Strep Throat: Symptoms, Causes, Treatment, and More

Strep throat is a contagious bacterial infection that can cause a sore, swollen throat and other symptoms.

Strep throat is a bacterial infection that causes inflammation and pain in the throat. This common condition is caused by group A Streptococcus bacteria.

Strep throat can affect children and adults of all ages. But it’s especially common in children between the ages of 5 and 15. Sneezing, coughing, sharing food utensils, and other types of close contact with someone with a strep throat infection can spread strep from one person to another.

What does strep throat look like?

How contagious is strep throat?

Strep throat is a highly contagious bacterial infection.

It usually spreads through small respiratory droplets that become airborne when someone with strep throat sneezes or coughs. Learn more about why strep throat is so contagious.

Strep throat is more common in children than in adults. It most commonly occurs in children and adolescents between the ages of 5 and 15.

Because it’s so contagious, strep throat can easily spread where children congregate, like in daycare centers and schools.

Adults who are frequently around children, like parents of school-aged children, may also be more susceptible to strep throat.

Strep throat is rare in toddlers under the age of 3 years. Find out what to do if your baby has a sore throat.

The severity of strep throat can vary from person to person. They typically develop within 5 days of exposure to strep bacteria.

Some people experience mild symptoms, like a sore throat. Other people have more severe symptoms, including fever and difficulty swallowing.

The common symptoms of strep throat include:

• a sudden fever, especially if it’s 101˚F (38˚C) or higher
• a sore, red throat with white patches
• a headache
• chills
• a loss of appetite
• swollen lymph nodes in the neck
• trouble swallowing

You can have strep throat without a fever. Find out more about having strep throat without a fever.

Less common strep throat symptoms include gastrointestinal symptoms like:

• stomach pain
• nausea
• vomiting

Children are more likely to experience these less common symptoms.

There’s also a rash associated with strep. This is called scarlet fever, or scarlatina. But most people with strep do not get a rash.

The rash of scarlet fever can appear before other symptoms start or up to 7 days after. The rash begins as red areas of skin and becomes fine bumps. The rash goes away in about a week, but you may experience skin peeling in affected areas for several weeks after the infection.

Some symptoms are signs of a viral infection, not strep throat. If any of your symptoms include the following, you might have a different illness:

• cough
• hoarse voice
• runny nose
• pink eye (conjunctivitis)

If you get antibiotics for presumed strep throat when you actually have mono, you can get a rash from the amoxicillin.

To get an accurate diagnosis, you may want to make an appointment with a doctor and get a strep test.

Strep throat is caused by bacteria called Streptococcus pyogenes or group A Streptococcus (also known as group A strep, or GAS).

You can catch strep throat if you touch your eyes, nose, or mouth after being exposed to these bacteria, like when someone with strep throat coughs or sneezes.

Strep throat can be spread when you share food or a drink with someone with an active strep throat infection.

You can also get strep throat by coming into contact with an object contaminated with group A strep bacteria, like a doorknob or faucet, and then touching your eyes, nose, or mouth. Kids who put objects in their mouths can also catch strep throat this way.

Risk factors

Some factors can increase your risk of contracting strep throat. They include:

• close contact with someone who has strep throat
• spending time in crowded settings, like schools, daycare centers, or military facilities
• being between the ages of 5 and 15
• having a school-aged child
• being an adult who has frequent contact with children, like a teacher or healthcare professional

Most adult cases of strep throat occur in those

Because close contact is the greatest risk factor for strep throat, the illness commonly spreads among members of a household.

Strep throat when pregnant

If you think you may have strep throat during your pregnancy, see your doctor right away to discuss treatment options.

Your doctor may prescribe antibiotics and will carefully monitor your medications. Get a better understanding of how to treat strep throat when you’re pregnant.

The bacteria that causes strep throat, group A streptococcus, is not the same as group B streptococcus, which is found around the vagina or rectum. While group B streptococcus can be passed to a baby during delivery, it’s unrelated to the bacteria that causes strep throat.

Because strep throat is a bacterial infection, a doctor will typically prescribe an antibiotic to treat it. These medications inhibit the spread of bacteria and infections.

There are eight different antibiotics recommended by the

• penicillin (oral or intramuscular)
• amoxicillin (oral)
• cephalexin (oral)
• cefadroxil (oral)
• clindamycin (oral)
• clarithromycin (oral)
• azithromycin (oral)

Penicillin and amoxicillin are the most common medications given for a strep infection. If you’re allergic to penicillin or amoxicillin, your doctor may prescribe a different medication, like the antibiotic azithromycin. Find out more about azithromycin for treating strep throat.

The doctor’s choice of antibiotic can also depend on whether the strep bacteria in a particular geographic area have become resistant to certain antibiotics.

The

• shortening the length of illness
• reducing symptoms
• preventing spread of the strep bacteria
• preventing rheumatic fever, which is a serious inflammatory immune response, and other serious complications like peritonsillar abscess

It’s important that you finish your antibiotic treatment course to overcome the infection completely. Some people stop taking their medication when symptoms improve, which can trigger a relapse. If this happens, the symptoms can return. It can also contribute to antibiotic resistance.

Home remedies for strep throat symptoms

In addition to antibiotics, at-home treatments can help relieve the symptoms of strep throat. These remedies include:

• getting plenty of rest
• drinking warm liquids, like lemon water and tea
• drinking cold liquids to help relieve throat soreness
• eating soft foods like yogurt and applesauce
• turning on a cool-mist humidifier
• taking over-the-counter pain relievers, like ibuprofen or acetaminophen
• sucking on throat lozenges, ice, or popsicles
• adding 1/4 teaspoon (5 ml) of salt to 1 cup (240 ml) of water and gargling the mixture

Natural remedies like honey and apple cider vinegar may also help. Here are 12 natural ways to relieve a sore throat.

Essential oil for strep throat

Essential oils are distilled from the leaves, bark, stems, and flowers of plants. They may help promote healing by killing germs and reducing inflammation.

The medical benefits of essential oils are controversial. But the following essential oils may provide some benefit in treating strep throat.

In a

• thyme
• lavender
• cinnamon
• peppermint
• clove
• eucalyptus
• tea tree

But the authors of the review caution that they’re much less effective than antibiotics. In addition, the antimicrobial activity in each is limited and short-lived, which means the type of formulation is important.

A

Ingesting essential oils isn’t recommended. They can be inhaled or diluted with oil and added to a bath. Some remedies, like ginger root or lemon juice, may be added to tea. Explore more about using these essential oils to treat a sore throat.

Foods often used to ease symptoms of a sore throat, but whose effectiveness specifically to treat strep throat is uncertain, include:

If it’s left untreated, strep throat can cause serious complications.

The potential complications include:

• ear infection
• sinusitis
• pneumonia, which occurs when the bacteria that cause strep throat pass into the lungs
• peritonsillar abscess, which is a pus-filled infection that develops in the back of the tonsils
• rheumatic fever, which is an inflammatory disease that affects the joints, the heart, and the skin
• post-streptococcal reactive arthritis, which is inflammatory arthritis in more than one joint
• poststreptococcal glomerulonephritis, which is an inflammation of the kidneys
• bacteremia, where bacteria is in the blood stream (also known as “blood poisioning”)
• meningitis, an inflammation of the membranes that cover the brain and spinal cord
• pediatric autoimmune neuropsychiatric disorder associated with streptococci (PANDAS), which involves sudden changes in a child’s movement, personality, or behavior after a strep bacteria infection
• streptococcal toxic shock syndrome, a rare but potentially fatal bacterial infection

In order to prevent complications, it’s recommended that you talk with your doctor if you have symptoms of strep throat.

A doctor may rule out strep throat if you have clear symptoms that indicate a viral infection, like a cough and runny nose. But it’s important to see a doctor even with these symptoms, so they diagnose the illness and treat it, if necessary.

See your doctor if you experience any of the following:

• a sore throat that lasts longer than 2 days
• a sore throat with white patches
• dark, red splotches or spots on the tonsils or the top of the mouth
• a sore throat with a fine, sandpaper-like pink rash on the skin
• difficulty breathing
• difficulty swallowing

Your doctor will examine your throat and check for signs of inflammation. They may also check your neck for swollen lymph nodes and ask about other symptoms.

If you do not have viral symptoms, like cough, runny nose, and a hoarse voice, your doctor can’t rule out strep caused by bacteria. But they can do a rapid test or take a throat culture to make a definitive strep diagnosis.

If you need help finding a primary care doctor, then check out our FindCare tool here.

Rapid strep test

If your doctor suspects you have strep throat, they may do a rapid strep test in the office.

This test determines whether your sore throat is caused by a strep infection or another type of bacteria or germ. Your doctor swabs the back of your throat with a long cotton swab, collecting a sample. The sample is then tested with a kit to look for signs of bacteria.

The results are available in about 5 minutes. Learn more about the rapid strep test.

Although the rapid test is reliable, it can miss some cases of strep throat. That’s why some doctors may recommend a throat culture even if the rapid test comes up negative.

Throat culture

If the rapid strep test is negative, the doctor may take another swab, called a throat culture, and send it to an outside lab for additional testing.

Doctors most frequently order a throat culture when the person is at high risk for serious complications from untreated strep. One such complication is rheumatic fever. Because children and teens are at higher risk for rheumatic fever, a doctor may order a throat culture even if their rapid test is negative.

Since adults are at low risk of developing rheumatic fever from strep, a doctor may not order a throat culture for an adult with a negative rapid test result.

Throat culture results are available within a few days. Learn more about the strep throat culture.

There’s no vaccine available to prevent strep throat. One of the most effective ways to help avoid infection is regularly washing your hands. If you can’t access soap and water, you can use a hand sanitizer instead.

Don’t share drinks or food with someone who has strep throat. If someone in your home has strep throat, don’t share their towels, sheets, or pillowcases. Wash dishes and laundry in water that’s hot and soapy.

Parents of children with strep throat can help stop the spread to other family members by:

• keeping the child’s eating and drinking dishes separate
• not sharing food, drinks, napkins, cloths, or linens between the child and others
• having the child cover all coughs and sneezes
• enforcing regular hand washing among everyone in the household
• replacing the child’s toothbrush after the course of antibiotics ends

If you have strep throat, sneeze or cough into the crook of your elbow or a tissue rather than into your hand. Be sure to wash your hands frequently. Explore more ways to prevent strep throat.

Strep throat	Sore throat	Cold	Mono
Causes	bacteria	virus/irritation	virus	virus
Symptoms	sore throat, trouble swallowing, fever, swollen tonsils, swollen lymph nodes	painful throat, itchy or scratchy feeling, painful swallowing	runny or stuffy nose, sneezing, sore throat, cough, fatigue, fever, headache	fever, sore throat, fatigue, swollen neck or armpit glands, swollen liver or spleen, loss of appetite
Duration	symptoms improve in 1-2 days after starting antibiotics	7-10 days	1-2 weeks	2-4 weeks
Treatment	antibiotics	none	none	none

Infectious sore throats are usually caused by a virus, while group A strep bacteria cause strep throat.

Not all sore throats result from a strep infection, and not all are infectious. Other illnesses or conditions can cause a sore throat too. These include:

• the common cold
• a sinus infection
• postnasal drip
• acid reflux
• smoking
• throat irritation from inhaled particles

Most sore throats caused by other medical conditions usually improve on their own in about

Strep throat and the common cold have different causes. Viruses cause the common cold, while a bacterial infection causes strep throat.

If you have a common cold, you usually have symptoms like coughing, a runny nose, and hoarseness. These symptoms, especially coughing, are not common with strep throat.

When your throat is sore due to a cold, the pain usually develops gradually and disappears in a couple of days, although some colds can last up to 2 weeks. The pain from strep throat can occur suddenly. It’s more severe and can persist for days.

Colds typically clear up on their own without the need for medical treatment. To prevent complications like rheumatic fever, antibiotics are usually prescribed to treat strep throat.

Infectious mononucleosis, commonly known as mono (or “the kissing disease”), is a disease that’s often caused by the Epstein-Barr virus. It usually affects teenagers and young adults, though younger kids can also get mono.

Just like strep throat, mono symptoms can include a sore throat, fever, and swollen lymph glands. But unlike strep throat that’s caused by a bacterial infection, mono is a viral infection. It isn’t treated with antibiotics.

There’s no cure for mono, and the symptoms usually last about a month. Treatment includes rest and pain relief to ease symptoms. If you have mono, a doctor may advise you to avoid contact sports until you’ve recovered.

Your doctor can perform blood tests to determine whether your sore throat is due to mono.

To reduce your risk of complications, make an appointment with your doctor if your strep throat symptoms don’t improve within 48 hours of taking an antibiotic. They may need to prescribe a different antibiotic to fight the infection.

If an abscess has formed, a doctor may need to cut and drain it.

You should start to feel better within a couple of days after beginning treatment for strep throat. If you do not, make an appointment with a doctor.

Ask your doctor when you or your child can return to work or school after beginning the antibiotic.