Strep Throat Common Cause of Pain During School Year
By Jamie Lien, M.D.
Your child has developed a sore throat and fever. Could she have strep throat? Do you really have to bring her to the doctor’s office?
Strep throat is a bacterial infection in the throat and the tonsils. It is caused by a group of bacteria called streptococcus. These bacteria make the throat inflamed and irritated, usually causing sudden, severe pain. The pain can be worse with swallowing. Some people may also have fever over 101 degrees F, red and white patches in the back of the throat, swollen tonsils, and swollen glands in the neck. Other possible symptoms include rash, headache, abdominal pain, body aches, loss of appetite, and vomiting.
Anyone can get strep throat, but it is most common in school-age children and teenagers (ages 5 to 15). Strep throat occurs most often during the school year when large groups of children are in close contact with each other, especially in late fall and early spring. It is very rarely detected in children less than 3 years of age.
Not all throat pain is caused by strep bacteria. Viruses are much more common causes of sore throat, and are usually accompanied by cold symptoms including coughing, sneezing, nasal congestion, and a runny nose.
Strep throat is contagious, especially among people in close contact, such as classmates or family members. When someone with strep throat breathes, coughs, or sneezes, tiny droplets containing the strep bacteria are released into the air. If these droplets are breathed in by other people, they can contract the disease. Bacteria can also live for a short time on surfaces such as doorknobs and water faucets, and people can become ill by touching the bacteria with their hands, then transferring it to their nose, mouth, or eyes. It usually takes two to five days to start showing symptoms.
You should see your pediatrician if the sore throat lasts longer than 48 hours or you suspect that your child may have strep throat. It is very important to treat this particular bacterial infection. Your doctor will ask about your child’s symptoms and perform a physical exam, and may swab the back of her throat for a rapid strep test. If this test is positive, she can start treatment right away. Rapid strep tests are not 100 percent accurate, so if her test is negative, the swab will be sent for a throat culture. The results of the throat culture will usually be available within a few days. If the strep bacteria grow in the culture, your pediatrician will make sure your child is being treated. Sometimes the pediatrician will start treatment for strep throat based on the symptoms alone, without waiting for results of the throat culture.
Strep throat is treated with antibiotics. The antibiotics will shorten the period of time your child is contagious to others, and should make her feel better more quickly. Untreated or partially treated strep infections can cause other health problems including tonsil and sinus infections, blood infections, rheumatic fever (which can cause heart damage and joint problems), and kidney disease. Take the entire course of prescribed antibiotics to make sure the infection is cleared.
Your child can also take over the counter medications like acetaminophen or ibuprofen to help with pain and fever. Children should not take aspirin unless specifically directed by a physician. Provide plenty of liquids to prevent dehydration. Avoid acidic juices, like orange juice or lemonade, which may irritate a sore throat. Warm liquids such as soup, tea, or hot chocolate can be soothing.
Most people get better and are no longer contagious a day or two after they start antibiotics, and can go back to school or work. Your child can avoid spreading the strep bacteria to other people by washing her hands often, covering coughs and sneezes, not sharing drinking glasses or eating utensils, and not sharing toothbrushes or towels. Your child should also switch to a new toothbrush 24 hours after she starts the antibiotics.
Dr. Jamie Lien is a pediatrician in the Emergency Department at Rady Children’s Hospital-San Diego and an assistant clinical professor of pediatrics at UC San Diego.