Q: My child complains his throat hurts. Does she have strep throat?
A: Sore throat is a common childhood complaint, especially during the fall and winter cough and cold season. The question though: is it a viral illness or is it strep?
A viral illness causing sore throat typically has a slower onset, lower fevers and is often accompanied by other symptoms typical of a viral cause such as cough, nasal congestion and runny or stuffy nose.
Strep throat, by contrast, often has quick onset of a sore throat with difficulty and pain with swallowing, higher fevers and often, swollen tonsils and lymph nodes in the neck. Fever typically is higher than 101 and other associated symptoms such as headache, stomach ache, vomiting and skin rash may also be present.
Your doctor may diagnose strep clinically by examining your child but, oftentimes, a strep swab will be done to determine whether strep is in the back of the throat. A rapid strep swab will give a quick answer in the office within 5 minutes or so. This test is usually relatively reliable but, if negative, a follow-up test can be sent to confirm whether strep is present or not.
Should either test be positive, your child will need to be treated with an appropriate antibiotic to get rid of the strep. Be sure to take the entire treatment course as prescribed. Good hygiene and hand washing is important to prevent transmission to others. Make sure family members aren’t sharing or drinking from the same glasses, water bottles, etc. Avoid school, daycare and contact with other children until your child has completed the initial 24-48 hours of antibiotic treatment. Change over to a new toothbrush after three days of treatment so as not to keep re-exposing with the streppy toothbrush.
Your child’s symptoms should begin to improve after the initial 24-48 hours of antibiotic.. If she has persistent or worsening symptoms, return to visit or call back to your doctor. Should your child develop a pattern of frequent or recurrent strep throat episodes, your doctor may refer you to an ENT (ear/nose/throat) specialist to determine whether a tonsillectomy may be an option to consider.
By Michael Jakubowski, MD, pediatrician at ThedaCare Physicians-Pediatrics in Appleton.