Strep Throat in Children

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Strep throat is an infection in the throat and tonsils caused by bacteria called group A Streptococcus (group A strep). Overall, viruses are the most common cause of a sore throat. However, most viral infections are self-resolving.

How do people get this infection?

Group A strep live in the nose and throat and can easily spread to other people. It is important to know that all infected people do not have symptoms or seem sick. People who are infected spread the bacteria by coughing or sneezing, which creates small respiratory droplets that contain the bacteria.

People can get sick if they:

  • Breathe in those droplets
  • Touch something with droplets on it and then touch their mouth or nose
  • Drink from the same glass or eat from the same plate as a sick person
  • Touch sores on the skin caused by group A strep (impetigo)

Who can get the infection?

Anyone can get strep throat, but there are some factors that can increase the risk of getting this common infection.

Strep throat is more common in children than adults. It is most common in children 5 through 15 years old. It’s rare in children younger than 3 years old.

Close contact with another person with strep throat is the most common risk factor for illness. For example, if someone has strep throat, it often spreads to other people in their household.

Infectious illnesses tend to spread wherever large groups of people gather together. Crowded conditions, like at schools or daycare centers, can increase the risk of getting a group A strep infection.

Common signs and symptoms of strep throat

In general, strep throat is a mild infection, but it can be very painful. The most common symptoms of strep throat include:

  • Sore throat that can start very quickly
  • Pain when swallowing
  • Fever
  • Red and swollen tonsils, sometimes with white patches or streaks of pus
  • Tiny, red spots on the roof of the mouth (the soft or hard palate)
  • Swollen lymph nodes in the front of the neck

Other symptoms may include a headache, stomach pain, nausea or vomiting, especially in children. Someone with strep throat may also have a rash known as scarlet fever (also called scarlatina).

Making a diagnosis

Only a rapid strep test or throat culture can determine if group A strep is the cause. A doctor cannot tell if someone has strep throat just by looking at his or her throat. If the test is positive, doctors can prescribe antibiotics. If the test is negative, but a doctor still suspects strep throat, then the doctor can take a throat culture swab.

Symptoms will improve one to two days after starting antibiotics. Please notify your doctor if there’s no improvement within 48 hours of starting treatment.

Possible complications of strep throat

Complications can occur after a strep throat infection. This can happen if the bacteria spread to other parts of the body. Complications can include:

  • Abscesses (pockets of pus) around the tonsils
  • Swollen lymph nodes in the neck
  • Sinus infections
  • Ear infections
  • Rheumatic fever (a heart disease)
  • Post-streptococcal glomerulonephritis (a kidney disease)


The best way to keep from getting or spreading group A strep is to wash your hands often. This is especially important after coughing or sneezing and before preparing foods or eating. To practice good hygiene you should:

  • Cover your mouth and nose with a tissue when you cough or sneeze
  • Put your used tissue in the wastebasket
  • Cough or sneeze into your upper sleeve or elbow, not your hands, if you don’t have a tissue
  • Wash your hands often with soap and water for at least 20 seconds
  • Use an alcohol-based hand rub if soap and water are not available

You should also wash glasses, utensils and plates after someone who is sick uses them. These items are safe for others to use once washed.

People with strep throat should stay home from work, school or daycare until they no longer have a fever and have taken antibiotics for at least 24 hours.

Take the prescription exactly as the doctor says to. Don’t stop taking the medicine, even if you or your child is feeling better, unless your doctor has told you to stop. Wash your hands often to prevent germs from spreading.

Fred Ogwara, M.D., is a pediatrician at MidMichigan Health. Dr. Ogwara sees patients in Midland. Those who would like to make an appointment may call (989) 837-9250.


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