Strep throat

Strep throat is a sore throat that is caused by a bacteria called Streptococcus. Strep throat is contagious and can be spread by breathing in droplets from an infected person's coughs and sneezes. It can also be spread through shared food or drinks. 

Symptoms of strep throat can include:

• a painful or scratchy throat, especially when you swallow
• difficulty swallowing
• redness at the back of your mouth
• fever
• bad breath
• the glands in your neck are swollen
• your tonsils are large and covered in white stuff
• headache
• stomach pain
• nausea and vomiting
• sometimes, you may also have a skin rash along with fever and sore throat, this condition is known as scarlet fever.

It's very difficult to tell the difference between a viral sore throat and strep throat. Every time your child has a sore throat take them to get their throat checked straight away. This could be by your doctor or nurse or at a school clinic. 

Don’t wait to see if your child’s throat gets better. ‘Strep throat’ needs to be treated immediately. Treating sore throats early can stop rheumatic fever from developing. 

Ask your children to tell you when they have a sore throat so they can be checked. Your child may get a lot of sore throats but you need to get it checked every time and straight away.

Video: Checking sore throats to prevent rheumatic fever

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Video source: KidsHealth(external link). Copyright Kylie Sullivan 2017. Licensed under a Creative Commons Attribution-ShareAlike 3.0 Unported License. 

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.

Strep infection is diagnosed by doing a throat swab.

The treatment of strep throat depends on your risk of getting rheumatic fever. If you are at low risk, treatment is aimed at self-care to ease the pain and the infection will get better on its own in a few days. However, some people will also need antibiotic medicine.

Self-care

• Suck a teaspoon of honey (not safe for children under one year) or gargle salt water.
• Adults can try using a gargle, throat spray or pain-relief (anaesthetic) lozenges. These are not suitable for children. 
• Take paracetamol – check doses carefully and ask your doctor or pharmacist whether it is safe for you. 

Antibiotic medicine

If you have a higher risk of getting rheumatic fever, or if you have a high risk of spreading the bacteria, eg, you are a healthcare worker, residential care worker, food handler, teacher, childcare worker or student, treatment with antibiotics may be started as soon a throat swab is done.

• Antibiotics (penicillin or amoxicillin) are normally given for 10 days. You should finish the full course to make sure the strep throat does not cause rheumatic fever.
• A one-off antibiotic injection to treat a strep throat might be a good alternative for children if you think they may find it hard to take the full 10-day course of capsules or liquid.
• Keep children away from school or early childhood centres for at least 24 hours after they start antibiotics, to reduce the risk of spreading the strep bacteria. 

Do the following to help stop infections spreading or coming back:

• Cover your mouth and nose with a tissue when you sneeze or cough.
• Avoid close physical contact such as kissing when you are sick, and don’t share eating or drinking utensils (eg, cups or knives and forks).
• Try to create space between your children when they sleep, to limit the chance of germs being spread through coughs and sneezes.