Strep throat, or Streptococcus, is a common bacterial infection in children and teens. While it is most prevalent in kids aged 5 to 15, younger children and adults can also be affected.
If left untreated, strep can cause high fever, kidney inflammation, and in some rare cases, even death.
This guide for parents should address all or most of your questions about strep throat, from symptoms and treatment to prevention and complications, ensuring you have the information needed to care for your child effectively.
What Is Strep Throat?
Strep throat is a bacterial infection that causes inflammation and pain in the throat. Unlike viral sore throats, which are often accompanied by a cough or runny nose, strep throat is caused by the Streptococcus pyogenes bacteria.
Step requires antibiotic treatment to prevent complications such as rheumatic fever or kidney inflammation. According to the Centers for Disease Control and Prevention, strep throat accounts for about 20-30% of sore throats in children.
What Does Strep Throat Look Like?
Strep throat often presents with visible signs that can help parents and healthcare providers identify the infection. The throat may appear red and inflamed, with swollen tonsils that sometimes have white or yellow patches or streaks of pus. Tiny red spots, known as petechiae, may also appear on the roof of the mouth. Sometimes, a red rash known as scarlet fever can develop, which feels like sandpaper to the touch.
A healthcare provider can confirm the diagnosis with a rapid strep test or throat culture. These tests are crucial because strep throat symptoms can overlap with viral infections, which do not require antibiotics.
Is Strep Throat Contagious?
Yes, strep throat is highly contagious. The bacteria spread through respiratory droplets when an infected person coughs, sneezes, or talks. It can also spread by touching surfaces contaminated with these droplets and touching your mouth or nose.
The contagious period for strep typically lasts 24-48 hours after starting antibiotics.
Without treatment, a person can remain contagious for 2-3 weeks.
How Do You Get Strep Throat?
Strep throat is transmitted through close contact with an infected person. This can occur through:
- Inhaling respiratory droplets.
- Sharing utensils, cups, or food.
- Touching contaminated surfaces and then touching your face.
Children in schools or daycare centers are particularly susceptible due to proximity and shared items. The American Academy of Pediatrics emphasizes the importance of good hygiene to prevent the spread of strep throat.
I recently wrote an article about flu symptoms in babies. If there is one commonality among illnesses, it’s the need to constantly clean surfaces and to remove children from daycare, school, or other care facilities until a doctor clears them to return. Because strep is highly contagious, it’s best to immediately remove your child from public care if it is reported. I fully recognize this is not always possible for parents, so you should closely monitor your child for the symptoms listed below.
Symptoms Of Strep Throat In Children
Strep throat symptoms can vary depending on the child’s age, but they often come on suddenly and can be severe.
The most common symptoms in older children include a severe sore throat, difficulty swallowing, and red, swollen tonsils that may have white patches or streaks of pus.
Fever, swollen lymph nodes in the neck, and tiny red spots on the roof of the mouth (petechiae) are also common. Some children may experience headaches or stomach pain, which can sometimes lead to vomiting.
Symptoms may be less straightforward in younger children, especially toddlers and preschoolers. Your child may be unable to verbalize their discomfort, so parents should watch for signs like excessive drooling (due to difficulty swallowing), irritability, decreased appetite, or vomiting. These symptoms can be subtle, so it’s essential to consult a healthcare provider if you suspect strep throat.
How Long Does Strep Throat Last?
According to Johns Hopkins, with proper antibiotic treatment, symptoms of strep throat typically improve within 1-3 days, and the illness usually clears up in 3-5 days. Without antibiotics, the illness can last 7-10 days, increasing the risk of complications.
How Is Strep Throat Treated?
Strep throat in children and teens is treated with antibiotics, most commonly penicillin or amoxicillin. These medications reduce symptoms’ duration, prevent infection spread, and lower the risk of complications. Over-the-counter pain relievers like ibuprofen or acetaminophen can help manage symptoms.
Can Strep Throat Go Away on Its Own?
It’s very rare for strep to go away without treatment. Untreated strep throat can lead to serious complications, such as rheumatic fever, kidney disease, or abscesses around the tonsils. Antibiotics are essential to prevent these risks.
Can You Get Strep Throat Without Tonsils?
Yes, it is possible to get strep throat even after a tonsillectomy, although the risk is lower. The bacteria can infect the remaining throat tissue.
How to Prevent Strep Throat
Preventing strep throat can be tricky because the bacteria is highly contagious. However, with some diligence, you can reduce the chance of getting strep throat.
- Practicing good hand hygiene.
- Avoiding close contact with infected individuals.
- Not sharing utensils or personal items.
- Disinfecting frequently touched surfaces.
When To See A Doctor
If your child has a sore throat accompanied by fever, swollen lymph nodes, or difficulty swallowing, consult a healthcare provider. A rapid strep test or throat culture can confirm the diagnosis and guide treatment.
Complications Of Untreated Strep Throat
Untreated strep throat can lead to serious complications in children, teens, and adults. I’ve listed the main issues that are caused by untreated strep.
Rheumatic Fever: An inflammatory disease that can affect the heart, joints, skin, and brain.
Post-streptococcal Glomerulonephritis (PSGN): A kidney inflammation that can occur even after the infection clears.
PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections): A rare condition where strep infections trigger sudden-onset OCD-like symptoms or tics in children.
Antibiotic Resistance & Alternatives For Strep Throat Treatment
While penicillin and amoxicillin are first-line treatments, some children may be allergic. Alternatives include:
- Cephalosporins (e.g., cephalexin)
- Macrolides (e.g., azithromycin, clarithromycin)
It’s important to use antibiotics responsibly to prevent resistance. You can learn more about those alternatives through the American Family Physician (AAFP).
Supportive Care At Home For Children With Strep
In addition to antibiotics, supportive care can help ease your child’s discomfort. Please note that none of these support care methods will cure strep, and at-home cures are not effective despite what you read from health influencers.
- Saltwater Gargles: This can soothe the throat for children old enough to gargle.
- Honey & Warm Tea: Honey can be soothing for children over the age of 1.
- Humidifiers: Keeping the air moist can help with throat irritation.
- Cold or Soft Foods: Popsicles, yogurt, and soup can be easier to swallow.
Returning to School After Strep Throat
Children should stay home until they have been on antibiotics for at least 24 hours and are fever-free without medication. The CDC recommendation of 24 hours is also followed by other recommendations for school-aged children.
Reinfection & Strep Carriers
Some children are strep carriers, meaning they always test positive but don’t have symptoms. Others may get repeat infections due to exposure. To prevent reinfection:
- Change toothbrushes after 24 hours on antibiotics.
- Ensure all family members are treated if they are asymptomatic carriers.
Differentiating Strep from Other Throat Infections
Many sore throats are viral, not bacterial. Key differences include:
- Strep Throat: Severe sore throat, fever, swollen lymph nodes, no cough or runny nose.
- Viral Sore Throat: Often accompanied by cough, runny nose, or hoarseness.
That’s a very simplistic breakdown but it’s a good starting point when you are still attempting to determine if your child may have strep throat.
Strep throat in children and teens is a common but treatable condition. Recognizing the symptoms early and seeking prompt medical care can prevent complications and ensure a quick recovery. Understanding how strep throat spreads and taking preventive measures can protect your child and others from this contagious infection.
The information provided is for educational purposes only. It should not be a replacement for medical care or advice. This info is not intended to diagnose or replace medical treatment. Consult your doctor if you have any questions about your child’s health. If they are experiencing an emergency, contact 911 or transport them to the nearest emergency room.