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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Moving Forward Safely

One of the most frustrating and anxiety-producing traits of our COVID –19 pandemic is how much uncertainty is involved in all aspects of this disease. Symptoms caused by the Coronavirus, age groups affected, the usefulness of medications, anticipated death rate, and the timeline for development of a vaccine are examples of information that sometimes change on a weekly basis.

Vermonters have done a great job of limiting the spread of the virus and protecting our most vulnerable neighbors by following the Governor's "Stay Home, Stay Safe" order over the past few months. Now, we've all been directed to wear masks in public. Both Bennington and Wilmington's Select Boards have passed local mandates requiring masks in public places. Thanks to these efforts—along with distancing, handwashing, and other factors—Vermont is among the states with the fewest number of infections. Continuing each of these important infection-prevention strategies is crucial to returning to a more normal way of life.

As we open up and begin to re-connect, we fully expect to see a rise in COVID –19 cases in Vermont. Thankfully, we have had time to prepare for this increase. We also have adequate PPE, and increased testing will help us gather crucial information for stemming the spread with less disruption to our normal lives.

More than ever, I find it helpful to focus on what we have learned and how it can help us move forward safely. Here is some of what we have learned so far: Most large hospitals, often treating over 1000 COVID patients daily, effectively protected their workers by obsessively following the rules of screening, hygiene, distancing, and masking. Each of these components is designed to work together; Each alone has its inherent limits.

  • Absent quick testing at the workplace, the best screening is asking employees if they have COVID-like symptoms (fever, chills, new cough, shortness of breath, sore throat, loss of taste or smell) and to stay home if they do.
  • Washing our hands (or using sanitizer) after touching well-handled items or visiting populated areas. Washing your hands 10 times daily is not too often.
  • Though an uncovered sneeze or cough can travel farther, 6 feet distancing continues to be the sweet spot for safety.
  • Masks (double layer cotton and surgical) are effective to prevent spreading of large and some small droplets containing virus. They also seem to give some minimal protection to those wearing a mask. Since possibly 40 percent of transmission happens when we do not have symptoms, we wear our masks to protect others and to suppress overall infection rate. They also help many people (not all) to avoid touching their face. The downside is a warm chin; the upside is you may be protecting someone from a significant illness. Masks are not a symbol of government intrusion. Masks are simply a tool to protect others and show empathy.

It is difficult to predict how many COVID-19 infections will occur in our communities in the coming months. What I am certain of is that our choices, on where we go and what we do, often affect the safety of those around us. As we learn to live with this virus in our community, following the recommendation above will help us all.

Marie George, MD, is SVMC’s infectious disease specialist.

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