Strep throat in children refers to an infection caused by bacteria of the genus streptococcus. This bacteria is also the causative agent of conditions such as acute pharyngitis, sore throat, and scratchy throat in children.
Although strep throat is commonly seen in all age groups, children have higher susceptibility rates and risks for complications due to this infection. Therefore, it is best to seek timely medical care if your child has any signs of strep throat to avoid future risks or progression of the infection.
Read on to discover the causes, risk factors, signs and symptoms, treatment modalities, diagnosis, and preventive methods for strep throat in children.
Causes Of Strep Throat In Children
Strep throat is caused by group A streptococcus (GAS) bacteria, also known as Streptococcus pyogenes. It is a highly contagious disease that can easily spread from an infected person to others through respiratory droplets expelled while coughing or sneezing.
Direct spread may happen by sharing drinks, food, personal items, or by touching contaminated surfaces, such as doorknobs. Touching the nose, mouth, or eyes with unwashed hands after handling the contaminated surfaces can be a significant cause of infection in children (1). It may take two to five days of the incubation period to develop symptoms after strep bacteria reach the body.
Children with an active infection, rather than asymptomatic carriers, spread bacteria to others. Usually, strep infection is not contagious 24 hours after starting antibiotics or once the fever subsides.
Risks Factors For Strep Throat In Children
Children aged five to fifteen years are more likely to get strep throat. Children younger than three years rarely develop strep throat (2).
Although it may occur in any season, winter and early spring have a high incidence of strep throat infection. The bacteria tend to spread between groups of people in close contact, such as children at school or daycare (3).
Signs And Symptoms Of Strep Throat In Children
The following symptoms and signs are seen in children with strep throat (4).
- Sudden onset of throat pain
- Pain while swallowing
- Swollen tonsils
- Red tonsils with white patches or pus
- Small red spots in the palate (roof of the mouth)
- Tenderness and swelling of the lymph nodes in the neck
- Headache and body ache
- Skin rash
- Nausea and Vomiting
- Poor appetite
These symptoms and signs are also seen in other causes of sore throat, such as viral infection. Tests may be required to identify the cause of sore throat and begin antibiotic therapy for strep throat.
When To See A Doctor
If your child has signs and symptoms of strep throat, seek prompt medical care. Timely diagnosis can help in differentiating strep throat from other causes of sore throat in children. It can also help avoid any potential complications of strep infection.
Complications Of Strep Throat In Children
Strep throat in children can be cured with appropriate treatment. However, untreated strep throat infection may spread to other parts of the body to cause the following complications (5).
- Peritonsillar abscess
- Skin infections, such as impetigo
- Middle ear infection (otitis media)
Timely treatment with antibiotics could decrease the risk of complications.
- Scarlet fever or scarlatina is caused by strep bacteria and causes high fever, bright red skin rashes, and sore throat in children.
- Post-streptococcal glomerulonephritis (PSGN) is an inflammation of the kidneys that develops about ten days after the development of strep throat infection. Sudden onset of hematuria (red blood cells in urine) and proteinuria (protein in urine) are seen in this disease.
- Post-streptococcal reactive arthritis is inflammation of the joints due to immune reaction.
- Rheumatic fever is a severe complication that affects the heart, especially the heart valves. It can also cause tender joints and skin nodules.
Rarely, strep throat may lead to pediatric neuropsychiatric disorders, such as tic disorders and obsessive-compulsive disorders. This condition is called PANDAS (pediatric autoimmune neuropsychiatric disorder associated with streptococcus infections). However, the relation of strep throat and psychiatric disorders requires more studies (9).
Diagnosis Of Strep Throat In Children
The following tests are often used to diagnose strep throat after the physical examination (5).
- A rapid antigen test is done on the throat swab, and this gives results in minutes.
- Throat swab and tonsil secretions are collected for culture, the results of which are usually available in a couple of days.
Symptoms such as cough, rhinitis, voice changes, conjunctivitis, etc. are usually seen in viral sore throat infection. Although rapid antigen tests give immediate results, a throat culture is the standard gold test for strep throat.
Treatment For Strep Throat In Children
The following medications can be used to cure the infection, relieve the symptoms, and prevent complications of strep throat in children (3).
- Oral antibiotics can reduce the severity of strep throat, prevent spread, and reduce the risk of complications if taken within 48 hours of illness. Penicillins and amoxicillin are common antibiotics prescribed.
- Symptom relievers such as ibuprofen or acetaminophen are given for pain and fever. Aspirin should be avoided since it may cause Reye syndrome in children.
After 24 hours of antibiotic treatment, children can go to school or daycare if there are no symptoms since the infection is not contagious beyond this time. Although the symptoms resolve and the child feels better, it is crucial to complete the prescribed treatment course to avoid recurrence and complications. Consult the doctor if there is no improvement in the child’s condition even after taking antibiotics for 48 hours or two days (10).
Home Remedies For Strep Throat In Children
Home remedies may help to ease symptoms in some children. However, it is advised to take an antibiotic course to fully cure strep throat and avoid future complications.
The following remedies may help ease symptoms and aid faster recovery (6). You may try these measures along with medical treatment.
- Getting enough rest during treatment could help in recovery.
- Stay hydrated to avoid dry throat that may worsen irritation and throat pain.
- Warm salt water gargles can help to soothe the throat.
- Try easy-to-swallow foods such as soup, mashed potatoes, yogurt, eggs, cooked cereals, broths, etc. You may also puree food in a blender to make them easy to swallow.
- Avoid spicy and acidic foods that may irritate the throat.
- Cold foods such as frozen fruit pop, yogurt, etc. can be soothing to the throat.
- Avoid irritants such as cigarette smoke, perfumes, fumes of cleaning agents and paints, etc.
Prevention Of Strep Throat In Children
The following tips may help to prevent strep infection in children (6).
- Wash hands often using soap and water or alcohol-based sanitizer
- Cover mouth while sneezing or coughing
- Do not share personal items with infected family members
- Wash utensils in soapy and hot water
- Disinfect doorknobs, handles, etc. often
These preventive measures also help to avoid many other infections, such as influenza and COVID-19. Teaching handwashing techniques and cough etiquette from an early age could protect your child from catching and spreading germs.
Frequently Asked Questions
1. Can my child go to school with strep throat?
Children with strep throat must stay at home and not go to school until they have taken prescribed antibiotics and show no signs of a fever (4).
2. Can a child get rid of strep throat without antibiotics?
Yes. If the child has strep throat with no or mild symptoms, they may not need antibiotics. However, administering antibiotics helps speed up the process of recovery (2).
3. Does strep throat hurt more than a sore throat?
The symptoms of strep throat are comparatively more severe than a sore throat. Therefore, it might hurt more than the latter (11).
It is imperative that you seek an immediate opinion from the doctor if your child shows signs of strep throat, as if left untreated, it might lead to complications such as sepsis or sinusitis. Strep throat in children is a contagious disease and can spread very easily. Thus, it is advised to keep your kids away from areas with a high risk of contamination. Ensure that your child gets proper rest, has the prescribed medications, and follows suitable preventative measures to help reduce the infection and prevent reinfection.
- Streptococcus pyogenes, a highly contagious bacteria that spreads through respiratory droplets of an infected person to others, causes strep throat in children.
- Pain while swallowing, sudden throat pain, fever, skin rashes, and red tonsils are common signs of strep throat.
- Antibiotic treatment is required for strep throat, and it can complicate a middle ear infection, sepsis, and peritonsillar abscess if left untreated.
2. Strep Throat: All You Need to Know; The Centers for Disease Control and Prevention
3. Pharyngitis (Strep Throat);; The Centers for Disease Control and Prevention
4. Strep Throat (Bacterial); Nationwide Children’s Hospital
5. Strep Throat; St. Louis Children’s Hospital
6. Sore Throat; St. Clair Hospital
7. Post-Streptococcal Glomerulonephritis; The Centers for Disease Control and Prevention
8. Rheumatic Fever; The Centers for Disease Control and Prevention
9. PANDAS; National Institute of Mental Health
10. Strep Throat Infection; Seattle Children’s Hospital
11. Strep Throat or Sore Throat? Best Ways You Can Tell; Cleveland Clinic