Strep Throat

This infection of the upper respiratory tract is caused by bacteria of the Streptococcus family. Though streptococci are the most common bacterial causes of repiratory infections, strep infections are much less common than viral respiratory infections (colds), which may have similar symptoms. Strep throat is most common in winter and spring. Children with strep throat also may develop a skin rash known as scarlet fever.

HOW DOES STREP THROAT DEVELOP?
Strep bacteria spread from person to person in droplets expelled during coughing and sneezing. Usually, however, close contact, such as sharing eating utensils or playing face-to-face, is needed for the bacteria to spread. Outbreaks of strep throat can occur in communities, day care centers, schools and families.

WHEN SHOULD I SUSPECT THAT MY CHILD HAS STREP THROAT?
Symptoms of strep throat include fever, sore throat, severe pain on swallowing, tender and swollen lymph glands in the neck, malaise and nausea. The throat and soft palate are red, swollen and frequently coated with a yellowish-white material. There is usually no cough. Fever typically lasts for one to three days, and sore throat persists for approximately five days.

Strep throat often resembles viral and other illnesses and is not always easy to recognize. Some children develop all characteristic signs of strep throat, but others may have only fever or only a mild sore throat. Children under four years of age can have a runny nose, which is sometimes the only symptom. You should strongly suspect strep throat if the child's fever rises suddenly and the throat becomes sore within several hours after the first symptoms develop.

IS MEDICAL ATTENTION NECESSARY
Yes. It is necessary to consult a doctor, mainly because strep throat, if left untreated, can lead to serious complications, including sinusitis, otitis media and rheumatic fever.

HOW CAN THE PEDIATRICAN TELL IF MY CHILD HAS STREP THROAT?
Strep throat can have a dramatic appearance with swollen tonsils covered with white pus. Equally likely, however, the physical finds will be minimal or subtle. Any time a child has a sore throat, the doctor checks for strep throat by taking a throat culture, which entails swabbing some material from the back of the throat and placing it in a culture medium. Within 24 hours, signs of the growth of strep bacteria on the culture plate should be detectable. Although quicker tests for strep are available, many doctors prefer the traditional method because it is more accurate.

WHAT TREATMENTS ARE AVAILABLE?
Treatment is usually not begun until culture results are available. Penicillin is the most commonly prescribed treatment for strep, although alternative medications are available for children who are allergic to penicillin. Oral antibiotics usually must be taken for ten days to eradicate all the infectious organisms.

PREVENTING STREP THROAT

• Discourage children from sharing eating utensils with siblings and classmates.

• Keep a child with strep throat out of day care, preschool or school for a full 24 hours after starting antibiotics.

CARING FOR A CHILD WITH STREP THROAT

• Encourage bed rest until fever subsides.

• Give children's acetaminophen (Tylenol, Panadol, Tempra, Datril and other brands) to reduce fever.

• Do not force the child to eat, because swallowing may be painful. Do, however, provide soft drinks, popsicles and clear soups.

• Give antibiotics for as long as the doctor prescribed, even after symptoms disappear, because the goal of the medication is to prevent complications.

GETTING HELP
Call your doctor if:

• Your child complains of a severe sore throat.

• Your child develops a sudden fever.

• Your child's throat looks extremely red or is coverd with streaks of puslike material.

Excerpt from THE DISNEY ENCYCLOPEDIA OF BABY & CHILD CARE, © 1995 DSH Communications, Inc. This material is based on current medical research and, to the best of the editors' knowledge and understanding, is accurate and valid. However the reader should not use information contained in this material to alter a medically prescribed regimen or as a form of self-treatment, without seeking the advice of a licensed physician.