Strep Throat

What is strep throat?

Strep throat is an infection of the throat and tonsils caused by group A streptococcus bacteria. It is one of the relatively few sore throats that are bacterial rather than viral, which matters because it is the type of sore throat that usually benefits from antibiotic treatment. Most sore throats are caused by viruses and clear up on their own, but strep throat is different and worth identifying.

Strep throat is especially common in children and teenagers, though adults can get it too, particularly those in close contact with children. It spreads easily from person to person through respiratory droplets and close contact. While usually not serious and very treatable, it is important because, untreated, strep infections can occasionally lead to complications, which is part of why doctors take care to diagnose and treat it appropriately.

Symptoms

Strep throat tends to come on quickly and can be more severe than a typical viral sore throat. Certain features make strep more likely, though only a test can confirm it. Common symptoms include:

• •A sudden, severe sore throat
• •Pain when swallowing
• •Red and swollen tonsils, sometimes with white patches or streaks of pus
• •Fever
• •Swollen, tender glands in the neck
• •Headache, and sometimes tummy pain or nausea (especially in children)
• •Notably, an absence of cough or runny nose often points more towards strep than a virus

Strep throat versus a viral sore throat

Telling strep throat from a common viral sore throat can be difficult, as they share symptoms, but some clues help. Strep throat is more likely when there is a sudden severe sore throat with fever, swollen neck glands and white patches on the tonsils, but crucially without the cough, runny nose and hoarseness that usually accompany viral infections. The presence of typical cold symptoms like a cough or runny nose makes a virus more likely.

However, these clues are not definitive, and the only reliable way to confirm strep throat is a test, such as a throat swab, done by a doctor. This matters because treatment differs: viral sore throats do not need and are not helped by antibiotics, while strep throat usually is treated with them. If you have a severe sore throat with the features above, particularly without cold symptoms, it is worth seeing a doctor to find out whether it is strep.

Treatment

Strep throat is usually treated with a course of antibiotics, which help clear the infection, speed recovery, reduce how long you are contagious, and lower the small risk of complications. It is important to complete the full course as prescribed, even once you feel better, to fully clear the bacteria. A doctor will confirm the diagnosis, typically with a throat swab, before prescribing.

Alongside antibiotics, the same self-care that helps any sore throat eases symptoms: resting, drinking plenty of fluids, and using paracetamol or ibuprofen for pain and fever as directed. Warm drinks, and for those over one year honey, can soothe the throat. Most people start to feel better within a day or two of starting antibiotics and are no longer contagious after about 24 hours of treatment, though they should still complete the course.

Recovery and preventing spread

With antibiotic treatment, most people recover from strep throat quickly, often feeling much better within a couple of days. Without treatment, the body usually clears the infection eventually too, but treatment shortens the illness, reduces spread, and lowers the small risk of complications, which is why it is generally recommended once strep is confirmed. Completing the full antibiotic course is the key part of recovery.

Because strep throat is contagious, simple measures reduce its spread to others, which is particularly relevant in households and around children. Washing hands regularly, covering coughs and sneezes, not sharing cups, cutlery or toothbrushes, and staying off work or school until at least 24 hours after starting antibiotics and feeling well all help. A person is generally no longer contagious after about a day of appropriate antibiotic treatment.

If symptoms do not improve after a couple of days of antibiotics, get worse, or you develop new symptoms such as a rash, difficulty breathing or swallowing, or a very high fever, it is important to seek further medical advice. While strep throat is usually straightforward and resolves well, these signs warrant review to ensure recovery is on track and to catch the less common situations that need extra attention.

Why strep throat is taken seriously

Although strep throat is usually a straightforward infection that resolves well with treatment, it receives more medical attention than a typical viral sore throat for a specific reason: untreated strep infections can occasionally lead to complications. These are uncommon, especially where treatment is available, but they are part of why doctors test for and treat strep rather than leaving every sore throat to resolve on its own.

Possible complications of untreated or inadequately treated strep include the infection spreading to nearby areas such as the sinuses, ears or tonsils, and, more rarely, conditions affecting other parts of the body that can follow a strep infection. Completing the full course of antibiotics as prescribed is important precisely because it helps fully clear the bacteria and reduces the small risk of these complications, even once you feel better.

This is why, if a sore throat has the features that suggest strep — sudden, severe, with fever and swollen glands but without cold symptoms — it is worth seeing a doctor to test and treat it appropriately, rather than assuming it is just another sore throat. For the great majority of people, confirmed strep throat treated with antibiotics resolves quickly and completely, and complications are avoided.