In general, signs and symptoms of strep throat include:
- Throat pain
- Difficulty swallowing
- Red and swollen tonsils, sometimes with white patches or streaks of pus
- Tiny red spots on the soft or hard palate — the area at the back of the roof of the mouth
- Swollen, tender lymph glands (nodes) in your neck
- Stomachache and sometimes vomiting, especially in younger children
It's possible for you or your child to have many of these signs and symptoms, but not have strep throat. The cause of these signs and symptoms could be a viral infection or some other kind of illness. That's why your doctor generally tests specifically for strep throat.
It's also possible to have the bacteria that can cause strep in your throat without having a sore throat. Some people are carriers of strep, which means they can pass the bacteria on to others, but the bacteria are not currently making them sick.
When to see a doctor
Call your doctor if you or your child has any of these signs and symptoms:
- A sore throat accompanied by tender, swollen lymph glands (nodes)
- A sore throat that lasts longer than 48 hours
- A fever higher than 101 F (38.3 C) in older children, or any fever lasting longer than 48 hours
- A sore throat accompanied by a rash
- Problems breathing or difficulty swallowing anything, including saliva
- If strep has been diagnosed, a lack of improvement after taking antibiotics for 24 to 48 hours
- A fever — or pain or swelling in the joints, shortness of breath or a rash — after a strep infection, even as long as three weeks after infection; these can be indicators of rheumatic fever
- Cola-colored urine more than a week after a strep infection, as this may indicate kidney inflammation (poststreptococcal glomerulonephritis)
The cause of strep throat is bacteria known as Streptococcus pyogenes, also known as group A streptococcus.
Streptococcal bacteria are highly contagious. They can spread through airborne droplets when someone with the infection coughs or sneezes, or through shared food or drinks. You can also pick up the bacteria from a doorknob or other surface and transfer them to your nose, mouth or eyes.
Several factors can increase your risk of strep throat infection:
- Young age. Strep throat occurs most commonly in children between the ages of 5 and 15.
- Time of year. Although strep throat can occur anytime of the year, it tends to circulate in late fall and early spring. Strep bacteria flourish wherever groups of people are in close contact. That's why the infection spreads easily among family members, in schools and in child care settings.
Although strep throat itself isn't dangerous, it may lead to serious complications — sometimes even with treatment.
Spread of infection
Strep bacteria may spread, causing infection in your:
- Middle ear
Strep infection may lead to other inflammatory illnesses, including:
- Scarlet fever, an illness characterized by a rash
- Inflammation of the kidney (poststreptococcal glomerulonephritis)
- Rheumatic fever, a serious condition that can affect the heart, joints, nervous system and skin
Researchers are investigating a possible link between strep infection and a rare condition called Pediatric autoimmune neuropsychiatric disorder associated with group A streptococci (PANDAS). PANDAS is a term used to describe certain children whose symptoms of neuropsychiatric conditions, such as obsessive compulsive disorder or tic disorders, are exacerbated by strep infection.
To prevent strep infection:
- Clean your hands. Proper hand cleaning is the best way to prevent all kinds of infections. That's why it's important to clean your own hands regularly and to teach your children how to clean their hands properly, using soap and water or an alcohol-based hand sanitizer.
- Cover your mouth. Teach your children to cover their mouths when they cough or sneeze.
- Don't share personal items. If you or your child does have strep throat, don't share drinking glasses or eating utensils. Wash those items carefully in hot, soapy water or in a dishwasher.