02/09/2025
Wrote this in 2018 but as someone getting over her first bout of strep in over 15 years….just re-posting a refresher course 😁
10 COOL/WEIRD FACTS ABOUT STREP THROAT
1. When a child has a sore throat, in general, there is a 37% chance that it is strep (Group A Strep, aka, Streptococcus pyogenes)
2. 15-20% of kids WITH NO SYMPTOMS AT ALL will be POSITIVE FOR STREP if tested. This means 15-20% of kids are strep “carriers”. A tiny amount of strep lives in their throat all the time, and it doesn’t make them sick. Let that sink in a moment. Think about all the unnecessary antibiotics kids are getting!
3. The most common symptoms of strep throat are a sore throat, fever, and swollen glands in the neck. I also see kids get nauseous, have stomach aches, and headaches. It’s odd – sometimes their only signs are fever and vomiting, or nausea and a headache.
4. Sometimes, strep comes with a rash. We then call it “Scarlet Fever” and it is no more dangerous than just plain strep throat. Someone just gave it a cool name and then we get to feel like we are living in that computer game “Oregon Trail”.
5. Most people look at the back of the throat to see if their kiddo has strep. I don’t look there – that’s typically where drainage from the nose causes bumps and other changes. When I look for strep, I look at the tonsils and the ROOF of the mouth – the arch over that dangly thing (the uvula) to see if there are dark red spots. (See pic)
6. If your child has congestion, coughing, a runny nose, watery eyes and/or diarrhea, she most likely doesn’t have strep. Chances are it’s just a cold or some allergies – and postnasal snot drip is the most common cause of sore throats in my office.
7. Strep is passed from kids to kid through “large respiratory droplets”. Yum. This means kissing, sharing drinks or food, or a sneeze or a cough either lands directly on another kid’s hand which then they put that hand in their mouth, nose, or eyes. Or, the drops land on a surface and another child touches it and touches their face somehow.
8. If you are a strep carrier, you don’t have much strep in your throat. It’s enough to catch on a strep swab, but not enough to fly out of your kid’s mouth and onto things and people (ew). Also, these bacteria aren’t as “mean” as typical strep bacteria are. So you aren’t really very contagious at all. And with 15-20% of kids being carriers, many of us live with them on a daily basis and are just fine.
9. I always talk with incredulous parents in the office about how “the strep came right back” after finishing antibiotics. They finished treatment and then the fever and sore throat hit again, and the test is positive again. I call these kids “strep bounce-backs” and it’s more common than you think. It doesn’t mean anything went wrong, and there are lots of explanations. Sometimes there are a lot of kids in the class passing it back and forth, and getting treated at different times. Sometimes, it is because the bacteria is hiding deep inside the tonsil folds and the antibiotic had a hard time reaching it. Changing up the antibiotic, or just repeating a course, can help it go away.
10. You can get over strep on your own, without antibiotics. Isn’t that amazing? Our immune systems are awesome. BUT, we like to treat strep with antibiotics anyway. Why? Because it makes you feel better sooner. It makes you less contagious to others (you are no longer contagious 12 hours after the first dose of Amoxicillin). And it can prevent a VERY rare complication we see with strep – when strep attacks the heart (acute rheumatic fever).
Hope this helps you to better understand strep!
❤️
Dr. Diane
(Instagram: drdianearnaout Facebook: Dr. Diane Arnaout)
📸 Mayo Clinic
