Your throat is on fire. So is your child’s. You keep waiting for more symptoms to cascade along, but so far you’re stuck with a fever and a throat so sore it’s hard to swallow. Could it be strep or something else?

Many things, including viruses, bacteria, allergens, environmental irritants, fungi and chronic postnasal drip, can cause a sore throat. While many sore throats will resolve without treatment, some – including strep throat – may require antibiotics.

What causes strep throat?

Strep throat is caused by group A streptococcus bacteria (group A strep). This type of bacteria can live in a person’s nose and throat with or without causing illness . (Meaning some people carry strep and can pass the bacteria to others, but the bacteria isn’t currently making them sick.)

The bacteria is spread when an infected person coughs or sneezes. You can become sick if you inadvertently come in contact with bacteria from an infected person. Common ways to catch strep throat include sharing plates, utensils or glasses with someone who is sick, or touching your nose, eyes or mouth after you've come in contact with a contaminated surface.

Strep throat is very common in children, but not as common in adults, according to the Centers for Disease Control and Prevention . It occurs most commonly in children 5 to 15 years old, but can affect people at any age.

Symptoms and complications

People with strep throat will most likely show symptoms that include:

  • Sore throat (can cause severe pain when swallowing)
  • A fever of 101°F or higher
  • Red, swollen tonsils, sometimes with white patches or streaks of pus
  • Tiny red spots at the back or roof of the mouth
  • Headache, nausea, vomiting
  • Swollen lymph nodes in the neck
  • Body aches or rash
  • Fatigue

While strep by itself isn't dangerous, it can lead to serious complications. Strep bacteria can spread to the tonsils, sinuses, skin, blood and middle ear. Strep can lead to other inflammatory illnesses as well, including scarlet fever (characterized by a rash); kidney inflammation; and rheumatic fever (a serious condition that affects the heart, joints, nervous system and skin).

Diagnosis and treatment

“It’s possible to have many of these symptoms and not have strep throat, which is why we test for strep, explained Dr. David Lee of Novant Health Village Point Family Medicine. “A strep test is required to diagnose strep throat. Just looking at someone’s throat is not enough.”

A rapid antigen test, sometimes called a rapid strep test, can quickly detect strep bacteria in a matter of minute. Rapid strep tests sometimes give false negatives, however. “If the test is negative and we still think strep throat could be a possibility, we can take a throat culture swab to test for the bacteria,” Lee explained. Throat culture results may take a few days.

If a strep test or culture comes back positive, your doctor can prescribe antibiotics to reduce symptoms; reduce the likelihood of spreading the infection to friends and family; and to decrease the length of time you’re sick.

“It’s important to remember to finish the prescription of antibiotics,” said Lee. “Just taking the medicine until you feel better isn't enough. When you stop taking the antibiotics before it’s time, you have a much greater risk of getting an infection later that could be resistant to antibiotics.”


“In terms of prevention, the main thing I suggest is wash your hands,” said Lee. “There is no vaccine for strep throat, so keeping your hands clean is the best defense. Use an alcohol-based hand sanitizer if you’re unable to wash your hands frequently.”

Although strep can occur at any time of the year, it tends to circulate most frequently in the late fall and early spring, and flourishes where groups of people are in close contact, such as in families, schoolrooms and childcare settings.