Health & Medicine

Your kid has sore a throat? It's probably not strep

If your child complains of a sore throat, your first instinct might be to make a quick trip to the doctor to see if it's strep throat. You may want to rethink that move.

Strep is short for Group A Streptococcus bacteria, the organisms responsible for 20 percent to 30 percent of sore throats among children ages 5 to 15, and 5 percent to 15 percent of sore throats in adults.

Strep throat is dangerous because, if untreated, it can lead to serious complications such as rheumatic fever (which can damage the heart) and inflammation of the kidneys. But strep throat is not as common as most parents think.

The most frequent cause of a sore throat is a viral infection, usually related to a cold. If the patient has a runny nose, stuffed nasal passages, coughing, sneezing and hoarse voice, it's very unlikely that the problem is strep throat, and there is probably no reason to visit the doctor unless symptoms get worse. Antibiotics will not help.

If you have had strep throat, you probably know the signs: sore throat, usually appearing quickly; pain when you swallow; fever higher than 101 degrees Fahrenheit; swollen tonsils and lymph nodes; and a bright red throat with white or yellow spots. When these symptoms are present, a visit to a doctor is recommended.

The gold standard for confirming a diagnosis is a throat culture, taken by rubbing a sterile swab over the back of the throat and the tonsils. But treatment may be delayed as long as two days while the culture is grown and tested.

A rapid antigen test can detect strep bacteria within minutes but may miss some infections. If results are negative, many doctors rely on the throat culture as a backup, but only for some patients. These rapid antigen tests are not usually recommended for adults or for children younger than 3.

For patients with a confirmed Streptococcus infection and a risk of complications, guidelines call for antibiotics — usually a 10-day course of either Penicillin V or amoxicillin. For persons not allergic to them, these medications are inexpensive, safe and effective. Increasing resistance to strep has been found in some of the more expensive broader spectrum antibiotics.

It's crucial that the patient take the full course of antibiotics, even after the symptoms get better. In addition to making you feel better sooner, antibiotics also shorten the time you are contagious. You are contagious even before symptoms appear and continue to be so for the first 24 hours after antibiotic therapy is started.

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