This spread of bacteria occurs easily in crowded locations such as schools and is much more common in the cold months of the year. The incubation period is the time between coming in contact with the strep and having symptoms, usually two to five days.

Streptococci (strep) are bacteria. There are many different species of this bacteria although only a few of them cause disease in humans. The different species have been given a letter to identify them. Groups A to G can cause problems in people. Group A Streptococci (Strep) is responsible for most of the important infections.

What are the symptoms?

The symptoms of strep throat include:

sudden onset of sore, red throat
painful swallowing
fever
chills
headaches
muscular aches and pains
nausea
tired feeling

Children may have stomach pain, vomiting or convulsions. Most symptoms disappear within one week although many weeks may be required for enlarged tonsils and lymph nodes of the neck to return to normal size.

Is a sore throat always strep throat?

No. Most sore throats are caused by viruses, not bacteria like strep. Runny nose, hoarseness, cough or red eyes are more typical of virus infections such as the common cold. This is not caused by strep and does not need to be treated with antibiotics.

Your doctor will need to make a careful assessment to know if your sore throat might be due to strep. After examining the throat, a doctor may decide to obtain a throat culture to test for strep. This test involves brushing a swab across the throat to get a sample that is sent to the lab for testing. The results are usually available within a few days. A rapid test is available to look for strep but it is not as accurate as the culture, so it is rarely used.

What about treatment?

The best drug for this problem is penicillin. It is usually prescribed two to four times a day for 10 days. If the drug is given for fewer than 10 days, the infection can return. Erythromycin, clindamycin or related drugs are recommended for those allergic to penicillin. With treatment, the symptoms of strep throat may go away as quickly as 24 hours. The symptoms rarely last more than five days.

Other measures that make people feel better include drinking clear fluids like chicken soup, Jell-O™ and fruit juices. Avoid smoking or breathing second hand smoke. Avoid unnecessary talking while a throat is sore. High fever can be managed with acetaminophen up to every four hours.

Is strep throat contagious?

Yes. Your child should stay home and away from others until the antibiotic has been taken for 24 to 48 hours. By this time, many symptoms should be cleared and the bacteria will not be spread to others.

What is a strep carrier?

A strep carrier is someone who continues to grow Group A strep in the throat even though feeling well. A carrier may still be able to spread the disease. As many as 10 to 20 per cent of school children may be carriers of strep in the winter time. Carriers are not treated with antibiotics as it is difficult to eliminate all strep with penicillin. Carriers will be treated when there is continued spread throughout a family or if there is an outbreak of rheumatic fever in a community.

What if strep throat is not properly treated?

Rheumatic fever may occur a few weeks after an untreated or partially treated strep throat is gone and almost forgotten. This disease is a rare but serious illness that may include various combinations of fever, weakness, swollen joints, a strange-looking rash and sometimes damage to the heart valves. There is no cure for rheumatic fever but careful medical attention is needed. The important point to remember is that adequate treatment of strep throat will prevent this disease.

What other problems occur after strep throat?

One to three weeks after a particular type of strep infection, a kidney disease called glomerulonephritis may occur. The symptoms include swelling of the face, hands and feet, smoky or rust-colored urine and high blood pressure. This illness usually disappears without treatment in children. It can be more serious in adults. Both rheumatic fever and post-strep glomerulonephritis are caused by the body's immune system as it tries to fight the strep infection.

Scarlet fever is also caused by strep. The onset is sudden, with fever and sore throat. Within one to five days a fine, red rash that feels like sandpaper appears. This may start on the chest and spread to other parts of the body. During the healing phase, the skin involved with the rash peels. The rash occurs because of a chemical or toxin released by the strep. This toxin causes damage to the small blood vessels in the skin. Scarlet fever is treated successfully with antibiotics for 10 days.

Do tonsils help to fight strep infections and tonsillitis?

Yes. Tonsils help the body's immune system resist infections. Tonsils and adenoids are located near the entrance to the breathing passages, on each side of the mouth cavity behind the tongue. They are part of a ring of glandular tissue which samples or filters bacteria and viruses. Unfortunately, tonsils can become infected by the viruses and bacteria they are sampling or filtering.

How are infections of the tonsils treated?

Strep infections of the tonsils are treated with antibiotics. If a child has four or more episodes of tonsillitis in one year or has very large tonsils, a doctor may recommend they be removed. Infected tonsils may become very large and cause difficulty with breathing, snoring and disturbed sleep patterns. Chronic mouth breathing from large tonsils and adenoids may cause malformations of the face and improper alignment of the teeth.

How can I help prevent strep throat?

Use tissues or handkerchief when you cough or sneeze.
Wash your hands before you touch food, dishes, glasses or cutlery.
Wash your hands after you cough, sneeze or blow your nose.
Be careful not to let your nose or mouth touch public telephones or drinking fountains.
Avoid sharing food or eating utensils with others.

Strep throat is a common infection of childhood. It responds well to antibiotic treatment and most children recover with no long lasting effects. If your child has a sore throat, check with your doctor. Don't take a chance on further serious illness as a result of incorrect or inadequate treatment.

Strep Throat A sore throat that needs medical attention