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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.

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Strep Throat is an infection in the throat that causes a great deal of pain and sickness. Strep is caused by bacteria called Group A Streptococcus. It is easy to spread strep. It spreads through infected people who cough and/or sneeze. The cough/sneeze spreads small droplets that contain the bacteria.

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Streptococcus Pyogenes

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- Sore Throat
- Fever
- Swollen 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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Group A Streptococcal Diseases are causing a rush in mortality rates. Group A is very infectious and spreads very easily.
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Prevention
- Wash Hands
- Disinfect Surfaces
- Cover Mouth and Nose when Coughing/Sneezing

- Don't Cover Cough/Sneeze with Hands

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Strep throat is diagnosed by a rapid test. The physician swabs the back of the patients throat and tonsils. The test takes roughly fifteen minutes and sometimes a second test is conducted for a throat culture.
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Antibiotics
- Amoxicillin
- Penicillin
Amoxicillin and penicillin are usually the first antibiotics given to treat strep. After 12 hours of taking the antibiotic, the patient is no longer contagious.

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Symptoms of strep throat include a severe sore throat and fever or chills.

What are the symptoms of strep throat?

Early strep throat symptoms include a sore throat that starts suddenly. In addition, you may develop a fever very quickly, with your highest temperature on the second day of infection.

Other signs of strep throat may include:

One symptom that strep throat doesn't normally cause is a cough. If you have a cough and other cold symptoms, you probably have a viral infection, not strep throat.

In addition, some people with strep throat may not develop any symptoms.

What does strep throat look like?

If you have strep throat, your throat and tonsils may appear red, sore and swollen. You may also have white patches, spots or streaks of pus on your throat and tonsils. In addition, you may develop tiny, red spots on the roof of your mouth called petechiae.

Depending on the strain of bacteria, you may also develop a strep throat rash known as scarlet fever. It shows up on your neck and chest first, but it may spread to other parts of your body.

Group A Streptococcus bacteria can also infect your skin and cause sores. When this occurs, the infection is called impetigo.

What does strep throat feel like?

Strep throat is typically a mild condition, but the infection can be very painful. Your sore throat may be severe and very uncomfortable. The lymph nodes in your neck may be very tender and swollen. You may have pain when swallowing. If you have a sore throat rash, it may feel rough like sandpaper.

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Strep Throat: Symptoms, Causes, Diagnosis & Treatment

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Strep throat is an infection in your throat and tonsils caused by a type of bacteria called group A Streptococcus. You need antibiotics to treat strep throat.

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More

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Rebecca Lancefield, Microbiologist, Rockefeller Institute, Streptococcus and Bacteria