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What to do if your child has strep throat

Strep throat is a common childhood illness, but as a pediatrician, I often talk to parents who are frustrated with how many times their kids get it. It’s important to understand a few things about strep throat, especially the difference between a sore throat and strep throat.


Not all sore throats are strep throats. Most sore throats, which often come with a runny nose, cough and hoarseness, are caused by viruses and usually clear up on their own without medical treatment.

Signs of strep throat

A child with strep throat will start to develop other symptoms within about three days, including:

  • Red and white patches in the throat

  • Difficulty swallowing

  • Red and enlarged tonsils

  • Nausea or vomiting

  • Fever, headache and ear pain

Diagnosing strep throat

If your child has a sore throat and other strep throat symptoms, call your pediatrician. He or she will probably do a rapid strep test, using a cotton swab to take a sample of the fluids at the back of your child’s throat. If it’s positive, your child has strep throat. If it’s negative, the doctor will send a sample to a lab for a throat culture. The results are usually available within a few days.


Treating strep throat

Strep throat usually requires treatment with antibiotics. With medical care, along with plenty of rest and fluids, your child should be back to regular activities in a few days.

Remember that strep throat is contagious. If you child does have it, it’s important to prevent him or her from spreading it:

  • Keep eating utensils, dishes and drinking glasses separate, and wash them in hot, soapy water after each use.

  • Your child shouldn’t share food, drinks, napkins or towels with family members.

  • Make sure your child covers his or her mouth and nose when coughing or sneezing.

  • Keep your child home from school or daycare until he or she has been on antibiotics for at least 24 hours.

  • Throw out your child’s toothbrush, and give him or her a new one. Do this once he or she has been taking antibiotics a few days and is no longer contagious.

Strep throat spreads like crazy

Strep throat is common in school-age kids. The bacteria that causes strep throat are found in the nose and throat, so sneezing or coughing easily spread the infection. That’s why it’s so important to teach kids about proper hand washing.

How many cases of strep throat are too many?

I’m often asked how many cases of strep throat are too many, and when the tonsils are really the bigger problem. According to recent studies, this is too many:

  • Seven cases of strep throat in one year

  • Five cases every year for two years

  • Several each year for the past three to four years

You should also take into consideration additional problems like missing large amounts of school, being a chronic carrier of the bacteria that causes strep throat and the chances of developing an abscess or severe infection in the soft tissue around the tonsils.

If this sounds a little too familiar, you may want to consider a referral to a specialist. It may be time to talk about the possibility of your child having tonsil surgery.