Strep Throat
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Older Adults

Strep Throat

Strep throat is a throat infection caused by a bacteria called group A Streptococcus (group A strep). The bacteria live in the nose and throat. Strep throat  spreads easily from person to person through airborne droplets when an infected person coughs, sneezes, or talks. Good hand washing is important to help prevent the spread of this illness. Children diagnosed with strep throat should not attend school or daycare until they have been taking antibiotics and had no fever for 24 hours.

Strep throat mainly affects school-aged children between 5 and 15 years of age, but can affect adults too. When it isn't treated, it can lead to serious problems including rheumatic fever (an inflammation of the joints and heart). Even with treatment, there can be rare but serious problems after strep, such as inflammation in the kidneys.

Doctor looking at girl's throat

How is strep throat spread?

Strep throat can be easily spread from an infected person's saliva by:

  • Drinking and eating after them

  • Sharing a straw, cup, toothbrushes, and eating utensils

When to go to the emergency room (ER)

Call 911 if your child has: 

  • Shortness of breath

  • Trouble breathing or swallowing.

  • Unable to talk

  • Feeling of doom

Call your healthcare provider about other symptoms of strep throat, such as:

  • Throat pain, especially when swallowing

  • Red, swollen tonsils

  • Swollen lymph glands

  • A skin rash, called scarlet fever

  • Stomachache; sometimes, vomiting in younger children

  • Pus in the back of the throat

What to expect at your visit

  • Your child will be examined and the healthcare provider will ask about his or her health history.

  • The child's tonsils will be examined. A sample of fluid may be taken from the back of the throat using a soft swab. The sample can be checked right away for the bacteria that cause strep throat. Another sample may also be sent to a lab for a culture that is more accurate testing.

  • If your child has strep throat, the healthcare provider will prescribe an antibiotic. It will kill the strep bacteria. Be sure your child takes all the medicine, even if he or she starts to feel better. Antibiotics will not help a viral throat infection.

  • If swallowing is very painful, pain medicine may also be prescribed.

When to call your child's healthcare provider

Call your healthcare provider if your otherwise healthy child has finished the treatment for strep throat and has:

  • Joint pain or swelling

  • Signs of dehydration (no tears when crying and not urinating for more than 8 hours)

  • Ear pain or pressure

  • Headaches

  • Rash

  • Fever (see Fever and children, below)

Fever and children

Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.

For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.

Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.

Infant under 3 months old:

  • Ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider

  • Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider

Child age 3 to 36 months:

  • Rectal, forehead (temporal artery), or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider

  • Armpit temperature of 101°F (38.3°C) or higher, or as directed by the provider

Child of any age:

  • Repeated temperature of 104°F (40°C) or higher, or as directed by the provider

  • Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.

Easing strep throat symptoms

These tips can help ease your child's symptoms:

  • Offer easy-to-swallow foods, such as soup, applesauce, popsicles, cold drinks, milk shakes, and yogurt.

  • Provide a soft diet and don't give spicy or acidic foods.

  • Use a cool-mist humidifier in the child's bedroom.

  • Gargle with saltwater (for older children and adults only). Mix 1/4 teaspoon salt in 1 cup (8 oz) of warm water.

Online Medical Reviewer: Ashutosh Kacker MD
Online Medical Reviewer: Daphne Pierce-Smith RN MSN CCRC
Online Medical Reviewer: John Hanrahan MD
Date Last Reviewed: 7/1/2019
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