What is strep throat?
Strep throat is an infection of the throat caused by group A Streptococcus bacteria, which cause swelling and irritation (inflammation) of the throat and tonsils.
Your throat connects your mouth to your esophagus and windpipe. The medical name for the throat is pharynx, which explains why a sore throat caused by a group A Streptococcus infection may also be referred to as streptococcal pharyngitis (inflammation of the throat). Strep throat may also be called streptococcal tonsillitis (inflammation of the tonsils).
Strep throat is the most common bacterial cause of a sore throat, although the majority of sore throats are caused by viral throat infections.
Left untreated, a strep throat can cause serious health problems elsewhere in the body. Colonies of bacteria can travel to the heart, kidneys, and other organs. Rapid diagnostic tests are used to confirm if sore throat is caused by group A Streptococcus so that prompt antibiotic therapy can be prescribed.
Strep throat is contagious. The infection can be passed in airborne particles to anyone but is most common in children. Symptoms of strep throat include a sore throat and cherry-red, inflamed and swollen tonsils. White patches of pus may appear on the tonsils. Other symptoms include pain with swallowing, headache and fever.
People who are in good health generally recover from strep throat at home by taking prescribed antibiotics as directed. Treatment also includes measures to help relieve symptoms and keep the body as strong as possible to minimize the risk of developing complications. Self-care measures include resting, taking medications to ease body aches and fever, and drinking plenty of fluids.
Curing a strep throat requires prescribed antibiotics. Seek prompt medical care if you have symptoms of strep throat, such as sore throat and fever; if you have a diagnosed case of strep throat that is not getting better with antibiotics; or if there is increased swelling of the tonsils.
Complications of strep throat, such as rheumatic fever and rheumatic heart disease, can be serious, even life-threatening in rare cases. Seek immediate medical care (call 911) someone is unable to swallow, has difficulty breathing, or has a change in alertness or consciousness.
What are the symptoms of strep throat?
Symptoms of strep throat can vary among individuals but generally include a sore throat. Not all people with strep throat will have a sore throat, especially early in the infection.
Common strep throat symptoms include:
- Abdominal pain, especially in children
- Difficulty swallowing
- Nausea and poor appetite
- Sore throat
- Swollen glands (lymph nodes) in the neck
- Swollen tonsils and throat that appear cherry red
Symptoms that might indicate a serious or life-threatening condition
In rare cases, strep throat can result in serious complications, such as acute glomerulonephritis, rheumatic fever, and peritonsillar abscess. Seek immediate medical care (call 911) if someone has any of these symptoms:
- Abnormal jerky movements
- Change in level of consciousness or alertness, such as passing out or unresponsiveness
- Change in mental status or sudden behavior change, such as confusion, delirium, lethargy, hallucinations or delusions
- Dark or bloody urine
- High fever (higher than 101°F)
- Inability to swallow
What causes strep throat?
Strep throat is caused by an infection of the throat and tonsils by group A Streptococcus bacteria. Despite popular belief, strep throat, colds, and other types of upper respiratory infections are not caused by being wet or cold, although in some cases these conditions may lower the body’s resistance to bacterial and other types of infections.
Strep throat is contagious and spreads quickly from person to person when someone with strep throat talks, coughs or sneezes. This shoots droplets contaminated with group A Streptococcus bacteria into the air, where others can breathe them in.
Strep throat also spreads when a person touches a person who has strep throat or a surface contaminated by group A Streptococcus bacteria, such as a contaminated computer keyboard or doorknob. Touching the mouth, eyes or nose before washing your hands can transmit the bacteria from the hands into the body.
What are the risk factors for strep throat?
Strep throat can occur in any age group or population. A number of factors increase the risk of catching strep throat, although not all people with risk factors will get strep throat.
Risk factors for catching strep throat include:
- Close exposure to a person with strep throat
- Poor hygiene habits, such as not washing your hands after contact with a person who has strep throat or after touching surfaces that are often contaminated with strep throat bacteria, such as doorknobs, computer keyboards, and telephones. Sharing unwashed drinking glasses, spoons, forks, and personal items, such as lip balm and toothbrushes, can also spread bacteria.
- Young age, such as preschool and elementary school children
Reducing your risk of strep throat
You can lower your risk of catching or spreading strep throat by:
- Avoiding contact with a person who has strep throat
- Avoiding touching the eyes, nose and mouth, which can transmit strep throat bacteria from the hands into the body
- Covering the mouth and nose with the elbow (not the hand) or a tissue when sneezing or coughing
- Not sharing unwashed drinking glasses, dishware, or personal items, such as lip balm and toothbrushes
- Using appropriate antibacterial cleaners to clean hands and surfaces
- Washing hands frequently during and after contact with a person who has strep throat
- Washing hands frequently throughout the day with soap and water for at least 15 seconds
- Using hand sanitizer if soap is not available
How can you prevent the spread of strep throat?
Strep throat is extremely contagious. If you or someone in your household has strep throat, it is important to take steps to prevent the further spread of the infection.
You can reduce the risk of spreading strep throat by:
- Avoiding sharing items that touch your mouth, such as drinking glasses, silverware, or lip balm
- Coughing or sneezing into your elbow, not your hand. If you cough or sneeze into a tissue, dispose of it promptly and wash your hands thoroughly.
- Throwing away your old toothbrush after you recover to avoid reinfecting yourself
- Using a separate tube of toothpaste from others in the family
- Washing hands frequently and thoroughly, especially before touching food or common surfaces like doorknobs or computer keyboards
What are the diet and nutrition tips for strep throat?
The pain caused by strep throat can make swallowing difficult, which in turn may reduce appetite. You can help relieve symptoms and maintain your nutrition by following these diet tips with strep throat:
- Avoid acidic foods, such as citrus fruits, as well as spicy dishes.
- Drink plenty of water, which keeps your throat hydrated and makes swallowing easier.
- Eat soft foods that are easy to swallow, such as applesauce, mashed potatoes, soft fruits, soup and yogurt.
- Puree foods to make them easier to swallow, such as in fruit or vegetable smoothies.
- Soothe pain with frozen foods, including frozen yogurt, ice cream, or sorbet (all in moderation, of course).
Ask your healthcare provider for guidance before making significant changes to your diet.
How do doctors diagnose strep throat?
While your doctor may suspect strep based on your symptoms and a physical, a strep test is the only definitive way to diagnose strep throat.
A rapid strep test can be performed in your doctor’s office or a health clinic. The provider will use a swab to collect a sample from the back of your throat. This may cause a brief gagging sensation, but the test only takes a few seconds. Within minutes, the results will show if group A Streptococcus bacteria are present.
If the test is negative, your doctor will likely order a throat culture in case the rapid strep test produced a false negative. This test requires another throat swab to collect a sample, which is then sent to a lab for more comprehensive testing. Results take a few days.
What to Know About At-Home Strep Tests
You can purchase at-home strep tests online or over the counter. However, doctors advise against using these kits for a variety of reasons.
At-home strep tests require a throat swab, which can be difficult to perform correctly without medical training. This can affect the accuracy of the results. If a test is a false positive, it could result in unnecessary use of antibiotics. If the result is a false negative, and no treatment is given, the infection could progress into serious complications including ear infections, rheumatic fever, or kidney inflammation.
If you suspect you or your child has strep throat, it is best to see your doctor right away for professional testing.
What are the treatments for strep throat?
Antibiotics that fight against group A Streptococcus bacteria are the only treatment for strep throat. The first choices for most people are penicillin or amoxicillin, unless you have an allergy to these medications. Other antibiotic options include cephalexin, clindamycin, azithromycin, or clarithromycin.
It is important to follow the instructions for your antibiotic prescription. If you or your child has trouble with the medication (such as inability to swallow it or nausea), talk with your doctor or pharmacist for suggestions on changing when and how you take the antibiotics.
It is also important not to stop taking the antibiotic even when you feel better. Your throat may have stopped hurting and you have no other symptoms, but this does not mean the infection has been fully eliminated. If you stop taking the medication too early, the infection may come back stronger than before and be more difficult to treat.
With the right antibiotic, you should notice an improvement in your strep throat symptoms within two days. If you do not feel better within this period, contact your doctor. You may need a different antibiotic. (Some strains of group A Streptococcus are resistant to azithromycin and clarithromycin.)
At-home remedies for strep throat symptoms
Antibiotic treatment is necessary to eliminate a strep throat infection, but additional at-home remedies can help soothe symptoms and speed up recovery.
- Drink plenty of water and fluids, to keep the throat from getting dry and to prevent dehydration.
- Eat chicken soup, which can be easier on your throat to swallow than solid foods and provides easy-to-digest nutrients and extra fluids to help keep up your strength.
- Gargle with warm, salted water to ease sore throat.
- Get extra rest and sleep, to help your body fight the infection.
- Suck on candy or throat lozenges, unless the patient is a young child, has dementia, or has other difficulty swallowing unrelated to the sore throat.
- Swallow honey, which can soothe a sore throat. However, do not give honey to infants under 12 months.
- Take over-the-counter pain relievers, such as acetaminophen (Tylenol) or ibuprofen (Motrin and Advil) for fever, sore throat, and body aches. Note: If your child has a sore throat that has not been medically evaluated and diagnosed, you should not give aspirin or products that contain aspirin because of the risk of a rare but life-threatening condition called Reye syndrome. Reye syndrome has been linked to taking aspirin during a viral illness, such as viral pharyngitis, which can mimic a strep throat.
- Use a cool-mist humidifier, particularly at night, to help keep nose and throat membranes moist.
What are the potential complications of strep throat?
Most people recover from strep throat at home by taking prescribed antibiotics as directed and using measures to help relieve symptoms and keep the body as strong as possible to minimize the risk of developing complications. However, in rare cases, strep throat may lead to complications that can be serious, even life-threatening in some people.
Complications of strep throat include:
- Acute glomerulonephritis (inflammation of the kidneys that can lead to kidney damage and kidney failure)
- Cervical adenitis
- Peritonsillar abscess
- Rheumatic fever
- Rheumatic heart disease