How can I tell if my child has strep?
You'll need to visit the doctor to be sure, but there are some clues. Tonsils that are swollen, bright red, and flecked with white are the clearest and most common indication of infection by the group A Streptococcus bacteria. A fever above 101 degrees Fahrenheit, chills, and noticeable swelling and soreness of the glands just under the jaw are also warning signs.
© CDC / Dr. Heinz F. Eichenwald
Your child may have difficulty swallowing and complain of a sore throat and a headache. He may also have a stomach ache and vomiting. In some cases, a child will develop a red, sandpaper-like rash all over his body. (This is scarlet fever, and it will go away once the strep infection is treated with antibiotics.)
Babies and toddlers with strep may only have a fever and thickened or bloody nasal discharge. They may also be irritable, lack appetite, and have swollen neck glands. Toddlers may have a stomach ache rather than a sore throat. Babies and toddlers may also get the scarlet fever rash.
Symptoms may be mild or severe. (By the way, your child's sore throat is less likely to be strep if he has cold symptoms, such as a runny nose.)
While most common in late fall, winter, and early spring – and in school-age children and their siblings – strep can show up at any time and at any age.
Does my child need to see a doctor?
Yes, make an appointment if you think your child may have strep. Bacteria cause strep throat, so it's treatable with antibiotics.
When allowed to linger, strep is not only painful but it can cause other problems, like a throat abscess (a pocket of white blood cells, or pus, that may require surgical removal) or (rarely) rheumatic fever.
Rheumatic fever happens when a child's immune system makes antibodies against the strep and these antibodies also attack normal kidney and heart cells. The disease isn't a killer, but it can cause painful joints and damage to the valves of the heart. In fact, kids who've had rheumatic fever can suffer heart problems throughout their lives.
If your child's doctor suspects strep, he'll take a throat culture to be sure. This quick test is easy and painless. Your toddler opens up wide, the doctor swabs the back of the throat – gag! – then it's over.
The doctor can order a "rapid antigen test" to detect bacteria in minutes. But a negative on this speedy test isn't conclusive, so he may want to send the sample to the lab for a culture. These results can take a day or two.
How is strep throat treated?
The doctor will prescribe an antibiotic. It's important that your child take the full course of the prescription. Stopping after a few days – when the symptoms have cleared – can give the remaining bacteria an opportunity to develop resistance to the drug and rally, causing a worse infection. (Read tips on helping the medicine go down.)
How can I make my child feel better?
A cold glass of juice or an ice pop soothes as well as hydrates. If your child is old enough to gargle, warm salt water (use about half a teaspoon of salt per cup of water) may help soothe her throat. So might warm liquids such as broth or tea with honey. (Don't give honey to a baby before her first birthday, however. It can cause a rare form of food poisoning in babies, called infant botulism.)
Pain relievers such as acetaminophen and (if your child is 6 months or older) ibuprofen can take the edge off the soreness as well. Never give your child aspirin, which can increase the risk of Reye's syndrome, a rare but potentially fatal illness.
Running a cool-mist vaporizer or humidifier in your child's room might help soothe her throat, too. (Be sure to follow the manufacturer's directions for keeping it clean. When dirty, the device can spread germs through the air.)
How contagious is it?
Very. Strep is caused by the highly contagious group A Streptococcus bacteria, which is transmitted via airborne droplets. So when a sibling or buddy who's infected sneezes or coughs – or opens a door or plays with a toy – he can pass the bacteria on to your child if your child's in the path of the sneeze or cough – or he touches the doorknob or toy and then touches his mouth or nose. (Symptoms usually show up two to five days after exposure.)
Once you know that your child has strep, keep him at home until his symptoms subside and for at least 24 hours after he starts taking antibiotics.
Most adults are not at high risk for strep, as most have had it before and developed some immunity. But it does happen. Also, adults can spread the bacteria to children even without becoming ill with the bacteria themselves. Wash your hands regularly when caring for a child with strep, and throw used towels and pillowcases into the wash promptly.
By the way, if you're breastfeeding and come down with strep, rest assured that you won't transmit the bacteria to your baby via your breast milk.
Is there any way I can prevent strep?
Not really. Many people carry strep in their throat without developing symptoms, so there's no way to avoid some exposure.
The best you can do is wash your hands – and make sure your child washes her hands, or wash them for her if she's too young to do a good job herself – frequently, especially before eating and preparing food. (It wouldn't hurt to wash up after coming home from daycare or an outing, either.)
Also, if someone in the family has strep, take care not to allow sharing of utensils, water bottles, cups, toothbrushes, or toys. Once the bout with strep is over, it's not a bad idea to replace your child's toothbrush to prevent re-infection. (He'll have some immunity to the bacteria, but it won't be 100 percent.)