When Strep Strikes

How can parents distinguish between a run-of-the-mill viral infection and an assault by the group A streptococcus bacteria?

WRITTEN BY Stephanie Sturdy
PHOTOGRAPH BY Prostock-studio

When complaints of a sore throat arise (as they frequently do in young children), the culprit
can be difficult to pinpoint. Some 85 percent or more of throat infections are viral and resolve within 10 days with over-the-counter treatments and a little TLC. The other 15 percent result from an invasion of the bacteria streptococcus. So when should you seek a doctor’s care to make sure your child is on the path to recovery?

Dr. Annette Anderson, a Roper St. Francis Healthcare primary care doctor, suggests monitoring your kid’s symptoms for a few days. “If a child has a runny nose and cough, it’s much less likely to be strep.” Strep shows up quickly, often accompanied by a sore throat, headache and possibly stomachache with vomiting. Occasionally, a rash will surface in younger patients.

If a fever of 100.4°F or higher persists for more than a few days without improvement, or if symptoms seem to worsen, it’s time for a sick visit. The doctor will check your child’s throat for swollen lymph nodes, redness or spots, which could indicate strep. A rapid throat swab test can detect most strep infections in minutes, and a throat culture may be sent to the lab to confirm.

If your child does have strep, the doctor may prescribe antibiotics. Be sure to complete the entire course of antibiotics as directed, since stopping early could allow the infection to return. Dr. Anderson also warns to watch out for dehydration. Getting a child to drink when their throat hurts is tricky, but it’s important to encourage fluids. (Try ice pops!) Strep is spread by respiratory droplets and contaminated surfaces, so help keep others healthy by encouraging your child to cover coughs and sneezes and wash their hands frequently.

Pick Your Sick
According to the CDC, streptococcus accounts for as little as 15 percent of all sore throats in children. So what other infections could be responsible for a sore throat, and what telltale symptoms might accompany them?

• Viral rhinitis (common cold): sneezing, coughing, runny nose, congestion
• Allergies: watery eyes, runny nose, congestion
• Influenza (flu): high fever, lack of appetite, cough, congestion, fatigue, body aches
• COVID-19: fatigue, cough, fever, headache
• Coxsackievirus (hand, foot and mouth disease): high fever, blisters on hands or feet and in throat
• Mononucleosis/Epstein-Barr virus (mono): extreme fatigue, swollen lymph nodes, body aches