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Recognizing signs of strep throat versus sore throats caused by viruses is key for early diagnosis and treatment.

Having strep throat does mean having a sore throat. But not every sore throat is strep throat. People often get sore throats due to a virus, but strep is different because it’s caused by a bacterial infection in the throat and tonsils. It gets its name from the type of bacteria that causes it: group A Streptococcus, or group A strep.

Anyone can get strep throat, but it’s more common in children, especially those between 5 and 15 years old. And it’s more prevalent during the colder months when people spend more time together indoors and in close contact, especially in schools and daycare centers. 

“While it can look different from person to person, recognizing strep symptoms is key for early diagnosis and treatment,” says Kevin Ly, MD, a family medicine provider at Geisinger. “Strep will not go away on its own. But with proper treatment, it should resolve in seven to 10 days.” 

Signs of strep throat

If you or your child have been exposed to strep throat, it can take two to five days for symptoms to develop.  

While strep throat is a mild illness in most cases, it can be very painful. A severe and persistent sore throat that comes on suddenly and looks red is a telltale sign of strep. 

Other common symptoms of strep throat include:

  • Body aches and fever of 101° F or higher
  • Painful swallowing
  • Red, swollen tonsils
  • White patches or streaks of pus on the tonsils
  • Tiny red spots on the roof of the mouth (called petechiae)
  • Painful, swollen lymph nodes in the neck
  • Fatigue and general ill feeling

Sometimes, strep throat can cause headaches, stomach pain, nausea and vomiting. Some people also develop a rash, known as scarlet fever. It typically appears on the neck and chest first, then can spread to other parts of the body. 

“If you have a cough, runny nose and congestion, a virus or allergies are likely causing the discomfort — not strep,” says Dr. Ly. “Symptoms of strep throat do not include those of the common cold.”

Is strep throat contagious?

Strep throat is highly contagious and spreads through close contact with others. When an infected person coughs, sneezes or even talks, tiny respiratory droplets that contain the bacteria are released into the air. You can be infected if you breathe in those droplets — or transfer them to your nose or mouth by kissing, sharing cups or utensils or eating from the same plate as a person who’s infected. 

“Even if you don’t exhibit any symptoms, you can still be contagious,” says Dr. Ly. “However, people who are sick with strep are more contagious than those who don’t have any symptoms.”

Fortunately, once you’ve been treated with antibiotics for 24 to 48 hours, you’re no longer contagious.  

Strep throat treatment

Because strep throat is a bacterial infection, antibiotics are the standard treatment to kill the bacteria causing it, which eases symptoms, controls spread and prevents complications. Typically, doctors prescribe penicillin or amoxicillin in pill or liquid form for 10 days, but you should start to feel better after a day or two on the antibiotics. 

You or your child can return to work, school or daycare once you no longer have a fever and have taken antibiotics for at least 12 to 24 hours. Just be sure to take all the medicine as prescribed, even if you start to feel better. Stopping treatment early can cause symptoms to return or lead to dangerous complications. 

“Strep throat requires treatment, so if your sore throat does not improve after a few days, it’s best to see a doctor to confirm a diagnosis with a throat swab test,” says Dr. Ly. “It’s the only sure way to tell strep from viruses that cause a sore throat.” 

While rare, untreated strep throat can cause rheumatic fever, a serious complication that can cause swelling and damage the heart, joints and brain.  

Strep throat prevention

Unfortunately, having had strep throat before doesn’t protect you from getting it again in the future. The good news: You can help protect yourself and your family from infection (or reinfection) with strep throat.  

Preventive measures include:

  • Washing your hands often with soap and water for at least 20 seconds to help keep germs from spreading. If a sink isn’t available, alcohol-based sanitizer is the next best thing. 
  • Covering your mouth and nose with a tissue when you cough or sneeze, and then throwing it in the trash. 
  • Avoiding sharing cups, plates and utensils with anyone who is sick.
  • Regularly cleaning and disinfecting surfaces that are frequently touched in your home, such as doorknobs, countertops and shared items. 
  • Replacing your toothbrush once you’ve been on antibiotics for strep throat for two to three days.
  • Keeping your immune system strong by getting enough rest, maintaining a healthy diet and exercising regularly.

“If repeated cases of strep throat occur in your family, talk to your provider,” says Dr. Ly. “Someone in the household could be a strep carrier, where the bacteria lives in their throat, but it’s not making them sick. Treating it may prevent repeated cases.”

Next steps: 

Learn about primary care at Geisinger
Sore throat from a cold or flu? Here are the remedies that work
These six foods can help boost your immune system

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