All About Strep Throat

Strep throat, otherwise known as group A strep, is a bacterial infection of the throat and tonsils, specifically the oropharynx. The bacteria that causes strep throat is called group A streptococcus (CDC 2018).

Strep throat can affect anyone, but is most common among school-aged children and teenagers between 5 and 15. Adults who are not exposed to children are unlikely to be infected, as are children younger than 3.

Strep A causes about one-third of sore throats in children, but only 1 in 10 sore throats in adults (CDC 2018).

How do you get Strep Throat?

Strep throat is generally transmitted via droplets or direct contact (VIC Health n.d.). Strep A bacteria will inhabit the nose and throat, and spread to others through coughing and sneezing. It is possible for someone to be infected without displaying symptoms or appearing unwell (CDC 2018).

You may catch strep throat by:

• Breathing in respiratory droplets from coughs or sneezes;
• Touching something with respiratory droplets on it;
• Sharing drinks, plates etc. with someone who is sick; or
• Touching impetigo - sores on the skin caused by strep A bacteria.

(CDC 2018; Better Health Channel 2017)

Rarely, strep throat can be caught from contaminated food items including:

• Milk and milk products; and
• Eggs.

(Better Health Channel 2017)

Untreated individuals can be contagious for two to three weeks. However, after taking antibiotics, you are generally no longer contagious after 24 hours (Healthdirect 2020).

Risk Factors

The following factors may make you more likely to catch strep throat:

• Being a school-aged child (between 5 and 15);
• Being a parent of a school-aged child;
• Being an adult who is often in close contact with children;
• Living in the same household as someone who has strep throat; and
• Spending time in a crowded facility (e.g. schools, daycare centres).

(CDC 2018)

Symptoms of Strep Throat

• Symptoms may include:
• Sore throat that comes on quickly;
• Pain when swallowing;
• Red, swollen tonsils that may have visible white patches or streaks of pus;
• Small red spots on the soft or hard palate;
• Swollen, tender lymph nodes;
• Fever;
• Chills;
• Headache;
• Rash;
• Loss of appetite;
• Feeling tired;
• Nausea or vomiting (particularly in children); and
• Body aches.

(Mayo Clinic 2018; Healthdirect 2020)

Many of these symptoms are nonspecific to strep throat and could indicate a viral infection instead. A strep throat test should be conducted to determine the cause of symptoms (Mayo Clinic 2018).

The following symptoms may indicate a virus instead of strep throat, though it is important to contact your general practitioner for a formal diagnosis:

Cough;

Runny nose;

Hoarse voice; and

Conjunctivitis.

(CDC 2018)

Complications of Strep Throat and Related Illnesses

Scarlet Fever

A strep infection may also lead to scarlet fever, which is a pink-red body rash with a sandpaper-like texture. It is mostly seen in children (NHS 2018).

Impetigo

Impetigo refers to a skin rash caused by strep A bacteria, though it can also be caused by staphylococcus aureus (golden staph). The rash causes blisters around the nose, mouth and legs, and in severe cases can cause fever and swollen lymph nodes. The blisters are highly contagious (Better Health Channel 2017).

Rheumatic Fever

Rheumatic fever is a possible complication of untreated strep throat or scarlet fever. It is a serious inflammatory response to the strep A bacteria that may affect the heart, joints, nervous system and skin (CDC 2018; Mayo Clinic 2018).

Rheumatic fever can cause inflamed and painful joints, a rash, fever, breathless and chest pain, and nervous system problems (such as involuntary twitching). It can also develop into permanent heart complications such as a heart murmur or enlarged heart (Better Health Channel 2011).

Diagnosing Strep Throat

To determine whether someone has strep throat, a medical practitioner will need to perform a ‘rapid strep test’, as simply looking at the throat is inconclusive. The test involves a throat swab, which is then tested for strep A bacteria (CDC 2018).

If the test comes back negative but the practitioner believes strep throat is still a possibility, they may take a throat culture swab. This test takes more time, as it monitors the swab to see if any strep A bacteria grows (CDC 2018).

Treating Strep Throat

Treatment options for strep throat will generally involve a course of antibiotics to reduce symptoms and reduce the risk of contagion (CDC 2018).

Preventing the Spread of Strep Throat

If you have strep throat, try to avoid spreading it to others.

• Wash your hands regularly;
• Stay away from work, school, etc.;
• Use tissues when you cough or sneeze and dispose of them;
• Avoid sharing crockery, cups and utensils with other people; and
• Avoid preparing food;

(Healthdirect 2020)

Untreated strep A infections may be contagious for 10 to 21 days. If you have taken medication, this may reduce the infectious period (Better Health Channel 2017).

Additional Resources

• Centers for Disease Control and Prevention, Group A Streptococcal Disease, https://www.cdc.gov/groupastrep/index.html
• KidsHealth, Strep Throat, https://kidshealth.org/en/parents/strep-throat.html
• Victoria Health, Streptococcal disease, https://www2.health.vic.gov.au/public-health/infectious-diseases/disease-information-advice/streptococcal-disease
• Hand Hygiene Essentials module: https://www.ausmed.com.au/cpd/courses/hand-hygiene-essentials

References

• Better Health Channel 2011, Rheumatic Fever, Better Health Channel, viewed 5 March 2020, https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/rheumatic-fever
• Better Health Channel 2017, Streptococcal Infection - Group A, Better Health Channel, viewed 5 March 2020, https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/streptococcal-infection-group-a
• Centers for Disease Control and Prevention 2018, Strep Throat: All You Need to Know, Centers for Disease Control and Prevention, viewed 5 March 2020, https://www.cdc.gov/groupastrep/diseases-public/strep-throat.html
• Healthdirect 2020, Strep Throat, Healthdirect, viewed 5 March 2020, https://www.healthdirect.gov.au/strep-throat
• Mayo Clinic 2018, Strep Throat, Mayo Clinic, viewed 5 March 2020, https://www.mayoclinic.org/diseases-conditions/strep-throat/symptoms-causes/syc-20350338
• NHS 2018, Scarlet Fever, NHS, viewed 5 March 2020, https://www.nhs.uk/conditions/scarlet-fever/
• Victoria Health n.d., Streptococcal disease (Group A beta-haemolytic streptococcus) Victoria Health, viewed 5 March 2020, https://www2.health.vic.gov.au/public-health/infectious-diseases/disease-information-advice/streptococcal-disease