on quickly

Painful swallowing

Red and swollen tonsils, sometimes with white patches or streaks of pus

Tiny red spots on the area at the back of the roof of the mouth (soft or hard palate)

Swollen, tender lymph nodes in your neck

Fever

Headache

Rash

Nausea or vomiting, especially in younger children

Body aches

It's possible for you or your child to have many of these signs and symptoms but not have strep throat. The cause of these signs and symptoms could be a viral infection or some other illness. That's why your doctor generally tests specifically for strep throat.

It's also possible for you to be exposed to a person who carries strep but shows no symptoms.

When to see a doctor

Call your doctor if you or your child has any of these signs and symptoms:

A sore throat accompanied by tender, swollen lymph glands

A sore throat that lasts longer than 48 hours

A fever

A sore throat accompanied by a rash

Problems breathing or swallowing

If strep has been diagnosed, a lack of improvement after taking antibiotics for 48 hours

Causes

The cause of strep throat is bacteria known as Streptococcus pyogenes, also known as group A streptococcus.

Streptococcal bacteria are highly contagious. They can spread through airborne droplets when someone with the infection coughs or sneezes, or through shared food or drinks. You can also pick up the bacteria from a doorknob or other surface and transfer them to your nose, mouth or eyes.

Risk factors

Several factors can increase your risk of strep throat infection:

Young age. Strep throat occurs most commonly in children.

Time of year. Although strep throat can occur anytime, it tends to circulate in winter and early spring. Strep bacteria flourish wherever groups of people are in close contact.

Complications

Although strep throat isn't dangerous, it can lead to serious complications. Antibiotic treatment reduces the risk.

Spread of infection

Strep bacteria may spread, causing infection in:

Inflammatory reactions

Strep infection may lead to inflammatory illnesses, including:

Scarlet fever, a streptococcal infection characterized by a prominent rash

Inflammation of the kidney (poststreptococcal glomerulonephritis)

Rheumatic fever, a serious inflammatory condition that can affect the heart, joints, nervous system and skin

Poststreptococcal reactive arthritis, a condition that causes inflammation of the joints

A possible relationship has been suggested between strep infection and a rare condition called pediatric autoimmune neuropsychiatric disorder associated with group A streptococci (PANDAS). PANDAS is a term used to describe certain children whose symptoms of neuropsychiatric conditions, such as obsessive-compulsive disorder or tic disorders, are worsened by strep infection. This relationship currently remains unproved and controversial.

Prevention

To prevent strep infection:

Clean your hands. Proper hand cleaning is the best way to prevent all kinds of infections. That's why it's important to clean your own hands regularly and to teach your children how to clean their hands properly using soap and water or an alcohol-based hand sanitizer.

Cover your mouth. Teach your children to cover their mouths when they cough or sneeze.

Don't share personal items. Don't share drinking glasses or eating utensils. Wash dishes in hot, soapy water or in a dishwasher.

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Strep throat is a bacterial infection that can make your throat feel sore and scratchy. Strep throat accounts for only a small portion of sore throats. If untreated, strep throat can cause complications, such as kidney inflammation or rheumatic fever. Rheumatic fever can lead to painful and inflamed joints, a specific type of rash, or heart valve damage.

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The Center for Disease Control and Development (CDC) discusses what exactly is Strep Throat, the causes of it, and disease treatment and prevention.

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Centers for Disease Control and Prevention

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Worried your sore throat may be strep throat? Doctors can do a quick test to see if a sore throat is strep throat. Antibiotics can help people with strep throat feel better faster and prevent spreading it to others.

Bacteria cause strep throat

Viruses cause most sore throats. However, strep throat is an infection in the throat and tonsils caused by bacteria called group A Streptococcus (group A strep).

How you get strep throat

Group A strep bacteria are very contagious. Generally, people spread the bacteria to others through

Respiratory droplets

Direct contact

Rarely, people can spread group A strep bacteria through food that is not handled properly (visit CDC's food safety page).

It usually takes two to five days for someone exposed to group A strep bacteria to become ill with strep throat.

Respiratory droplets

Group A strep bacteria often live in the nose and throat. People who are infected spread the bacteria by talking, coughing, or sneezing, which creates respiratory droplets that contain the bacteria.

People can get sick if they:

Breathe in respiratory droplets that contain the bacteria

Touch something with those droplets on it and then touch their mouth or nose

Drink from the same glass or eat from the same plate as a person infected with group A strep bacteria

Direct contact

People can also spread group A strep bacteria from infected sores on their skin. Other people can get sick if they:

Touch sores on the skin caused by group A strep bacteria (impetigo) or come into contact with fluid from the sores

It is important to know that some infected people do not have symptoms or seem sick. People sick with strep throat are much more contagious than those who do not have symptoms.

Pain, fever, but no cough is common

In general, strep throat is a mild infection, but it can be very painful. The most common symptoms of strep throat include:

Sore throat that can start very quickly

Pain when swallowing

Fever

Red and swollen tonsils, sometimes with white patches or streaks of pus

Petechiae - pronounced pi-TEE-kee-eye - on the soft or hard palate (tiny, red spots on the roof of the mouth)

Swollen lymph nodes in the front of the neck

Other symptoms may include a headache, stomach pain, nausea, or vomiting - especially in children. Someone with strep throat may also have a rash; it is known as scarlet fever.

Some symptoms suggest a viral cause rather than group A strep

The following symptoms suggest a virus is the cause of the illness instead of strep throat:

Cough

Runny nose

Hoarseness (changes in your voice that make it sound breathy, raspy, or strained)

Conjunctivitis (pink eye)

Up to 3 in 10 children with a sore throat have strep throat

About 1 in 10 adults with a sore throat has strep throat

Some people are at increased risk

Anyone can get strep throat, but there are some factors that can increase the risk of getting this common infection.

Age

Strep throat is more common in children than adults. It is most common in children 5 through 15 years old. It is very rare in children younger than 3 years old.

Adults who are at increased risk for strep throat include:

Parents of school-aged children

Adults who are often in contact with children

Group settings

Close contact with another person with strep throat is the most common risk factor for illness. For example, if someone has strep throat, the bacteria often spread to other people in their household.

Infectious illnesses tend to spread wherever large groups of people gather. Crowded settings can increase the risk of getting a group A strep infection. These settings include:

Schools

Daycare centers

Military training facilities

A simple test gives fast results

A doctor will determine what type of illness you have by asking about symptoms and doing a physical exam. If they think you might have strep throat, they will swab your throat to test for strep throat. There are two types of tests for strep throat: a rapid strep test and throat culture.

Rapid strep test

A rapid strep test involves swabbing the throat and running a test on the swab. The test quickly shows if group A strep bacteria are causing the illness.

If the test is positive, doctors can prescribe antibiotics.

If the test is negative, but a doctor still suspects strep throat, then the doctor can take a throat culture swab.

Throat culture

A throat culture takes time to see if group A strep bacteria grow from the swab. While it takes more time, a throat culture sometimes finds infections that the rapid strep test misses.

Culture is important to use in children and teens since they can get rheumatic fever from an untreated strep throat infection. For adults, it is usually not necessary to do a throat culture following a negative rapid strep test. Adults are generally not at risk of getting rheumatic fever following a strep throat infection.

Antibiotics get you well fast

Doctors treat strep throat with antibiotics. Benefits of antibiotics include:

Decreasing how long someone is sick

Decreasing symptoms (feeling better)

Preventing the bacteria from spreading to others

Preventing serious complications like rheumatic fever

Someone with strep throat should start feeling better in just a day or two after starting antibiotics. Call the doctor if you or your child are not feeling better after taking antibiotics for 48 hours.

When to return to work, school after illness

People with strep throat should stay home from work, school, or daycare until they:

AND

Have taken antibiotics for at least 12 hours

Antibiotic dos and don'ts

1. Do take the prescription exactly as the doctor says to.

2. Don't stop taking the medicine, even if you or your child feels better, unless the doctor says to stop.

You can find more guidance on taking antibiotics on CDC's Antibiotic Do's & Don'ts Page.

Not everyone needs antibiotics

Someone who tests positive for strep throat but has no symptoms (called a "carrier") usually does not need antibiotics. They are less likely to spread the bacteria to others and very unlikely to get complications.

If a carrier gets a sore throat illness caused by a virus, the rapid strep test can be positive. In these cases, it can be hard to know what is causing the sore throat.

If someone keeps getting a sore throat after taking the right antibiotics, they may be a strep carrier and have a viral throat infection. Talk to a doctor if you think you or your child may be a strep carrier.

Serious complications are not common

Complications can occur after a strep throat infection. This can happen if the bacteria spread to other parts of the body. Complications can include:

Abscesses (pockets of pus) around the tonsils or in the neck

Swollen lymph nodes in the neck

Sinus infections

Ear infections

Rheumatic fever (a disease that can affect the heart, joints, brain, and skin)

Post-streptococcal glomerulonephritis (a kidney disease)

Protect yourself and others

People can get strep throat more than once. Having strep throat does not protect someone from getting it again in the future. While there is no vaccine to prevent strep throat, there are things people can do to protect themselves and others.

Good hygiene

The best way to keep from getting or spreading group A strep is to wash your hands often. This is especially important after coughing or sneezing and before preparing foods or eating.

To prevent group A strep infections, you should:

Cover your mouth and nose with a tissue when you cough or sneeze.

Put your used tissue in the waste basket.

Cough or sneeze into your upper sleeve or elbow, not your hands, if you don't have a tissue.

Wash your hands often with soap and water for at least 20 seconds.

Use an alcohol-based hand rub if soap and water are not available.

You should also wash glasses, utensils, and plates after someone who is sick uses them. These items are safe for others to use once washed.

Antibiotics

Antibiotics help prevent someone with strep throat from spreading the bacteria to others.

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Worried your sore throat may be strep throat? Doctors can do a quick test to see if a sore throat is strep throat. Antibiotics can help people with strep throat feel better faster and prevent spreading it to others. Viruses cause most sore throats.