Acute throat infections are among the most common infectious diseases seen by family physicians — they are responsible for 2 to 4 percent of all visits to a family doctor. Strep throat is the most common cause of a sore throat among children between the ages of 5 and 15. (1) Be aware of specific strep throat symptoms and what is uncommon with strep throat in order to determine whether the illness is caused by a viral or bacterial infection.
Strep throat is bacterial and many doctors use antibiotics to reduce the duration of symptoms and the spread of bacteria. However, viral infections cause a majority of sore throats, in which case antibiotic treatment is unnecessary and can even do more harm than good. (2)
What Is Strep Throat?
Strep throat is an infection in the throat and tonsils caused by group A Streptococcus bacteria, also called group A strep. The following strep throat symptoms typically develop within five days of exposure to the strep bacteria.
1. Sore Throat
The most common symptom of strep throat is a sore throat that usually starts quickly and can cause pain when swallowing. Strep throat does not cause cold symptoms, like coughing or sneezing.
2. Red and Swollen Tonsils
A person with strep throat usually has red and swollen tonsils; sometimes there will be white patches or streaks of pus in the throat as well.
3. Red Spots and White Coating
Petachiae are red spots on the roof of the mouth at the back, near the throat. Petachiae commonly appears in clusters and may look like a rash. You may also notice a white or yellow coating on the throat and tonsils.
4. Swollen Lymph Nodes
Swollen lymph nodes in the neck are a common sign of strep throat. You also may notice swollen tonsils, but this also can be caused by a viral infection.
A fever of 101 degrees Fahrenheit or above and chills are possible strep throat symptoms. Lower fevers may be a symptom of a viral infection instead of strep throat.
A headache and even body aches and joint pain are sometimes experienced with strep throat.
7. Stomach Pain
Some people with strep throat, especially younger children, may experience stomach pain, nausea and vomiting. However, diarrhea seems to be more common with viral infections and not strep throat. (3)
In some cases, a strain of strep throat can lead to a rash that spreads over the whole body — this is a condition called scarlet fever. The group A strep bacteria form a toxin that can cause the non-itching, red-colored rash. Around the second day after infection, many small dots turn from pink to red. They begin to spread from the torso, to the throat and then to the hands and feet within a few days. The rash is often especially visible in the groin region or under the arms. (4)
Strep throat symptoms in infants and toddlers may also include fussiness, a thick nasal discharge and reduced appetite. With or without antibiotic treatment, strep throat usually goes away in 3 to 7 days.
A major concern for people with strep throat is that it will lead to serious complications. If the strep bacteria spreads, it can cause an infection in the tonsils, sinuses, skin, blood or middle ear. Untreated strep throat can also lead to inflammatory illnesses like scarlet fever, inflammation of the kidneys and rheumatic fever, a serious condition that can affect the heart, skin, nervous system and joints.
It can be difficult to tell the difference between strep throat symptoms and symptoms of a viral infection, like mononucleosis (mono), which is also common in teens. Just like strep throat symptoms, with mono you will experience a sore throat, fever, swollen lymph nodes, rash and body aches. You may also feel extreme fatigue.
Rather than strep bacteria, a virus typically causes sore throats. Something to keep in mind while trying to make a self-diagnosis is that strep throat usually doesn’t occur with cold symptoms, like coughing, sneezing or runny nose. If you have a sore throat with cold symptoms, chances are that it’s caused by a viral infection and it’s not strep throat. (5)
Strep Throat Causes and Risk Factors
The group A strep bacteria that causes strep throat is highly contagious. It can live in your nose and throat without causing illness. It spreads through contact after an infected person coughs or sneezes. If you touch your mouth, nose or eyes after touching something that has the bacteria on it, you may develop strep throat. Drinking from the same glass, eating from the same plate as a sick person, or even touching sores on the skin that are caused by group A strep, can all spread the bacteria.
Children aged 5 to 15 years are much more likely to have strep infections than are younger children and adults. Researchers suggest that this should be remembered when treating sore throats, as only a small portion of people with sore throats actually have bacterial infections. (6) According to the Institute for Clinical Systems Improvement, viruses cause 85 to 95 percent of throat infections in adults and children younger than 5 years of age; for those aged 5 to 15 years, viruses cause about 70 percent of throat infections, with the other 30 percent due to bacterial infections, mostly group A strep. (7)
Although strep throat can occur at anytime, it tends to circulate from late fall to early spring. This is most likely due to the seasonal variation of strep bacteria concentration and because people tend to be in closer quarters during the colder seasons.
Strep throat is tested with a rapid strep test, which is a diagnostic tool that determines whether or not strep bacteria is responsible for a patient’s sore throat symptoms. A rapid stress test may assist a doctor in deciding whether or not to prescribe an antibiotic to a patient who shows signs of strep throat.
Conventional Treatment for Strep Throat
The conventional method most commonly used to treat strep throat is antibiotics, such as penicillin or amoxicillin. According to research published in Canadian Family Physician in 2007, there is no convincing evidence that treating strep throats with penicillin is necessary. Doctors found that strep throat symptoms caused by a bacterial sore throat failed to clear much faster when treated with antibiotics than they would if left alone. The author of one review noted that doctors may treat strep throat with antibiotics because patients expect that to be the treatment. They are often terrified of strep, afraid that the illness may be something more serious. (8)
Viral infections cause 85 to 90 percent of sore throats. Treating these patients who have sore throats with antibiotics does not relieve symptoms. But research shows that just mentioning a sore throat to a doctor almost guarantees a prescription for antibiotics. (9)
The research pertaining to the efficacy of antibiotics when used to treat a sore throat is mixed. A 2004 study published in Cochrane Database of Systematic Reviews found that antibiotics can have a modest beneficial effect, improving symptoms at 3 to 4 days and reducing the illness duration by about half a day. The study found that antibiotic treatment had no effect on time off school or work. (10)
Over-the-counter pain medicines, such as acetaminophen, are also commonly taken for strep throat. But did you know that acetaminophen overdose is one of the most common poisonings worldwide? Just like the side effects of taking too much aspirin or ibuprofen overdose, acetaminophen can lead to abdominal pain, vomiting, diarrhea and even more serious conditions like liver failure, coma or death when it’s used in excess. (11) If you are going to use Tylenol or another acetaminophen to relieve strep throat symptoms such as headache or body aches, do not take more than 4,000 milligrams per day (for adults).
10 Natural Treatments for Strep Throat
1. Elderberry — Elderberry has antibacterial and antiviral effects. Recent studies show that elderberry has a protective effect against the development of bacterial and viral respiratory symptoms. (12)
2. Echinacea — The regular use of echinacea benefits the immune system and your overall health. There is considerable evidence suggesting that the phytochemicals in echinacea, and one of its compounds called echinacein, have the capacity to inhibit bacteria and viruses from penetrating healthy cells. (13)
3. Vitamin C — Use vitamin C to boost your immune system and repair tissue damage in the throat.
4. Vitamin D — Studies show that there’s a link between vitamin D deficiency and the recurrence of group A strep throat. (14)
5. Raw Honey — A daily dose of raw honey raises levels of health-promoting antioxidants in the body, which help block free radicals and boosts the immune system. (15)
6. Himalayan Salt — Gargling with pink Himalayan salt water helps to reduce swelling and creates an inhospitable environment for bacteria in your throat.
7. Bone Broth — Bone broth helps to keep you hydrated and it delivers minerals that are essential for boosting your immune system. Instead of spending hours making bone broth from scratch, use protein powder made from bone broth.
8. Oil Pulling — Research shows that oil pulling has the power to reduce the presence of strep bacteria in the mouth and it can be used as an effective preventive measure in maintaining oral health. (16)
9. Hot Fluids — Hot fluids such as tea, soup and water can help to reduce throat irritation and discomfort. Drinking herbal tea can help to enhance immunity as well; try ginseng, chamomile or dandelion tea. Using a vaporizer or humidifier at home can help help to soothe swollen air passages.
10. Essential Oils — Use essential oils for a sore throat and to fight bacterial growth. Peppermint oil can help to reduce inflammation in the throat. Lemon oil has antibacterial properties. Thyme oil supports the immune and respiratory systems.
Because strep throat is so contagious, it’s important that you avoid passing the infection to others and reinfecting yourself. As long as you have strep throat symptoms, avoid sneezing or coughing on others, and be sure to wash your hands often. Replace your toothbrush when you first develop symptoms and then again after you are well.
Research suggests that viruses, such as influenza and adenovirus, cause the majority of sore throats. Because strep throat symptoms and symptoms of non-strep sore throat are so similar, a laboratory evaluation should be done before you decide to use antibiotics, as they will not be effective against viral sore throats.
See your doctor if you have trouble swallowing or your throat is blocked by swollen tonsils. If you begin antibiotic treatment, you should see improvements within 2 days.
- Strep throat is an infection in the throat and tonsils caused by group A Streptococcus bacteria, also called group A strep.
- The group A strep bacteria that causes strep is highly contagious; it can live in your nose and throat without causing illness; it spreads through contact after an infected person coughs or sneezes.
- The most common strep throat symptoms include sore throat, red and swollen tonsils, red spots on the roof of the mouth and a white coating on the throat and tonsils, swollen lymph nodes, fever, headache and body aches, stomach pain and a rash.
- Strep throat usually doesn’t occur with cold symptoms, like coughing, sneezing or runny nose.
- The conventional method most commonly used to treat strep throat is antibiotics, such as penicillin or amoxicillin; however, in adults, viral infections cause 85 to 90 percent of sore throats. Treating patients who have sore throats with antibiotics does not relieve symptoms.