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Sore or strep throat: How to tell the difference


Sore or strep throat: How to tell the difference

Sore throats are common in the winter. Sometimes, they’re caused by viruses such as the cold or flu or even dry air irritating the lining of the throat.
But a sore throat can also be a symptom of strep throat, which – unlike the cold or flu – typically requires a visit with your physician and a prescription antibiotic to treat.

Strep more common in children

Strep throat is caused by a highly contagious microbe known as group A streptococcus. In general, strep is not serious, but it can be very painful.
The illness is more common in children than adults. Up to 30 percent of children with a sore throat have strep throat, according to the Centers for Disease Control and Prevention, compared to about 10 percent of adults.

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The illness is spread through the saliva or mucus of an infected person – either through direct contact or indirectly through contact with contaminated surfaces and objects.
“Strep A is something that you want to identify and treat promptly,” says Dr. Alex Suda, a family medicine physician at Tidelands Health Family Medicine at The Market Common. “Treatment can help you feel better faster, reduce your risk of spreading the disease to others and help limit the chances of developing complications.”

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Complications from strep are uncommon but can occur if the bacteria spread to other parts of the body. For example, strep can cause sinus and ear infections, abscesses around the tonsils or neck, rheumatic fever and post-streptococcal glomerulonephritis, a kidney disease.

Is it strep?

So how do you know if that sore throat requires medical attention? Here are five indicators of a strep infection:

    • Fever: Strep infections typically come with a fever of about 101 degrees.
    • No cough: Unlike other infections, such as the flu or COVID-19, strep throat typically doesn’t present with a cough. The absence of a cough is a fairly good sign you’re dealing with strep, Suda says.
    • 72 Hours: A persistent sore throat that lasts for three days or more can indicate strep.
    • Swollen tonsils: Say “ahh” and check the back of your throat. If your tonsils are red and swollen with a whitish film on them, you may have strep.
    • Sore Neck: Swollen lymph nodes under your chin or in the front of your neck can indicate a strep infection.

Some people also develop a sandpaper-like rash on the legs, chest or arms during a strep infection, Dr. Suda says.
“Going to see your provider will really solidify your concerns,” he says.
Your care provider can test for strep using a rapid test or by taking a throat culture swab, which is often used if your care provider suspects you have strep despite testing negative with a rapid test.


To avoid catching strep throat, follow the same simple rules you would for any other airborne disease:

    • Wash or sanitize your hands thoroughly and regularly to avoid transferring bacteria from surfaces to your body.
    • Cover your mouth and nose with a tissue when you cough or sneeze, being sure to disposed of your used tissue properly.
    • Distance yourself from people you know are sick.

And if you come down with strep throat, keep yourself isolated to avoid spreading it to other people until your infectious period has passed. People with strep should stay home until they no longer have a fever and have taken antibiotics for at least 12 hours, according to the CDC.

Dr. Alex Suda is a family medicine physician who offers care at Tidelands Health Family Medicine at The Market Common. He is a graduate of the Tidelands Health MUSC Family Medicine Residency Program.

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