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Strep Throat (Streptococcal) Infection FAQs

Reviewed by Charles Patrick Davis, MD, PhD

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Q:Strep throat usually occurs in the summer months. True or False?

A:False. Strep throat infections usually occur in late fall, winter, and early spring.

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Q:Just about any painful sore throat is caused by strep. True or False?

A:False. A sore throat can occur for a number of reasons, and a sore throat does not necessarily indicate a strep infection. Strep throat is caused by Streptococcal (strep) bacteria. There are many different types of strep bacteria. Streptococcus, or strep, is the most frequently found bacterial cause of sore throat. Mycoplasma, Neisseria, Corynebacterium, Yersinia, and non-group A Strep bacteria are some of the other bacterial causes of throat infection. Some reports suggest that over 600 million cases of strep throat occur annually worldwide.

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Q:Symptoms of strep throat often mimic the symptoms of a bad cold. True or False?

A:False. Cold symptoms such as coughing, sneezing, or a runny/stuffy nose usually indicate that strep throat is not present. Throat infection with strep bacteria can cause a variety of symptoms associated with inflammation of the throat and its nearby structures. The most common symptoms of strep throat are: - Fever - Sudden, severe sore throat - Swollen, tender lymph nodes on the sides of the neck - Painful swallowing (odynophagia) - White or yellow patches seen on the tonsils and throat (tonsillar exudates) Other possible symptoms also include headache and belly pain. Less common symptoms are a red skin rash, vomiting, and body aches.

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Q:Is strep throat contagious?

A:Yes. Strep throat is highly contagious. The most common way to catch strep throat is by close contact with an infected person. Specifically, close contact with airborne droplets of an infected individual is the most common way of acquiring Streptococcus infection. The risk of being contagious with strep throat diminishes substantially after initiation of proper treatment. It is also possible that bacteria may be present without causing an infection. A person may be a carrier of the bacteria but not infected.

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Q:Which places are most likely to have conditions that facilitate the spread of strep bacteria?

A:Day care centers. Remember, close contact with airborne droplets of an infected individual is the most common way of catching Streptococcus infection. Close quarters such as college dormitories, day care centers, military facilities, gyms, schools, and family members provide ideal conditions for transmission of strep throat from one person to another. The risk of acquiring strep throat from an affected family member nears 40%.

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Q:Strep infection is treated with antibiotics. True or False?

A:True. If strep throat is detected, it usually must be treated adequately with antibiotics if people want to have symptoms decline faster and to lessen the chance of any complications. Streptococcus is highly responsive to penicillin and the cephalosporin antibiotics. Penicillin has shown good effectiveness, and it is reliable and inexpensive. Other penicillin derivatives such as amoxicillin (Amoxil®, DisperMox®, Trimox®) and amoxicillin-clavulanate (Augmentin®, Augmentin XR®) are all adequate treatments for strep. However, some bacterial strains may be resistant to certain antibiotics. Note: It is important to take the full course of antibiotics as prescribed and not to stop the medication when symptoms resolve. Prematurely discontinuing antibiotics can result in the infection being inadequately treated, with potentially adverse consequences or relapse of the infection.

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Q:Strep throat is difficult to diagnose. True or False?

A:False. Strep throat is easily diagnosed with a throat culture, the gold standard in diagnosing strep throat infection. A throat culture involves touching a cotton swab to the throat and tonsil area. Rapid strep tests (also called the Rapid Antigen Detection Test or RADT) are available and can give results in minutes.

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Q:What is a rare but serious complication of strep throat?

A:Rheumatic fever. Rheumatic fever (acute rheumatic fever or ARF) is an autoimmune disease that may occur after a group A Streptococcal throat infection that causes inflammatory lesions in connective tissue, especially that of the heart, joints, blood vessels, and subcutaneous tissue. Prior to the broad availability of penicillin, rheumatic fever was a leading cause of death in children and one of the leading causes of acquired heart disease in adults. Serious kidney disease that may result in kidney failure may also be a consequence of Streptococcal infection.

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Q:Strep bacteria is also known as the dreaded "flesh-eating bacteria." True or False?

A:True. The commonly known strep throat is due to only one member of the Streptococcus family of bacteria. This certain Streptococcus (Streptococcus pyogenes) belongs to the group A Streptococcus bacteria (GAS for short). This group of bacteria is also known to cause the flesh-eating bacterial infection called necrotizing fasciitis. GAS also causes a variety of other health problems such as: impetigo, soft tissue infections, rheumatic fever, scarlet fever, puerperal fever (fever after a pregnant female delivers); lung infections such as pneumonia; cellulitis, wound infections, bone infections, sinusitis, meningitis, and toxic shock syndrome (TSS).

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Q:People get strep throat because they have not been vaccinated against it. True or False?

A:False. Currently, there are no vaccines available against group A Streptococcus bacteria. However, simple steps can be taken in order to limit the spread of strep throat. Strep throat can best be prevented by: covering the mouth and nose when sneezing or coughing; washing hands frequently; frequently washing dishes and utensils used by the infected individual; separating dishes, utensils, and other household items used by the infected person; avoiding sharing food or drinks with the infected individual.

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Q:Tonsils serve no purpose. True or False?

A:False. The tonsils are red, oval clumps of tissue located at the back and to the sides of the throat. This location allows the tonsils to intercept germs as they enter the body through the nose and throat. They contain infection-fighting cells and antibodies (infection-fighting proteins in the body) that stop the spread of the germs further into the body.
Note: Surgical removal of the tonsils is much less common today thanks to the present ability to rapidly and accurately diagnose strep infection, and thanks to the excellent antibiotics currently available.

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Q:What causes most sore throats?

A:Viruses. Viruses are the most common cause of throat infections in children and adults. Many types of viruses are known to cause throat infections, and their symptoms may be difficult to distinguish from those of a bacterial infection. This is where a throat culture proves valuable.
Note: Throat infections caused by viruses usually occur in non-winter months.

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Q:Why is early detection of strep throat so important?

A:Early detection of strep throat can decrease the duration of the illness and suffering and can reduce transmission of the disease. Studies have shown that if treated within the first 48 hours of symptoms, the duration of the symptoms is reduced by 1-2 days. Another reason to treat strep infection early is that there is a 35% reduction in transmitting the disease by contact. There are reports that within 24 hours of starting antibiotics (such as penicillin) for strep throat, individuals become minimally contagious.

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Q:Left untreated, the body will likely clear strep throat on its own. True or False?

A:True. If untreated, the body will generally clear the infection within 2-5 days, and this is the usual course of the illness. Still, as mentioned earlier, untreated strep throat can cause possible and serious complications to develop. These complications can include: rheumatic fever, otitis media (spread of the infection to the middle ear); meningitis, pneumonia, toxic shock syndrome (TSS), and abscess formation. It is thought that if the strep throat infection is untreated or inadequately treated by antibiotics, the bacteria remain in the tonsils and promote a persistent immune response from the body.

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