Sore throat

Also called pharyngitis

Sore throats can be painful and cause discomfort when you swallow.

COVID-19 pandemic

If you have any respiratory symptoms such as a cough, sore throat, shortness of breath, head cold or loss of smell, with or without fever, call your GP or Healthline's dedicated COVID-19 number 0800 358 5453 to check whether you need to be tested for COVID-19.

Key points about sore throats

  1. Having a sore throat is very common, especially in children (see sore throat in children). The discomfort can range from a scratchy feeling to severe pain.
  2. A sore throat can be caused by a viral infection such as a cold or the flu or a bacterial infection, most commonly Streptococcus (often known as 'strep throat').
  3. If you are at higher risk of rheumatic fever, you need to have any sore throat checked by a nurse or GP. This is because untreated strep throat can cause rheumatic fever and heart damage for life.
  4. If you are at higher risk of rheumatic fever and you have strep throat you will be prescribed a course of antibiotics.  
  5. If you are not at higher risk of rheumatic fever, antibiotics are usually not required or helpful for a sore throat.

Seek immediate medical help if you:

  • have difficulty breathing, eg, struggling for each breath or making a grunting noise with each breath
  • have great difficulty swallowing
  • develop a skin rash
  • are not able to drink much or shows signs of dehydration (very dry mouth, no urine for more than 8 hours, confused and drowsy)
  • develop a fever (high temperature)
  • have severe pain at the back of your throat 
  • have any other symptoms that appear life threatening.

Call Healthline 0800 611 116 if you are unsure what to do.

Māori and Pasifika children are most at risk of developing rheumatic fever and should see a doctor or nurse if they show ANY sign of sore throat.

What causes a sore throat?

Around 90% of sore throats are caused by viral infections such as the common cold or flu. Viral sore throats usually get better by themselves within a week. Antibiotics do not fix viral sore throats.  

Some sore throats are caused by bacteria, most commonly Streptococcus (often known as 'strep throat'). Children and young people at risk of rheumatic fever require treatment with antibiotics for 10 days to prevent rheumatic fever. Read more about strep throat

Other conditions that can cause a sore throat include:

What are the symptoms of a sore throat?

The main symptoms of a sore throat are:

  • a painful or scratchy throat, especially when you swallow
  • difficulty swallowing
  • redness at the back of your mouth
  • bad breath
  • cold and flu symptoms such as a cough, hoarseness, red eyes and runny nose (usually not seen with strep throat).
  • the glands in your neck are swollen
  • your tonsils are large and covered in white stuff.

It is not possible to be sure from symptoms whether a sore throat is caused by a virus or bacteria. This is why people at higher risk of rheumatic fever should always get a throat swab done. See diagnosis and treatment of strep throat.

When to see your doctor about a sore throat

People at higher risk of rheumatic fever

For people at higher risk of rheumatic fever, it is very important that a sore throat is always checked early by a nurse or GP. This is because untreated strep throat can cause rheumatic fever and heart damage for life.

You are at higher risk of rheumatic fever if:

  • you have had rheumatic fever before
  • someone in your family or household has had rheumatic fever.

Or if you have 2 or more of the following:

  • Māori or Pasifika ethnicity
  • Aged 3–35 years
  • Live in poorer or crowded living conditions.

Everyone else

If you are not high risk for rheumatic fever, you should see your GP or nurse if your symptoms are not improving after 48 hours, or if you:

  • have neck stiffness or ear pain
  • have swollen glands (feel for tender lumps in your neck) that are getting bigger
  • have any other symptoms you are concerned about.

Seek immediate medical help if you:

  • have difficulty breathing, eg, struggling for each breath or making a grunting noise with each breath
  • have great difficulty swallowing
  • develop a skin rash
  • are not able to drink much or shows signs of dehydration (very dry mouth, no urine for more than 8 hours, confused and drowsy)
  • develop a fever (high temperature)
  • have severe pain at the back of your throat 
  • have any other symptoms that appear life threatening.

Call Healthline 0800 611 116 if you are unsure what to do.

How are the causes of a sore throat diagnosed?

Your doctor will ask questions about your symptoms and look in your mouth. They may take a throat swab to test for Streptococcus if you are at high risk of rheumatic fever or are at risk of spreading a strep throat infection, eg, you are a:

  • healthcare worker
  • residential care worker
  • food handler
  • teacher
  • childcare worker
  • student.

If glandular fever is suspected you may need to have a blood test.

How is a sore throat treated?

The treatment of a sore throat depends on the cause. A sore throat that is caused by a viral infection is usually treated by self-care measures such as:

  • pain relief medicines
  • drinking more fluids
  • eating soft foods
  • trying ice blocks 
  • honey and lemon juice.

Antibiotics won't help a sore throat that is caused by a viral infection. Read more about what can I do to ease a sore throat

If you have a sore throat that is caused by Streptococcus or strep throat and you are at high risk of rheumatic fever, antibiotics will be given. Antibiotics may also be given if you are at risk of spreading a strep throat infection, eg, if you are a:

  • healthcare worker
  • residential care worker
  • food handler
  • teacher
  • childcare worker
  • student.

The course of the antibiotics is usually for 10 days, and it is important that you or your child complete the full 10 days of antibiotics, even if you or your child start to  feel better. This helps to stop strep throat from turning into rheumatic fever. Antibiotics can be given in a form of a capsule, liquid or as an injection. 

What can I do to ease a sore throat?

To help soothe a sore throat you can:

  • drink plenty of cool or warm water or diluted juice
  • eat cool, soft food or warm soups
  • older children and adults may be able to gargle with warm salt water
  • suck on ice cubes
  • avoid smoking or smoky places
  • rest as much as you can
  • suck medicated throat lozenges (not for children)
  • take pain relief medication such as paracetamol or ibuprofen.

Learn more

Sore throat  Ministry of Health, NZ
Rheumatic fever prevention programme Ministry of Health, NZ
Sore throat in children KidsHealth NZ
It starts with a sore throat East Bays Courier, Auckland
NZ children get better start to life  NZ Government Press Release
Budget 2013: Additional $21.3m to fight rheumatic fever  NZ Government Press Release
Cough, colds and sore throats – manage symptoms without antibiotics Choosing Wisely, NZ

References

  1. Sore throat Auckland Regional HealthPathways, NZ, 2020
  2. Sore throat  Ministry of Health, NZ
Credits: Health Navigator Editorial Team. Reviewed By: Dr Christine McIntosh BSc,MBChB, Dip. Paed. Dip. O&G, FRNZCGP Last reviewed: 11 Mar 2019