What to Know About Strep Throat this Winter

Although it causes irritation similar to other sore throats, strep throat is not the same. It’s highly contagious, and the bacteria that causes strep can lead to infections in other parts of your body, or even rheumatic fever, a disease that damages the heart and can be fatal. 

“If you think you or someone in your family has strep throat, you should see a medical professional to help you end the illness before it gets worse or spreads,” says Columbia pediatrician Katie Keown, MD. “Strep throat is common and spreads quickly. But there are things you can do to help prevent it.” 

Prevention is especially important at this time of year. Dr. Keown’s practice has treated many cases of strep throat in recent months and expects a lot more. “Strep is seen year-round, but it is most common in late fall through early spring. It spreads quickly during winter,” she explains. “During the COVID-19 pandemic, rates of strep throat were unusually low due to masks and social distancing. Now, overall rates are rising.” 

Dr. Keown shares the basics about strep throat causes and symptoms, and how to reduce the risk of infection.

What is strep throat?

Childhood throat infections are caused by germs, like viruses or bacteria. When a throat infection is caused by Group A Streptococcus bacteria, it is informally referred to as “strep throat.” Strep throat is most commonly seen in school-aged children and teenagers, but anyone can get it.

How do you get strep throat?

Strep can be spread through coughing, sneezing, or touching a contaminated surface before touching your nose or mouth.

What are the symptoms of strep throat?

Strep throat causes sore throat, fever, and fatigue. It can also cause pain with swallowing and rash. Some children experience headaches or abdominal pain.

Strep throat typically does not cause nasal congestion or cough in older children and teenagers. 

Strep throat is very rare in babies and toddlers, but these groups can have runny nose and cough if they do get strep.

How do you know if a sore throat is strep?

If your doctor or other health care professional suspects strep, the next step is a rapid strep test or throat culture to confirm so it can be correctly treated.

Is strep contagious? 

Yes. Strep throat is highly contagious. 

How long is strep contagious?

It can take two to five days to start having symptoms after being exposed to strep. If strep throat is not treated with antibiotics, children can be contagious for up to a month. 

Strep throat is typically no longer contagious 12 to 24 hours after starting antibiotics. Children can return to school after two doses of antibiotics given 12 hours apart.

How do you get rid of strep throat?

Antibiotics. Although strep throat can get better on its own, antibiotics can prevent serious complications from strep, like rheumatic fever, especially in older children and teenagers.

Antibiotics for strep throat given by mouth are given for 10 days. It is very important to complete the full course of treatment that your doctor prescribes.

For pain relief, taking medicines like acetaminophen and ibuprofen (which also lower fever) or gargling with salt water can help.

How can you prevent strep throat?

It’s important to cover coughs and sneezes with your hands or sleeve, and wash hands often.

In addition, do not share utensils, plates, cups, towels, or tissues. It may be helpful to tell children it is okay not to share when sick.

It is also very important to wash hands properly by using soap and water, and rubbing hands and fingers together while singing “Happy Birthday” twice. If you don’t have soap and water, use hand sanitizer, but soap and water are best.

Can you get strep without tonsils?

Yes. You can still get strep throat if you do not have tonsils. But, strep may be less common and less severe in children without tonsils. 

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Katie Keown, MD, is an assistant professor of pediatrics at Columbia.