Strep throat, also known as "sore throat," is a bacterial infection affecting the tonsils at the back of your throat. It's caused by a bacteria called Streptococcus pyogenes, or strep for short. This infection is most common among kids aged three to 15.2
What are first signs of strep throat?
When you get strep throat, it often begins with a sudden sore throat. You might also get a fever quickly, and it tends to peak on the second day of being sick.4
What are the strep symptoms?
Symptoms start 1 to 5 days after exposure and include:
- Fever
- Sore throat
- Tender and swollen neck glands
Sometimes, people with group a strep infection can get complications like a red rash all over the body that feels rough like sandpaper. When this happens, people refer to the disease as "scarlet fever."3
Symptoms of scarlet fever include:
- All the symptoms of throat infection.
- A red rash may appear, starting as small red bumps on the chest and belly. This rash might spread across the whole body, resembling sunburn and feeling rough like sandpaper. It tends to appear redder in armpits and groin.
- The rash typically sticks around for 2 to 5 days. Once it fades, skin on the fingertips and toes might start to peel.
- Redness of the tongue may be prominent. The tongue develops swollen bumps, giving it a "strawberry" look.
- The roof of the mouth may have tiny red spots known as "petechiae".1
Other complications may include:
- Quinsy: This involves the formation of a pus-filled abscess near the tonsils.
- Rheumatic Fever: Although uncommon, it can bring about symptoms like fever, joint pain, and a skin rash shortly after a sore throat. Later stages may involve heart inflammation or trembling and instability.
- Kidney Inflammation and Impairment: While less frequent, this complication can lead to inflammation and decreased kidney function.
Note: Cough, hoarseness and runny nose are NOT symptoms of streptococcal infection but indicate viral respiratory infections.1
"Carriers or asymptomatic carriers" are people who carry streptococci bacteria in their throats but not feel sick at all.3
How is strep throat diagnosed?
Your doctor will ask you questions to check if you might be at risk. They'll look at your throat and feel your neck for signs of strep symptoms. If they suspect you have it, they'll gently swipe the back of your throat to test for bacteria. A quick strep test gives results on the spot, while a more detailed test usually takes about two days for results.2
Is strep throat contagious?
Yes, sore throat is highly contagious. Illness can spread easily in places where people are close together, such as homes, schools, daycares, and military camps. This is especially true when children are present.5
How do you get strep throat?
Strep throat usually results from direct contact with another person with strep throat. Strep bacteria spread easily through infected person's saliva and nasal secretions.
When an infected person cough, sneeze, talk, laugh, or sing, they can spread infectious droplets into the air without realizing it.
Strep throat spreads through various means, including:
- Inhaling airborne droplets containing the strep-a bacteria.
- Transmitting bacteria from contaminated surfaces to the nose or mouth through hand contact.
- Directly contacting infected skin lesions.
- Sharing items like cups, plates, glasses, or utensils with an infected individual.
- Although rarely, strep throat can also result from improper food handling practices.
Once the bacteria enters the body, it will invade throat cells. Afterwards, it will cause symptoms to appear within two to five days of exposure.
Asymptomatic carriers can play a role in transmission, particularly during outbreaks.1
How long does strep throat lasts?
Strep throat usually kicks in around 1 to 3 days after catching the bacteria. This is the period when symptoms like sore throat and fever start showing.
After that, you enter the infectious period. During this time, if you have strep throat, you can pass it on to others. If left untreated, this infectious period can last for 2 to 3 weeks after you first get sick.
But, when you use the right antibiotics to treat the infection, the time you're contagious becomes much shorter. Typically, it's only about 24 hours after you begin treatment.5
Can strep throat clear up on its own?
We highly recommend that you see a healthcare provider if you are concerned you may have strep throat. Strep throat typically goes away in three to seven days with or without antibiotic treatment. If you don't take antibiotics, you can remain contagious for 2-3 weeks.
Not taking antibiotics also raises your chances of getting complications like rheumatic fever. Bacterial infections can also bring on other viruses like the flu, which can be serious and even deadly.
Pro tip: If you have strep throat, change your toothbrush and disinfect surfaces that may have the virus to prevent getting it again. Make sure your family does the same.7
How to treat strep throat?
Doctors often treat strep throat with penicillin or antibiotics for 10 days. Getting treatment early can reduce the chances of having problems from the bacteria. Finishing the full course of antibiotics as directed is crucial.8
What are other ways to treat strep throat?
You can try using over-the-counter painkillers like:
- Over-the-counter Pain Relievers: Try acetaminophen (like Tylenol) or ibuprofen (like Advil), if they're safe for you.2
- Hot Tea with Honey: Sipping on hot tea with a dash of honey can soothe your sore throat.2
- Saltwater Gargle: Gargling with warm salt water can also help ease the discomfort in your throat.2
Do I need to treat my family?
If someone in your household has symptoms of strep throat, it's crucial to get them tested. Only people who test positive for the bacteria need treatment.2
How can you prevent strep throat?
- People with strep throat should avoid childcare, school, and work until they have been on antibiotics for 24 hours. They should also avoid public areas until they feel better.5
- Good and frequent hand washing will help stop the spread of the virus.
- Children and adults should not share items such as cups, glasses, and utensils
- Avoid public places when sick and avoid eating or drinking from another’s plate, glass or utensils.
- Observe proper cough etiquette:
- Sneeze, blow your nose or cough into a disposable tissue, and discard the tissue immediately into a bin.
- If tissues are not available cough/sneeze into your upper arm or sleeve; avoid using your hands.
- Turn away from other people when coughing/sneezing.
- Move away from other people who are coughing/sneezing.
- Always wash your hands after coughing/sneezing/blowing your nose.
- If soap and water are not available, use an alcohol-based rub.
- Try to keep your hands away from your eyes, nose and mouth.
Use spray bottles to apply a mixture of bleach and water daily. The ratio should be 1 part bleach to 9 parts water. Apply this mixture on surfaces like toilets, sinks, floors, tables, and water fountains. Concentrate on the places where the person has visited.9
FAQs
What should I do if my child has strep throat?
A public health advisory focuses on the responsibilities of the parents or guardians when a child contracts strep throat:
- Take the child to the GP or family doctor to assess every case of strep throat.
- Keep child home until they are feeling well enough to participate in normal center activities. If the doctor prescribes antibiotics, keep the child at home until they have taken the antibiotics for 24 hours.
- If having problems getting the child to take medication, please discuss with GP. Completing the full course of antibiotics is crucial.
Can someone have strep without fever or sore throat?
Yes. Some who have strep may be asymptomatic ― they may not feel sick ― but still capable of spreading the germ. However, a person is much more likely to be contagious if they have strep throat symptoms.5
Do I need antibiotics?
Strep throat typically improves on its own within three to five days. Taking antibiotics can stop you from spreading it and prevent complications. But, even without antibiotics, complications are rare. If you do take antibiotics, you might start feeling better a day sooner than if you didn't.2
Should I take antibiotics if I had contact with a person with no symptoms of strep throat?
No. Doctors should only give antibiotics to people with symptoms and a positive culture for strep throat.
Can I take leftover strep throat antibiotics I already have at home?
No. It's not safe to use leftover meds from a past sickness or share them with others. Using old antibiotics for strep can make it harder to treat and may lead to serious side effects.4
Does strep throat cause cough?
Cough is generally not a symptom of strep throat. Cough, hoarseness, runny nose, reddened eyes and other symptoms may point to a viral respiratory infection.5
Can I get a strep vaccine?
No. Currently, there is no vaccine for Strep A.5
When should I go see a doctor?
If symptoms persist, let your doctor know right away. Keep taking your antibiotic unless your doctor tells you otherwise.
If you don't feel better within one to two days of starting the antibiotic, get in touch with your provider. You should also call if you have any of the symptoms of a strep throat.
What questions should I ask my doctor?
- When will I get my throat test results?
- Should I take antibiotics? What kind?
- How can I ease my symptoms at home?
- How long can others catch what I have?
- Are my tonsils okay?
What does strep throat look like?
A person with strep will have red and swollen tonsils. White patches or streaks of pus may form on the tonsils. The person will also notice tiny, red spots on the roof of the mouth. Their lymph nodes in the front of the neck will have swollen.11
What’s the difference between strep throat and tonsillitis?
Inflamed or infected tonsils is how you identify tonsillitis. Tonsillitis can stem from viruses or bacteria. Most times, viruses are the culprit. But sometimes, it's bacteria, like group A Streptococcus.
Strep throat only happens because of group A Streptococcus bacteria, it is not viral.4
Is it possible to catch strep throat if you don't have tonsils?
Yes. Even if you've had your tonsils removed, you're not completely protected from getting strep throat. While it might happen less frequently, you can still catch the infection. Plus, if you do get it, your symptoms might not be as bad.4
Sources:
1. Division of Public Health, Streptococcal Pharyngitis (Strep Throat) Disease Fact Sheet, 09.2013
2. American Academy of Family Physicians, Tonsillitis (Strep Throat), 01.2023
7. Sarah Thebarge, Home remedies for strep throat symptoms, 03 Jan 2024
8. Florida Health Santa Rosa County, Strep Throat (Streptococcal Throat Infection)
9. Pennsylvania Department of Health, Strep throat Fact Sheet, 11.2018
10. Health New Zealand, Regional Public Health, Strep Throat Fact Sheet
11. Centers for Disease Control and Prevention, Strep Throat: All You Need to Know, January 19, 2024
