Sore Throats and Strep
Viruses (as seen in colds), which can occur year round, cause most sore throats. Allergies, poor nasal function, air pollutants, or acid reflux can also cause sore throats. Viruses are easily transmitted by direct contact with contaminated surfaces and can survive for hours on hands, toys and other surfaces. Despite precautions, children, especially the younger ones, often catch as many as five to ten respiratory infections each year. This is due to a youngster’s lack of previous exposure to the several hundred strains of viruses that exist. Unfortunately, cold and flu viruses do not respond to antibiotics; prevention measures such as frequent handwashing, good nutrition/hydration, and plenty of sleep are often most effective.
For children between the ages of two and eighteen, there is a greater tendency to develop “strep throat.” This is caused by the contagious streptococcus bacteria, which can be dangerous because of the problems that can result from this infection. Complications such as scarlet fever, rheumatic fever and, rarely, kidney disease, can be the result. Symptoms usually begin 2-4 days after contact, and the degree of illness can vary from child to child. One child may have low fever (101-102° for a day or two), recover spontaneously and suffer no complications. Another child, however, may have 104-105°, be severely ill, and suffer serious complications. Hence, prompt medical care and attention is vital to full recovery.
How to Tell?
Even though there is a somewhat characteristic appearance to strep throat, you can’t always tell by looking. You can suspect strep if (1) the tonsils are beefy red, (2) the uvula is red and swollen (the fleshy part at the back of the throat that hangs down like a raindrop), and (3) there are big lymph nodes in the neck and under the chin. The child may also talk as if he or she has a hot potato in the back of the throat. Interestingly, symptoms that tend not to be associated with strep throat are: stuffy nose, cough, and laryngitis. (These suggest another cause such as a cold or allergy). The only certain way to diagnose strep throat is with a throat culture.
It is best to contact your pediatrician if the following applies:
ü There is a fever over 101.5°
ü The onset of sore throat is rapid.
ü The sore throat persists beyond one or two days.
Contact physician if:
ü A rash appears with the sore throat, especially one that looks like sand paper or “goose bumps” along with the appearance of “strawberry tongue” (signs of scarlet fever).
ü Complaints of belly pain (indicating that the lymph nodes in the abdomen are swollen).
ü Recent contact with another child who was diagnosed with strep throat or the skin infection, impetigo.
ü Pus or greenish-yellow discharge seen in the back of the throat.
ü Large, rubbery lymph nodes in the neck region.
ü “Petechiae,” tiny red dots (hemorrhages) surrounding the tonsils and extending on the palate. Also, small white dots or patches may be visible on the palate or tonsils.
Medical treatment is penicillin (or erythromycin for those who are allergic to penicillin). It is important to finish the entire course of medication, even if your child feels better. This will help ensure that the medication has time to kill all the attacking organisms down to the very last “bug”! In addition to antibiotic treatment, you can try home remedies: salt water gargles, honey or lemon in tea, and acetaminophen or ibuprofen for pain and fever.
Special note: Remember to replace toothbrushes after this or any other illness.
RETURN TO SCHOOL AFTER STREP THROAT:
Your child should not return to school until at least 24 hours after medication has started, and in accordance with your doctor’s orders; this is also a Health Department requirement.
Thank you for the wonderful privilege of caring for your child. Please contact me if I may assist in any way whatsoever.