What to know about strep throat in kids

When a child's throat is sore, families often wonder — could it be strep throat? This bacterial infection is common in children and needs treatment to avoid complications. Nazima Zakhidova, M.D., Pediatrician at Children's Health℠, shares answers to common questions about strep throat in kids and when families should see their doctor.

What is strep throat?

Strep throat is an infection caused by bacteria called Streptococcus pyogenes. It is the most common bacterial throat infection in children and typically affects children from 3 to 15 years old. Older teens and adults can get strep throat too, but it is much less common. Strep throat is rare in children under 3.

What are common signs and symptoms of strep throat?

What does strep throat look like? Common symptoms of strep throat in kids include:

• Sore throat

• Headache

• Fever above 100.4˚F

• Stomachache and vomiting

• Red, enlarged tonsils

• White spots on the tonsils

• Red dots on the roof of the mouth

• Lymph nodes that are swollen and/or painful

"A sore throat and fever will typically come on quickly with strep," Dr. Zakhidova says. "Stomachache and vomiting are more common in kids 10 and under. Cold symptoms like congestion, cough and runny nose are not common. Typically, if a child is coughing a lot we are less likely to think strep."

Is strep throat contagious?

Yes, strep throat is very contagious. Kids can get strep throat from being very close to other kids, from sharing drinks or coming into contact with saliva or nasal secretions from someone who has strep. Kids are generally no longer contagious after taking antibiotics for 24 hours and can return to school.

Families can help reduce the spread of strep throat by:

• Frequent handwashing

• Not sharing drinks

• Staying home and avoiding close contact with others when you are sick

• Taking your child to the doctor if you think they may have strep

Taking a few easy steps after your child has recovered can also help reduce the spread of strep throat.

"I always remind families to change out toothbrushes after 48 hours of antibiotics." Dr. Zakhidova says. "Bacteria can stay on surfaces, so it's important to sterilize anything that goes in the mouth, including mouthguards or water bottles."

How is strep throat diagnosed?

Strep throat is diagnosed with a throat swab. A health care provider will use a long Q-tip to get a small sample from the back of your child's throat and then test the sample for the bacteria that causes strep. The swab does not hurt, but it may be briefly uncomfortable.

"It's important to confirm that a child has strep before starting treatment because not all sore throats need antibiotics and we don't want to use them when a child doesn't need them," Dr. Zakhidova says.

What is the difference between strep and a sore throat?

Strep throat is a specific type of bacterial infection. A sore throat is a more general term for any kind of pain, scratching or irritation in the throat.

"Strep specifically refers to one kind of infection, but a sore throat can happen for many reasons," Dr. Zakhidova says. "COVID‑19, flu, or other viruses can cause that. So can allergies, air pollution and lots of talking or yelling. We've even had kids with strep and flu or COVID‑19 at the same time, though it's not common."

The amount of pain a child describes is not generally the best way to tell if your child has strep throat or a sore throat.

"We see some kids who have a very sore throat from a lot of coughing and others who show up with strep saying their throat kind of hurts but their stomach hurts more," she says. "Kids also have different pain tolerances."

How is strep throat treated?

Strep throat is typically treated with oral antibiotics for 10 days. It's important for children to get treatment for strep throat to prevent spreading it to other people and to avoid complications.

"Untreated strep can lead to complications such as acute rheumatic fever and kidney inflammation," Dr. Zakhidova says.

When should your child see a doctor for strep throat?

Dr. Zakhidova recommends calling the doctor if your child has a fever above 100.4 that comes on quickly, along with a sore throat and headache.

"You don't necessarily have to come right away — kids get fevers for many reasons and often get better with rest and fluids," Dr. Zakhidova says. "But if they have a fever for three days or more, definitely bring them in. It's also based on the parents' comfort level and we're happy to see your child at any point."

Learn more

Children's Health is here to support all of your child's health needs. We provide expert Primary Care as well as specialty care through our comprehensive Ear, Nose and Throat (ENT) program. Learn more and find a doctor.