Key Facts
- Strep throat spreads easily when someone with it breathes, coughs, or sneezes near you.
- If you have a severe sore throat and a fever over 100.4°F or 38°C, make an appointment with your health care provider to have a throat culture.
- You can return to school and work after you have no fever and have been on antibiotics for at least 24 hours.
“Strep throat” is a sore throat that is caused by Group A Streptococcus bacteria. It’s the most common bacterial infection of the throat, and the words “Strep Throat” (or “strep”) come from the name of the bacteria.
How does someone get strep throat?
Group A strep bacteria are contagious and can be spread in two different ways: direct contact with an infected person or object, and/or through the air.
How is strep spread through contact and through the air?
- Direct Contact – If you kiss, shake hands, or share food/drinks with a person who has strep, you are at risk for developing strep. Another example is, imagine you touch a doorknob or a screen after a person with strep touches these items, then you touch your face or mouth, you are now at risk for developing strep.
Airborne – Imagine you are in a confined space breathing in the same air after after someone (who has strep) coughs, breaths, or sneezes, you are now at risk.
What are the symptoms of strep throat?
The most common symptoms of strep throat include:
- Sore throat
- Fever of 100.4°F or 38°C or higher
- Trouble swallowing
- Swollen, red tonsils (the tonsils may also have white patches)
- Sore swollen glands (lymph nodes in your neck)
- Headache
- Fatigue (feeling very tired)
Less common symptoms include skin rash, body aches, not feeling hungry, stomachache, and throwing up. Having a runny nose or cold symptoms makes it unlikely you have strep throat.
If you have any of these symptoms or have been close to someone with strep throat, it’s important to see your health care provider so they can test you for strep.
Some of the symptoms of strep throat are similar to those of another type of sore throat caused by viruses. However, a Group A strep infection is more serious and requires a visit to your health care provider, a rapid strep test and/or throat culture, and antibiotics.
How can a health care provider (HCP) tell if I have strep throat?
First, a HCP will look for signs and symptoms of strep throat, such as a sore throat, swollen glands, and no runny nose, hoarseness, or cold symptoms. They will likely ask you to open your mouth as wide as you can (and say “ahh”), then may use a tongue depressor (an instrument that looks like a popsicle stick and is used to push your tongue down) to get a good look at your throat and your tonsils. The HCP will feel your neck to check for tender, swollen lymph nodes and may take your temperature to see if you have a fever.
Throat culture – a HCP will also gently rub a sterile cotton swab over the back of your throat and tonsils. This doesn’t take long and isn’t painful, but it may cause you to gag for a second. The purpose of the swab is to get a sample that will be tested for strep bacteria.
After swabbing your throat, a HCP will do a rapid strep test. This test can detect strep bacteria within minutes. If the test is positive, a HCP will prescribe treatment right away. If the test is negative, a sample will be sent to a lab for more testing, because rapid strep tests may miss some strep infections.
What is the treatment for strep throat?
If you’ve tested positive for strep throat, a HCP will give you a prescription for antibiotics (usually penicillin or amoxicillin, unless you’re allergic). The medicine will help lessen your symptoms and lower the chance of any complications. You can return to school and work after you have no fever and have been on the medicine for 24 hours.
Even though you will start feeling better within a day or two of starting the antibiotics, it’s extremely important that you take ALL of the medicine the HCP prescribed for you. If you stop taking the medicine early, the strep could come back. If you aren’t getting better after taking antibiotics for 48 hours, you should contact your PCP.
Other things you can do to feel better when you have strep throat include:
- Drink lots of fluids – cool liquids such as water and ginger ale can help. Sucking on an ice pop and drinking warm liquid, such as soup and decaffeinated tea, are good too.
- Rest – take naps and go to bed early
- Gargle with salt water but don’t swallow
- Try throat lozenges
- Take acetaminophen or ibuprofen. Ask your primary care provider how much you should take.
Is there anything I can do to prevent getting strep throat?
Yes. Avoid being around anyone who has strep. If you’re living with someone who has a strep infection, wash your hands often, and don’t share drinking glasses, eating utensils, or toothbrushes.
It’s also important to prevent re-infecting yourself. If you have strep, make sure to get a new toothbrush. Buy a new toothbrush (throw the old one away) after 2-3 days on antibiotics to lower your risk of re-infection. Otherwise, the bacteria can live in the toothbrush and make you sick again once you’ve finished your medicine.
Our health guides are developed through a systematic, rigorous process to ensure accuracy, reliability, and trustworthiness. Written and reviewed by experienced healthcare clinicians from Boston Children's Hospital, a Harvard Medical School teaching hospital and consistently ranked as a top hospital by Newsweek and U.S. News & World Report, these guides combine clinical expertise, specialized knowledge, and evidence-based medicine. We also incorporate research and best practices from authoritative sources such as the CDC, NIH, PubMed, top medical journals, and UpToDate.com. Clinical specialists and subject matter experts review and edit each guide, reinforcing our commitment to high-quality, factual, scientifically accurate health information for young people.