Strep throat: Signs and symptoms

A sore throat and a hoarse voice can be the first sign of an illness, or the result from a long day of yelling at a concert or sporting event. Most people just take a throat lozenge or a spoonful of honey and go about their day, but what if that sore throat is more than just a minor pain and is the first sign of a more serious and contagious illness? An expert from the Texas A&M College of Nursing talks about when a sore throat is the beginning of something more severe.

“Strep throat is an infection different than the flu or other illness,” said Kara Jones-Schubart, RN, MSN, assistant professor at the Texas A&M College of Nursing. “It is a type of pharyngitis, or inflammation of the back of the throat caused by a bacteria.”

Strep throat is caused by a bacteria called group A beta-hemolytic streptococcus (it’s easy to see why it’s shortened to “strep throat”). The infection causes a very sore or painful throat, fever and swollen lymph nodes in the neck. Health care providers will also notice a very telling symptom.

“Symptoms develop rather quickly,” Jones-Schubart said. “A provider may notice white patches called exudate on the tonsils.”

Children aged 5 to 15 most often contract strep, but adults can get it too. Strep is highly contagious and easily spreads during the winter months. It may be difficult to tell at home the differences between a common cold and a contagious strep throat, but generally strep throat will involve throat pain, difficulty swallowing and fever.

“Sometimes young children with strep will also complain of stomach pain,” noted Jones-Schubart. If a sore throat interferes with eating and drinking or a fever develops, it’s best to err on the side of caution and contact your health care provider.

“A provider may order a rapid strep test to determine if strep is present,” Jones-Schubart said. “While fairly accurate, rapid strep tests can result in some false-negatives. In some cases, a provider may then order a throat culture.”

If someone does have strep throat, they can take antibiotics in conjunction with medications to help manage their symptoms, such as ibuprofen for fever and a throat lozenge. Jones-Schubart stressed the importance of completing a course of antibiotics and not just stopping once symptoms improve. Stopping treatment too soon may not kill all of the bacteria, and if you become sick again, then the remaining bacteria may be resistant to the antibiotics you’ve taken.

Unfortunately, for viral  causes of sore throat, there is nothing that can be done except treat the symptoms and wait it out.

“Provider can often differentiate between a case of viral pharyngitis or bacterial strep because of the differences in symptoms,” Jones-Schubart said. “Patients with strep throat won’t often have cough or runny nose or nasal congestion. These symptoms may be more suggestive of viral pharyngitis.”

Strep throat is very contagious, so it’s best to practice good preventive tactics to keep from passing the illness along.

“Avoid sharing utensils and keep an infected person’s toothbrushes separated from others, and swap toothbrushes or toothbrush heads when the infected person is finished with antibiotics,” Jones-Schubart said. “Strep can be passed easily between close contacts, so cover your coughs, wash your hands and wipe down shared surfaces.”

Strep throat isn’t typically serious if treated quickly, but it can occasionally have complications. Conditions like scarlet fever can develop among children. Rheumatic fever can occasionally happen if strep isn’t treated.

“Rheumatic fever isn’t very common in the United States,” Jones-Schubart said. “However, we do occasionally see scarlet fever, which is a red rash in children that accompanies strep throat. The rash will resolve with treatment.”