Strep Throat in Kids: Symptoms, Causes & Treatment

Infectious Diseases Physician Ami Patel, MD, answers common questions about strep throat.

What is strep throat and what causes it?

Strep throat is a bacterial infection of the throat and tonsils caused by the bacteria streptococcus pyogenes, which is also known as group A streptococcus. While it’s most common in children during winter and early spring, people of all ages can contract strep throat at any time.

What are the symptoms of strep throat in children?

In general, strep throat is a mild infection. The most common signs and symptoms can include:

  • Sore throat/throat pain, which can start very quickly
  • Pain when swallowing
  • Red and swollen tonsils which can sometimes have white patches or streaks of pus
  • Red spots on the roof of your mouth
  • Fever

Additional symptoms might include:

  • Headache
  • Body aches or generally not feeling well
  • Rash
  • Abdominal pain, nausea or vomiting, especially in younger children

While a strep throat infection typically makes your throat feel sore, not all sore throats are strep throat. There are many causes of sore throat and often children have this symptom because of a virus.

Symptoms such as a cough, runny nose or conjunctivitis (pink eye) suggest a viral cause rather than strep throat/group A streptococcus. If your child has a sore throat or symptoms of strep throat, it is important to contact your doctor to determine if testing and treatment for strep throat are needed.

comparison of virus and strep throat symptoms in kids

When should families contact a doctor?

Families should contact a doctor if their child develops the signs and symptoms of strep throat mentioned above to determine what testing and treatment might be needed. Testing can usually be done in the doctor’s office and involves a simple swab of the throat.

If your child has been diagnosed with strep throat, contact your doctor if the symptoms do not begin to improve within a couple days after starting treatment.

How long does strep throat typically last?

It can typically take 2-5 days for someone exposed to the group A streptococcus bacteria to become ill with strep throat. With proper diagnosis and treatment, most children are feeling better and can return to school and activities within a few days.

How is strep throat treated?

Antibiotics are used for treatment of strep throat and can decrease how long someone is sick with strep throat, lessen the symptoms, prevent bacteria from spreading to others, and prevent complications.

Within 24 hours of starting antibiotics for strep throat, your child should start feeling better and will no longer be contagious. However, it’s important to complete the entire course of antibiotics prescribed by your doctor even if your child is feeling better.

Please note, not everyone with a sore throat needs antibiotics. This is true if the sore throat is cause by a viral infection and not the group A streptococcus bacteria. You should contact your doctor if your child has symptoms of strep throat to determine if they need testing to help determine if antibiotics are needed.

Can strep throat go away on its own?

Generally, you should not wait for strep throat to go away on its own. If untreated, strep throat can cause complications as described below. Therefore, prompt testing and treatment are important as antibiotic treatment reduces the risk of serious complications.

What complications can occur from strep throat and how common are they?

Serious complications of strep throat and the group A streptococcus bacteria are rare. Complications can occur after a strep throat infection if the bacteria spread to other parts of the body. Therefore, it’s important to contact your doctor if you have signs and symptoms of strep throat to determine what testing and treatment is needed, or if symptoms are not getting better within a couple days after starting treatment. Diagnosis and treatment of strep throat reduces the risk of complications.

Complications of strep throat or the group A streptococcus bacteria include:

  • Ear infection
  • Sinus infection
  • Abscesses of the tonsils or neck
  • Rheumatic fever
  • Post-streptococcal glomerulonephritis
  • Invasive infections such as blood stream infections, toxic shock syndrome, and other severe infections

Is strep throat contagious and how does it spread?

Strep throat and the streptococcus bacteria are very contagious. The bacteria can spread from person-to-person through respiratory droplets, secretions, or saliva. People who are infected can spread the bacteria by talking, coughing, or sneezing which creates respiratory droplets that contain the bacteria or through shared food and drinks. Other people can get the infection if they breath in in the droplets, touch something that contains the droplets and then touch their mouth or nose or share personal items such as utensils or drink containers.

The best way to protect against spreading streptococcal bacteria and to decrease risk of strep infection is to:

  • Wash your hands often, especially after coughing or sneezing
  • Cover your mouth when coughing or sneezing
  • Avoid sharing personal items such as eating utensils or drinking glasses

When can you return to work, school or activities if you have been diagnosed with strep throat?

People with strep throat should stay home from work, school, daycare, or activities until they no longer have a fever and have taken antibiotics for at least 12 hours.

Can a child get strep throat even if they don’t have tonsils?

Strep throat usually affects your throat and tonsils. If you have had your tonsils removed your risk of strep throat decreases, however, you can still get the infection. If you do not have tonsils, you may get the infection less often or your symptoms may not be as severe.

Learn more about recurrent sore throats in children

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