Strep throat, technically called streptococcal pharyngitis, is a common illness caused by the bacteria Streptococcus pyogenes, or Group A Streptococcus (GAS). While people of all ages can contract it, children are the population most frequently affected. Strep throat accounts for a significant percentage of sore throat cases in children and requires specific medical attention.
Understanding Transmission and Age Susceptibility
The bacteria are highly contagious and spread easily through respiratory droplets when an infected person coughs or sneezes. Transmission also occurs through contact with contaminated surfaces, such as doorknobs or shared utensils, if the bacteria are then transferred to the mouth, nose, or eyes.
Children are particularly susceptible to infection due to environments like schools, daycares, and crowded homes. The typical age range for strep throat is between five and 15 years old. Infections are less common in children under three years of age, and infants and toddlers often present with less typical symptoms compared to older children.
Key Symptoms of Strep Throat in Children
The signs of strep throat in children generally appear suddenly, without the gradual onset characteristic of a common cold. The primary symptom is a rapid-onset sore throat, which makes swallowing painful. A high fever, often reaching 101°F or higher, frequently accompanies the throat pain.
Examination of the throat may reveal red and swollen tonsils, sometimes displaying patches or streaks of white pus. Another specific visual sign is the presence of tiny red spots, known as petechiae, located on the soft or hard palate. Swollen and tender lymph nodes in the neck are also a common physical finding.
Symptoms typically absent in a strep infection help distinguish it from a viral illness. A cough, runny nose, hoarseness, or congestion usually suggests a viral cause rather than a bacterial one. In younger children, the infection may manifest with non-respiratory symptoms, including stomach ache, nausea, or vomiting.
Confirmation and Antibiotic Treatment
If a child presents with classic symptoms, medical confirmation is necessary before starting treatment. The first diagnostic tool is the rapid strep test, which involves a quick throat swab to check for GAS antigens. This test provides results within minutes, allowing for immediate treatment if positive.
If the rapid test is negative, the sample is often sent for a throat culture. A culture is a more sensitive test that involves growing the bacteria in a lab, with results available within one to two days. This backup step ensures that a true infection is not missed, which is a particular concern in this age group.
Strep throat is one of the few common upper respiratory infections that requires an antibiotic prescription, such as penicillin or amoxicillin. Treatment should begin within 48 hours of symptom onset to maximize effectiveness. The medication reduces the severity and duration of symptoms and minimizes the risk of serious complications. A child who has been on an antibiotic for at least 24 hours and is fever-free is considered non-contagious and can return to school or childcare.
The child must complete the full course of antibiotics, typically 10 days, even if symptoms disappear quickly. Stopping the medication prematurely allows some bacteria to survive, which can lead to a recurrence of the infection. Finishing the entire regimen clears the bacteria completely and prevents the development of long-term health issues.
The Importance of Preventing Rare Complications
The main reason for prompt diagnosis and antibiotic treatment is to prevent the development of certain severe conditions that can arise from an untreated GAS infection. These serious, systemic consequences are termed non-suppurative sequelae because they are not caused by the direct spread of pus-forming bacteria. The most concerning of these is Acute Rheumatic Fever (ARF), a condition that can appear several weeks after the initial throat infection.
ARF involves an autoimmune response where the body’s immune system mistakenly attacks its own healthy tissues. This disease can cause joint inflammation, specific skin rashes, neurological symptoms, and potentially permanent damage to the heart valves. Antibiotic treatment started within nine days of the initial infection is highly effective at preventing ARF.
Another complication is Post-Streptococcal Glomerulonephritis (PSGN), which is an inflammation of the tiny filters within the kidneys. PSGN typically occurs one to two weeks after the throat infection and can affect kidney function. Unlike ARF, antibiotic treatment of the initial strep throat infection does not reliably prevent this particular kidney condition. The same bacteria can also cause Scarlet Fever, which is characterized by a distinctive, sandpaper-like rash that develops along with the sore throat.