STREP THROAT Part 1: what is it, who gets it, and why do we care about it?

You just got the call from the school nurse, who tells you: “I have your child here with me and she has a sore throat. I think you need to take her to the doctor to see if it’s strep throat.”

What exactly IS Strep Throat?

Strep throat is a throat infection caused by Group A streptococcus bacteria. Symptoms can include sore throat, fever, pain with swallowing, enlarged lymph nodes (glands) in the neck, headache, belly pain, vomiting, and rash. Not all symptoms are present in all kids with strep throat.

Symptoms do NOT include cough, profuse runny nose, or diarrhea. Only about 15 percent of all kids coming to our offices with a main concern of “sore throat” are going to actually have strep throat. That means that MOST kids with sore throats will turn out to have something other than strep throat, usually some form of virus causing pain or post-nasal drip.

Who gets Strep Throat?

The most common age for kids to get strep throat is between ages 5 to 12 years old. For some reason, kids younger than 3 years are not as prone to strep throat. Also strep throat is seen less often in adults than school aged kids.  Some children appear really ill with strep throat and other kids just have a bad sore throat, but with pain medicine can look quite well.

So why do we care about strep throat?

Most children’s immune systems are really good at fighting the strep germ off and in fact most kids will get better from strep throat even if they are not treated. However, some kids’ immune systems get a little haywire when fighting the strep germ, and in addition to making antibodies (germ-fighting cells) to fight the strep, they make antibodies against their own heart valves (immune system gets confused) which causes rheumatic fever. It has been shown that treating strep throat with antibiotics shortens the duration of strep throat only by about one day, but more importantly prevents the body from making the wrong kind of immune cells, or antibodies, against the heart valves thus lowering the risk of rheumatic heart disease.

Strep throat can also lead to other complications such as scarlet fever (strep throat plus sandpaper-feeling rash on the skin), peritonsilar abscesses (pus pocket in the tonsils) and kidney inflammation (first symptom can be cola-colored urine).

Stay tuned for Part 2 about Strep Throat: how it is diagnosed and treated.

Julie Kardos, MD
© 2010 Two Peds in a Pod      

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