Strep Throat
Courtney Carter
/ Categories: WELLNESS, 2024

Strep Throat

Signs, Symptoms, and Treatments

A common bacterial infection, strep throat prompts an estimated 5.2 million Americans  to visit the doctor each year, and results in nearly 3 million antibiotic prescriptions.

In addition to being incredibly painful, untreated strep can lead to serious complications including pneumonia, meningitis, kidney inflammation, infections of the ear and sinuses, rheumatic fever, and more. Which is why it’s important to act promptly when you suspect strep.

While anyone can get strep, it’s most common in school-aged children 5-15 years of age.

Spread by direct contact and respiratory droplets that an infected person puts into the air when they cough, talk or sneeze, strep is considered VERY contagious.  It can spread quickly in a variety of close-proximity settings including daycares, schools, afterschool programs, and workplaces where people work side-by-side. Strep throat typically develops 2 to 5 days after exposure to the bacteria. 

 

While symptoms can vary, common signs include:

  • Sudden, severe sore throat pain

  • Difficulty swallowing

  • A fever up to 100.4°F

  • Swollen lymph nodes on the front of your neck.

  • Tonsil Changes, including red, swollen tonsils, possibly with white or yellow spots

  • Red Spots on the roof of the mouth 

Other potential symptoms may include fatigue, headache, stomachache and sometimes vomiting, especially in younger children. In some cases, a rash may appear on the neck, armpit, or groin.

It's important to note that strep throat typically does not cause coughing or a runny nose. These symptoms are more common with a viral infection than a bacterial strep infection.

Fortunately, diagnosing and treating strep is relatively easy.

 

DIAGNOSIS

Strep is diagnosed using one of two tests: rapid strep test or a throat culture.

Both tests involve taking a swab of the throat. While a rapid test offers quick results—about 15 minutes—it’s not as comprehensive as a throat culture, which may take 24 hours to analyze. In fact, if a rapid test is negative but a patient’s symptoms suggest a strep, very often a throat culture will be ordered to confirm the results.

 

TREATMENT

The standard treatment for strep is antibiotics, typically penicillin or amoxicillin. Patients typically start to feel better in one to two days after taking their first dose. It is very important to complete the full course of antibiotics even if the patient starts to feel better.

People with strep throat should stay home and isolate until their fever has subsided AND they’ve taken antibiotics for at least 24 hours to prevent infecting others. In addition, you should replace your toothbrush after taking antibiotic for 24 hours.

 

Myth Buster

Despite the long-held notion that once you’ve had strep, you can’t get it again, it is possible to become re-infected.

So, even if you’ve already had strep, you still need to take precautions to protect yourself and others.

 

If your symptoms don't improve or get worse after 24-48 hours of antibiotic treatment or you develop new symptoms, such as swelling in the neck or face, difficulty swallowing even saliva, or trouble opening your mouth, contact your doctor immediately.

 

 Kristin Andrew, FNP-BC, is a member of the care team at Southwestern Vermont Medical Center Pediatrics

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Emergency Department: Open, Ready, Safe. 

The last 3 months have been a uniquely challenging experience in the SVMC Emergency Department (ED) and emergency departments and hospitals all over the country and the world. I am very proud of all our staff has done and continues to do to ensure safe care for patients during this era of COVID-19. We are grateful that cases of COVID-19 in our area have been the lowest in the U.S. and have decreased even further over the past several weeks. We are also heartened to see that patients who had been avoiding the ED are now confident to return to get the care they need.

It may be surprising to hear that over the past few months, the sickest patients we have seen in the ER have not had COVID-19. Many people have refrained from seeking care for serious medical problems due to the fear of being exposed to the virus, assuming that the hospital was not a safe place to be and not recognizing the seriousness of their symptoms. The most challenging moments of the past several months have involved critically ill patients who tried to stay away for far too long due to fear of being exposed to COVID-19. We have had many sad moments trying to care for those who waited until it was too late for us to help with conditions that could have been easily treated if presented sooner.

One might expect that the greatest challenges related to the pandemic were those needed to adapt our facilities and procedures and the work of caring for sick COVID-19 patients. SVMC is fortunate to have built a strong foundation of safety and infection-prevention methods over many years, which made this transition much easier. Still, when it became apparent that we were going to see COVID-19 cases coming through our doors, we implemented many COVID-specific changes very quickly.

From day one our staff have all been fully trained to use protective equipment effectively, to focus on cleaning and disinfecting, and to move patients safely through the new areas created to keep them safe. We also spaced the waiting room chairs to allow for plenty of distance and initiated drive-by testing to keep potentially contagious people outside and away from other patients.

We immediately increased our standard of protective equipment we use. For example, all staff who relate with patients now wear both a mask and protective shield, which is a proven and effective strategy to prevent transmission. Those staff who work with patients with respiratory or other contagious symptoms also wear a gown and advanced respirators developed in cooperation with Mack Molding in Arlington. They look strange, but they help us deliver care safely.

We also quickly built special spaces and units in the hospital to treat and segregate patients with respiratory symptoms who might be contagious from those with other routine medical problems. Outpatients with symptoms that could be related to COVID-19 are directed to a spacious area called the Respiratory Evaluation Center. There they can be taken to a safe treatment space called a negative-pressure room without encountering any patients who are using the ED for other reasons or any staff who are not fully equipped with protective gear. There are similar, safe, negative-pressure units for those who require treatment in the ED or hospital.

Our hard work paid off. We have treated a number of COVID-19 patients in our ED and, as far as we know, not a single staff member was sickened in relation to their work here, and no patients have contracted COVID-19 while under our care. With our current procedures and drastically declining COVID numbers, we are confident that we can continue that trend. Furthermore, SVMC recently received a perfect score on a rigorous survey specifically designed to judge our ability to prevent transmission of COVID-19. At this time our ED is safer than just about any other public place you could go.

My goal in writing today is to communicate that SVMC’s Emergency Department is open, ready, and safe. If you need emergency care, we are here and we can care for you safely. Please do not defer emergency care until it is too late for us to help. While many symptoms can represent a serious medical problem, the most concerning are chest pain, difficulty breathing, fast heart rate, confusion, high fever, intense headache, drooping face, dehydration, or weakness. Of course, with any other symptom you feel indicates a serious problem, come in right away or call 9-1-1.

For us, spending time with patients and connecting on a personal level is the best part of our jobs. We take pride in our life-saving role in our communities and the work we have been able to do during the pandemic, but we cannot help if you do not come in. Please don’t hesitate to get the care you need when you need it.

Adam Cohen, MD, is a board-certified emergency medicine physician at Southwestern Vermont Medical Center. He also serves as the chair of the Department of Emergency Medicine and the medical director of SVMC’s Emergency Department.

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