How to recognize the signs you have strep throat

A scratchy, sore throat can make you or your child feel miserable, and when it’s caused by strep, it can become serious.

Strep throat is an infection of the throat and tonsils. It occurs year-round but is most common in winter and early spring. It spreads easily and can lead to severe illness if not treated with antibiotics.

What is strep throat?

Strep throat is caused by group A Streptococcus bacteria, whereas most sore throats are caused by viruses.

While viral sore throats usually resolve on their own, doctors treat strep throats with antibiotics to reduce the risk of complications. These include rheumatic fever and other conditions that can damage the heart valves, kidneys and joints.

Strep throat is most common in children ages 5-15 because they spend a lot of time together in school and other group settings where the bacteria can easily spread. It is rare for children younger than 3 years old.

In general, complications from strep throat are more common in kids than adults. They are rare in adults in the U.S.

Can you get strep throat without tonsils?

You can still get strep throat even if you no longer have your tonsils. However, not having them may reduce the severity or frequency of strep throat infections.

Symptoms of strep throat

Strep throat symptoms usually develop quickly and may include:

• Fever
• Swollen tonsils
• Pain with swallowing
• Fast onset of sore throat
• Patches of white pus on tonsils
• Swollen lymph nodes in the neck
• Small red spots on the roof of the mouth
• Rash on the body

Less common symptoms, especially in children, may include:

• Headache
• Stomach pain
• Nausea and vomiting

What does strep throat feel like?

Strep throat can feel like a bad cold that comes on quickly. People with strep throat often have a very sore, swollen throat and may have difficulty swallowing. They may also have a fever that leaves them feeling rundown.

What does strep throat look like?

Swollen lymph nodes in the neck and swollen tonsils are common signs doctors look for when evaluating patients for strep throat. They also check for white patches or streaks of pus on the tonsils and tiny red dots, a condition called petechiae, on the roof of the mouth. These symptoms can indicate strep throat.

Strep throat vs. sore throat

The bacteria that cause strep don't usually affect the lower respiratory tract, so you typically don't cough up phlegm. A cough can indicate a viral rather than a bacterial sore throat, so it may not be strep-related.

A doctor can often tell when a virus causes a sore throat based on symptoms and an exam. In these cases, testing for strep throat is not usually needed. Other times, a throat swab test is required to confirm strep throat.

A healthcare provider swabs the back of the throat and tests the sample for the bacteria that cause strep. Results of this rapid strep test are available in minutes. Your doctor may also confirm the diagnosis with a throat culture/PCR test. A culture/PCR test takes longer but can detect infections that a rapid strep test may miss.

Is strep throat contagious?

Strep throat is highly contagious. After infection, symptoms may take several days to develop. The infection can spread to others a few days before symptoms appear and remains contagious until you've taken antibiotics for at least 24 hours.

How strep throat spreads

When someone with strep throat coughs or sneezes, they release respiratory droplets that contain bacteria. If droplets land on your hands and you then touch your mouth, nose or eyes, you may develop strep throat.

Steps to prevent the spread

If you or someone in your family has strep throat, wash your hands frequently to remove bacteria. Avoid sharing common household items, especially plates, glasses and utensils. Remember to cover your mouth and nose when coughing or sneezing and remind others to do the same.

Treatment for strep throat

If test results are positive, your provider will likely prescribe amoxicillin or penicillin. These antibiotics are effective against strep bacteria and typically have few serious side effects. Antibiotics not only help prevent complications but also relieve symptoms more quickly. Even if you or your child feels better, it's important to follow through with your doctor's instructions to complete the entire course of antibiotics.

If test results are negative, your sore throat could be caused by a viral infection.  Sore throats caused by viruses get better on their own without antibiotics. Antibiotics only help with strep throat. Taking antibiotics when they are not needed will not help you feel better faster and can cause harm because of side effects.

How long does strep throat last?

Most people who receive antibiotics for strep throat feel better within 48 hours. Recovery can take longer, depending on the severity of the illness, your immune system and how much rest you get.

Does strep throat go away on its own?

Strep can go away on its own, but there is a risk of serious complications, especially in children. Antibiotics can prevent these issues and relieve common symptoms, making recovery from strep more comfortable.

Can you test for strep throat at home?

While at-home strep tests are available, it can be difficult to ensure you're swabbing the throat correctly, especially with an uncooperative child. The Centers for Disease Control and Prevention (CDC) recommends talking to your healthcare provider if you or your child has a sore throat or any other concerning symptoms.

When can I return to normal interactions?

The CDC recommends that a person with strep stay home from work, school or daycare until they are fever-free and have been taking antibiotics for at least 12 to 24 hours. Your healthcare provider may have more specific recommendations.

How to soothe strep throat at home

A body fighting an infection like strep throat needs rest to heal and recover. Try to get long periods of quality sleep and stay hydrated. These additional suggestions may also help you feel better:

Non-prescription pain medicine

Always use over-the-counter medicines as directed to relieve pain and discomfort. Some cold medications are not recommended for children of certain ages because of the risk of serious, sometimes life-threatening, side effects. Ask your doctor or pharmacist about appropriate medicines and doses.

Gargling

If a child is old enough to hold water in their mouth and swish it around, gargling can help reduce pain. Mix 1/4 teaspoon of salt with 8 ounces of warm water to make a homemade gargle solution. Gargle with the mixture three times a day until symptoms subside.

Warm liquids

This is one case when Grandma's remedy, a bowl of chicken soup, can be good medicine. Warm, salty fluids like those in soups and broths can soothe sore throat tissues.

Homemade freezer pops

If it's difficult to drink big gulps of liquid, consider freezer pops made from sports drinks that include electrolytes. They can help keep you hydrated, provide a small amount of glucose and soothe throat soreness with their cool temperature.