Strep Throat: All You Need to Know
Worried your sore throat may be strep throat? Healthcare providers can do a quick test to see if a sore throat is strep throat. Antibiotics can help people with strep throat feel better faster and prevent spreading the bacteria to others.
- Bacteria cause strep throat
- How you get strep throat
- Symptoms often include pain and fever
- Some people are at increased risk
- A simple test gives fast results
Viruses cause most sore throats. However, strep throat is an infection in the throat and tonsils caused by bacteria called group A Streptococcus (group A strep).
Group A strep bacteria are very contagious. Generally, people spread the bacteria to others through
- Respiratory droplets
- Direct contact
Rarely, group A strep bacteria can be spread through food that isn’t handled properly (visit CDC’s food safety page).
It usually takes 2 to 5 days after exposure to become ill with strep throat.
Group A strep bacteria often live in the nose and throat. People who are infected spread the bacteria by talking, coughing, or sneezing. This creates respiratory droplets that contain the bacteria.
People can get sick if they:
- Breathe in respiratory droplets that contain the bacteria
- Touch their mouth or nose after touching something with those droplets on it
- Use the same plate, utensil, or glass as a person infected with the bacteria
People can also spread group A strep bacteria from infected sores on the skin. Other people can get sick if they touch those sores or come into contact with fluid from the sores.
Some people infected with group A strep do not have symptoms or seem sick. People who are sick with strep throat are more contagious than those who do not have symptoms.
In general, strep throat is a mild disease, but it can be very painful.
Common symptoms may include:
- Pain when swallowing
- Sore throat that started very quickly and may look red
- Red and swollen tonsils
- White patches or streaks of pus on the tonsils
- Tiny, red spots on the roof of the mouth, called petechiae
- Swollen lymph nodes in the front of the neck
Less common symptoms may include vomiting and headache
Some people, especially children, may have other symptoms, too.
Other symptoms may include:
- Stomach pain
- Nausea or vomiting
- Rash (scarlet fever)
Symptoms do NOT include cough or runny nose
The following symptoms suggest a virus is the cause of the illness instead of strep throat:
- Runny nose
- Hoarseness (changes in your voice that make it sound breathy, raspy, or strained)
- Pink eye (conjunctivitis)
- Up to 3 in 10 children with a sore throat have strep throat
- About 1 in 10 adults with a sore throat has strep throat
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 is very 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, the bacteria often spread to other people in their household.
Contact with children: Parents of school-age children and adults who are often in contact with children are at increased risk.
Crowded settings can increase the risk of getting any group A strep infection including strep throat. These settings include:
- Daycare centers and schools
- Detention or correctional facilities
- Homeless shelters
- Military training facilities
A healthcare provider will determine what type of illness you have by asking about symptoms and doing a physical exam. If they think you might have strep throat, they will swab your throat to test for strep throat. There are two types of tests for strep throat: a rapid strep test and throat culture.
Rapid strep test
A rapid strep test involves swabbing the throat and running a test on the swab. The test quickly shows if group A strep bacteria are likely causing the illness.
A throat culture takes time to see if group A strep bacteria grow from the swab. While it takes more time, a throat culture sometimes finds infections that the rapid strep test misses.
Healthcare providers treat strep throat with antibiotics.
Call a healthcare provider if you or your child aren’t feeling better after taking antibiotics for 48 hours.
Stay home from work, school, or daycare until you no longer have a fever. You also need to have taken antibiotics for at least 12 to 24 hours. Ask a healthcare provider how long you should stay home after starting antibiotics.
A carrier is someone who tests positive but has no symptoms. Generally, carriers don’t need antibiotics. They’re less likely to spread the bacteria to others and very unlikely to get complications.
If a carrier gets a viral sore throat (with or without a rash), a strep test can be positive. In these cases, it’s hard to know what’s causing the sore throat.
Talk to a healthcare provider if you think you or your child may be a strep carrier.
After a negative rapid strep test, healthcare providers may do a throat culture.
For children and teens, culture is important.
For adults, it’s usually not necessary to do a throat culture.
Antibiotics aren’t needed if all the test results are negative.
Healthcare providers treat strep throat with antibiotics to
- Decrease how long someone is sick
- Decrease symptoms
- Prevent the bacteria from spreading to others
- Prevent serious complications like rheumatic fever
Complications can occur after a strep throat infection if the bacteria spread to other parts of the body.
Complications can include:
- Abscesses (pockets of pus) around the tonsils or in the neck
- Sinus infections
- Ear infections
- Rheumatic fever (a disease that can affect the heart, joints, brain, and skin)
- Post-streptococcal glomerulonephritis (a kidney disease)
People can get strep throat more than once. Having strep throat does not protect someone from getting it again in the future. While there is no vaccine to prevent strep throat, there are things people can do to protect themselves and others.
Many daily healthy habits can help prevent infections:
- Cover your mouth and nose with a tissue when you cough or sneeze.
- Put your used tissue in the waste basket.
- 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.
- Wash glasses, utensils, and plates after someone who is sick uses them. These items are safe for others to use once washed.