Strep throat is a common bacterial infection caused by Group A Streptococcus (GAS) bacteria, primarily affecting the throat and tonsils. While often associated with school-aged children, questions arise about its presence in infants. This article addresses whether one-year-olds can contract strep throat and provides information on recognizing symptoms, diagnosis, treatment, and prevention.
Strep Throat in One-Year-Olds
One-year-olds can get strep throat, though it is less common in this age group compared to children aged 3 years and older, with peak incidence typically between 5 and 15 years. The lower prevalence in infants may be partly due to less exposure in group settings like daycare or maternal antibodies. Despite its rarity, studies indicate that Group A Streptococcus infection in infants is not uncommon; one study found 7.4% of one-year-olds tested positive.
Strep throat spreads easily through respiratory droplets when an infected person coughs, sneezes, or talks. Infants can contract the infection through close contact with infected family members or caregivers, or by touching contaminated surfaces and then their nose or mouth. A one-year-old in frequent contact with a strep carrier (someone with the bacteria but no symptoms) could be at risk.
Recognizing Symptoms in Infants
Identifying strep throat in one-year-olds can be challenging because their symptoms often differ from those seen in older children who complain of a sore throat. Infants cannot verbalize their discomfort, so parents must observe other signs. Instead of a classic sore throat, a one-year-old with strep might exhibit general fussiness, increased irritability, or a persistent fever. A high or consistent fever can be an early indicator.
Other common symptoms include decreased appetite, refusal to feed, nausea, vomiting, abdominal pain, thickened or bloody nasal discharge, or difficulty sleeping. A fine, red, sandpaper-like rash, known as scarlet fever, can also appear on the torso, legs, or arms, which is highly suggestive of strep. Swollen glands in the neck and redness in the throat or tonsils may also be present, though harder to spot in a baby. Symptoms like cough, hoarseness, or a runny nose are more indicative of a viral infection, making diagnosis without medical testing difficult.
Diagnosis and Treatment
Medical consultation is important when strep throat is suspected in a one-year-old. Diagnosis begins with a physical examination and discussion of symptoms. To confirm strep throat, a healthcare provider performs a rapid strep test by swabbing the back of the throat. This test provides results within minutes.
If the rapid test is negative but strep is still suspected (especially in young children where false negatives can occur), a throat culture may be sent for confirmation. Throat cultures are considered the “gold standard” for diagnosis, with results usually taking one to three days. If the test confirms strep throat, antibiotics (such as amoxicillin or penicillin) are the standard treatment for infants. Completing the full course of antibiotics (typically 10 days) is important even if symptoms improve quickly, to fully eradicate the bacteria and prevent complications. An infant is generally no longer contagious after about 12 hours on antibiotics and once their fever has resolved.
Understanding Complications and Prevention
Untreated strep throat in a one-year-old can lead to complications. While rare in children under three, rheumatic fever can affect the heart, joints, brain, and skin, potentially causing permanent heart damage. Another possible complication is post-streptococcal glomerulonephritis, a type of kidney inflammation. Other complications include ear infections, sinus infections, or tonsil abscesses if the bacteria spreads.
Prevention focuses on reducing the spread of the highly contagious bacteria. Frequent and thorough handwashing with soap and water, especially before meals and after coughing or sneezing, is a primary measure. Caregivers should ensure sick individuals cover their mouths when coughing or sneezing, ideally into an elbow or tissue. Avoiding the sharing of eating utensils, cups, and personal items can also help limit transmission. Regularly cleaning and disinfecting frequently touched surfaces can further reduce the risk of infection.