Strep throat is a type of throat infection that is most common during the winter months. But what are the main symptoms and causes, and how is it treated?

7 minute read

What is strep throat?

Strep throat, or to give it its full name, streptococcal pharyngitis, is a type of bacterial infection caused by group A streptococcus (GAS) bacteria.

Many people carry strep A on their skin or in their throats without any problems, but sometimes it can cause infections such as impetigo, cellulitis and strep throat.

Symptoms of strep throat

Some people with strep throat may not have any symptoms. If you do experience symptoms, they may include:

• A sore throat that comes on quickly

• A sudden fever (a temperature above 38C)

• Pain when swallowing

• Red, swollen tonsils, possibly with white patches or streaks of pus

• Tiny red spots on the roof of the mouth (petechiae)

• Swollen, tender lymph nodes in your neck

• Headache

• Loss of appetite

Other symptoms that are more common in children may include:

• Rash (scarlet fever)

• Nausea or vomiting

• Stomach pain

What causes strep throat?

Strep throat is caused by infection with group A streptococcus bacteria. It is highly contagious, which means it is easily passed from one person to another.

Strep throat can be spread either by direct contact or through droplets in the air.

You can catch strep throat by:

• Touching a contaminated object like a tap, doorknob, or surface and transferring the bacteria to your eyes, nose, or mouth

• Sharing food, drink, cups, plates, glasses or eating utensils with an infected person

• Handling contaminated food

• Close contact like kissing

• Inhaling droplets that are expelled into the air when an infected person coughs, sneezes, laughs, or sings

Strep throat - risk factors

Anyone can get strep throat, but you may be at a higher risk if you:

• Are between the ages of 5 and 15

• Are elderly

• Have a school-aged child

• Spend time in a crowded environment such as a school, nursery, dormitory, or military facility

• Are in frequent contact with children, such as a teacher, nanny, or healthcare professional

When to see a doctor

Strep throat in itself isn’t usually serious, but untreated strep throat can lead to serious complications.

Call your doctor or 111 if you or your child have symptoms of strep throat.

Seek medical attention if your child:

• Has a sore throat that is getting worse or lasts longer than 48 hours

• Is under three months old with a fever above 38ºC, or older than three months with a fever above 39ºC

• Has a sore throat accompanied by a rash or swollen, tender lymph glands

• Has difficulty breathing or swallowing

• Has been diagnosed with strep throat and hasn’t improved after taking antibiotics for 48 hours

• Is feeding or eating much less than normal

• Is showing signs of dehydration

• Is very tired or irritable

Seek medical attention if you:

• Have a sore throat that is getting worse or not getting better after a couple of days

• Have white patches around your tonsils

• Have red spots on your tonsils or the roof of your mouth

• Have a fever for over two days

• Have difficulty breathing

• Are drooling because you cannot swallow

• Have swelling of your neck or tongue

• Have a stiff neck or difficulty opening your mouth

• Have a sore throat and a rash

• Have a sore throat and a weakened immune system due to a chronic medical condition or medication

How is strep throat diagnosed?

Strep throat is diagnosed by taking a swab from your throat. Though unpleasant, this process is normally quick and shouldn’t be painful.

You can also buy a home test for strep A from your local pharmacy or online.

There are two types of tests for strep A, a rapid test, and a throat culture. The results of the rapid test are ready in around 15 minutes, but may occasionally give a false negative result.

If your rapid test result is negative, but your doctor suspects you have strep throat, a throat culture may be taken to double-check your result. The results normally take between two and five days.

Treatment for strep throat

Strep throat is treated with antibiotics. Take your medication exactly as your doctor tells you and finish the course, even if you feel better. Ask your doctor or pharmacist if you have any questions.

Home treatments for strep throat

As well as antibiotics, there are some things you can do at home to help relieve the symptoms of strep throat, including:

• Rest

• Take over-the-counter painkillers like paracetamol or ibuprofen

• Gargle with warm, salty water — dissolve half a teaspoon of salt in a glass of warm water, gargle, and then spit it out (not suitable for children)

• Drink plenty of water

• Eat cool or soft foods that are easy to swallow

• Suck ice cubes, ice lollies, hard sweets, or lozenges

• Avoid smoking, vaping or smoky environments

Complications of strep throat

Untreated strep infections can spread to other parts of your body, which can result in complications such as:

• Ear or sinus infections

• Abscesses (pus-filled pockets) around your tonsils

• Guttate psoriasis — a skin condition that causes small, round, raised spots on the skin

• Scarlet fever — an infection that causes flu-like symptoms and a rash

• Rheumatic fever — an inflammatory condition that can affect the heart valves

• Post-streptococcal reactive arthritis — a condition that causes inflammation of the joints

• Post-streptococcal glomerulonephritis — a rare type of kidney disease

• Invasive streptococcal infection — occurs when group A streptococcus bacteria spread to other parts of the body. It can cause life-threatening conditions such as streptococcal toxic shock syndrome, and necrotising fasciitis.

Strep Throat FAQs

What’s the difference between strep throat and tonsillitis?

Tonsillitis is a broad term to describe inflammation of the tonsils, whereas strep throat is a bacterial infection. Tonsillitis can be caused by viruses or bacterial infections, including strep throat.

How can I get rid of strep throat overnight?

Unfortunately, it isn’t possible to cure strep throat overnight. Strep throat is a bacterial infection that needs to be treated with antibiotics.

Does strep throat go away on its own?

No, strep throat doesn’t go away on its own and needs to be treated with antibiotics. Untreated strep throat can lead to serious complications.

How long does strep throat last?

After starting antibiotics, you should start to feel better within a day or two. Symptoms usually clear up completely within seven to 10 days.

When can I go back to work or school if I have strep throat?

If you feel well enough and don’t have a fever, you can return to work or school 24 hours after starting antibiotics.

Is there a vaccine for strep throat?

There is currently no vaccine for group A streptococcus, the bacteria that causes strep throat.

Can strep throat be prevented?

Sometimes it isn’t possible to prevent strep throat, but there are some things you can do to reduce your risk, including:

• Washing your hands frequently with soap and water or an alcohol-based hand sanitiser if soap and water are not available

• Covering your mouth with your elbow or a tissue when you cough or sneeze

• Throwing used tissues away immediately

• Not sharing personal items such as drinking glasses or eating utensils

• Washing dishes in hot, soapy water or a dishwasher

How long is someone with strep throat contagious?

You are no longer contagious around 24 hours after starting antibiotics. People with untreated strep throat may remain contagious for up to a month.

How do I know if I have a virus or strep throat?

The only way to tell for sure if you have strep throat is by having a throat swab, but your sore throat is more likely to be caused by a virus if your symptoms include:

• Cough

• Runny nose

• Conjunctivitis

• Hoarse voice

Summary

Strep throat is a common bacterial infection, especially in children. It is treated with antibiotics. Strep throat is easily spread from person to person and left untreated can lead to serious complications.

If you or your child have symptoms of strep throat, make an appointment with your GP, or call 111 for advice.