Strep throat is an infection caused by Streptococcus bacteria. Group A Streptococcus (GAS), or Streptococcus pyogenes, is the leading bacterial cause of throat and tonsil infections in children worldwide.

It most commonly affects school-age children, especially ages 7-8 years old, and adolescents.

What are the symptoms of strep throat?

Your child may have strep if they have a sore throat, fever, inflamed tonsils, and swollen glands, especially without a runny nose or cough.

The most common symptoms of strep throat include:

An extremely sore throat and pain with swallowing.
Red, inflamed-looking throat, sometimes with white streaks.
Inflamed tonsils with pus.
Stomach aches, nausea, and vomiting.
Swollen glands in the neck (swollen lymph nodes).
Fever.
Headache.

A sore throat with a runny nose, cold symptoms, pink eye, and a cough are not symptoms of strep throat. A viral sore throat usually causes inflammation of the throat around the tonsils, not of the tonsils themselves.

Strep throat can be diagnosed with a rapid strep test. If you suspect your child has strep throat, bring them to your pediatrician's office to get tested.

Treatment for strep throat

Strep throat is treated with antibiotics. Penicillin or amoxicillin are commonly prescribed. After taking antibiotics, your child should start to feel better within a few days. Be sure to complete the entire course of antibiotics prescribed, even if your child begins to feel better before the course is complete.

Group A strep infections can cause a sore throat with a rash, also known as scarlet fever. Fevers, headaches, and throat pain typically improve with antibiotics within 24 hours. If a rash is present, it can take 3-5 days for it to go away.

Not getting treatment for strep throat can result in tonsil abscesses (pus-filled fluid pockets on the back of the throat) and rheumatic fever, which affects the heart.

Symptom relief

After getting tested and started on antibiotics, or before your appointment, you can try home remedies to soothe your child's symptoms.

Medications

Give Tylenol every 4 hours or ibuprofen every 6 hours as needed for pain. Ibuprofen is generally more effective at treating throat pain.

Cool drinks and soft foods

Cool drinks and soft foods are easier for your child to tolerate when their throat is inflamed. Offer your child cool options like milkshakes, popsicles, or slushes. Give your child a soft diet or foods that need less chewing, like bananas, puddings, or soups. Cut your child's food into smaller pieces, as it is harder to swallow with swollen tonsils. Avoid citrus, salty, or spicy foods.

Make sure your child stays well hydrated. Fluid intake is more important than eating solids when your child is ill.

Age-specific remedies

Children over 1 year can sip warm fluids like chicken broth or apple juice.
Children over 6 years can suck on candy or lollipops. Butterscotch seems to help.
Children over 8 years can try a warm salt water gargle. Use warm water with a bit of table salt added.

Medicated throat sprays or lozenges are generally not helpful.

The spread of Group A strep

Strep throat spreads through respiratory droplets or direct contact with moisture on hands of people who have it. Touching your nose and mouth after contact with contaminated surfaces can also spread strep. Strep throat is very contagious!

Help prevent the spread of strep throat by:

Teach your child to wash their hands before touching their face or eating. Practice good hand hygiene.
Do not share utensils, napkins, or towels.
Have your child cover their cough or sneeze with their elbow or tissue.
Have your child change their toothbrush 48 hours after starting antibiotics to prevent re-infection.

Children with Group A strep typically feel symptoms 2-5 days after being exposed.

Recovery time and when to call

Most children can return to school after 12 hours of taking antibiotics, as long as they are fever-free and feeling better. They must have taken 2 doses of antibiotics before returning to school.

If your child isn't feeling better after a few days of taking antibiotics, call your pediatrician's office.

Resources:

This article was written by Katie Taibl, BSN, RN, CPN. Katie is the Patient and Family Outreach Educator at Roslindale Pediatric Associates. She was previously a Pediatric Float Pool RN at Tufts Children’s Hospital, where she worked in Pediatric Med-Surg, PICU, NICU, and Oncology. She is passionate about writing articles on relevant pediatric health topics to help patients and families access actionable, user-friendly health content.