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What to know about strep throat in children

Cases of group A streptococcus, also known as strep throat, have been on the rise in Illinois. While this bacterial infection is most common in children during winter and early spring, people of all ages can contract strep throat at any time.

Dr. Ami Patel, Lurie Children's Infectious Diseases physician, shares information about how strep throat can present in children and what parents and caregivers can do to help.

In general, strep throat is a mild infection. The most common signs and symptoms can include:

• Sore throat/throat pain, which can start very quickly.

• Pain when swallowing.

• Fever.

• Red and swollen tonsils which can sometimes have white patches or streaks of pus.

• Red spots on the roof of your mouth.

Additional symptoms might include headache, body aches or generally not feeling well, rash, abdominal pain, and nausea or vomiting, especially in younger children. While a strep throat infection typically makes your throat feel sore, not all sore throats are strep throat. There are many causes of sore throat and often children have this symptom because of a virus.

"Symptoms such as a cough, runny nose or conjunctivitis (pink eye) suggest a viral cause rather than strep throat/group A streptococcus," said Patel. "If a child has a sore throat or symptoms of strep throat, it's important to contact a doctor to determine if testing and treatment for strep throat are needed."

Patel notes testing can usually be done in the doctor's office and involves a simple swab of the throat. If a child has been diagnosed with strep throat and starts treatment, families should also contact a doctor if their symptoms do not begin to improve within a couple days of starting treatment.

When it comes to treatment, antibiotics are used for treatment of strep throat and can decrease how long someone is sick with strep throat, lessen the symptoms, prevent bacteria from spreading to others and prevent complications.

"Within 24 hours of starting antibiotics for strep throat, children should start feeling better and will no longer be contagious," said Patel. "However, it's important to complete the entire course of antibiotics prescribed by your doctor even if your child is feeling better."

It's important to remember that not everyone with a sore throat needs antibiotics. This is true if the sore throat is caused by a viral infection and not the group A streptococcus bacteria. Families should contact their doctor if their child has symptoms of strep throat to determine what the best course of action is. It can typically take two to five days for someone exposed to the group A streptococcus bacteria to become ill with strep throat. With proper diagnosis and treatment, most children are feeling better and can return to school and activities within a few days.

Patel suggests you shouldn't wait for strep throat to go away on its own. If untreated, strep throat can cause complications as described below. Therefore, prompt testing and treatment are important as antibiotic treatment reduces the risk of serious complications.

While serious complications of strep throat and the group A streptococcus bacteria are rare, complications can occur after a strep throat infection if the bacteria spread to other parts of the body. Quick intervention and treatment can help reduce this risk.

Complications of strep throat or the group A streptococcus bacteria include:

• Ear infection.

• Sinus infection.

• Abscesses of the tonsils or neck.

• Rheumatic fever.

• Post-streptococcal glomerulonephritis.

• Invasive infections such as blood stream infections, toxic shock syndrome, and other severe infections.

Strep throat is also highly contagious, Patel says, and therefore people who have the infection should be conscious about interactions with others.

"The bacteria can spread from person to person through respiratory droplets, secretions or saliva. People who are infected can spread the bacteria by talking, coughing or sneezing, which creates respiratory droplets that contain the bacteria, or through shared food and drinks," said Patel. "Other people can get the infection if they breath in the droplets, touch something that contains the droplets and then touch their mouth or nose or share personal items such as utensils or drink containers."

That said, the best way to protect against spreading streptococcal bacteria and to decrease risk of strep infection is to wash your hands often, especially after coughing or sneezing, cover your mouth when coughing or sneezing, and avoid sharing personal items such as eating utensils or drinking glasses.

Patel advises that children with strep throat should stay home from school, day care or activities until they no longer have a fever and have taken antibiotics for at least 12 hours.

• Children's health is a continuing series. This week's article is courtesy of Ann & Robert H. Lurie Children's Hospital of Chicago. For more information, visit www.LurieChildrens.org.

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