Feels Like a Tough Pill to Swallow? Learn All About Strep Throat Infections

Prickly throats are common in regular throat infections, tonsillitis, allergies, asthmatic attacks, acid reflux, COVID-19, bacterial infections, etc. and can make swallowing painful. Strep throat stands out due to its invasive nature and complexity. Strep (streptococcal) infection in India is significant, with 15%-30% of acute pharyngitis cases in children caused by group A streptococci bacteria.

Strep throat is a bacterial infection of the throat (the upper airways called the pharynx) and the tonsils (the lymph nodes visible at the end of your mouth) caused by streptococcus pyogenes, which is also called group A streptococcus (GAS). According to studies, children in India experience seven episodes of sore throat annually, with group A streptococcus responsible for 13.5% of these cases.

GAS has two varieties. It is the most common cause of acute pharyngitis and is treatable. Interestingly, a study reported that streptococcus pyogenes-related pharyngitis was prevalent in North India, but its pyoderma variant was more common in South India.

It is very contagious and can be transmitted from an infected individual via touch, sneezing, and other means. With a prevalence between 5 and 15 years of age, strep throat has an incubation period of 2–5 days. GAS bacteria stick to the lining of the throat using the sticky proteins (adhesins) on their surface. Once they're attached, they release toxins that damage the tissue and cause irritation, leading to the swelling, redness, and pain that we know as a sore throat or pharyngitis.

Strep throat is typically characterised by a sore throat followed by a sudden fever of 101˚F (38˚C) or higher. The throat could feel sore, making it difficult to swallow and look red, possibly with white spots. You could also have a headache, feel chills, lose your appetite, have stomach pain, and notice swollen lumps (lymph nodes) in your neck. Some also experience nausea and vomiting. 

On examination, the doctor might reveal additional signs such as white patches, spots, or streaks of pus on your throat and tonsils. Small red spots, called petechiae, can also appear on the roof of your mouth. A rash on the neck and chest — known as scarlet fever — can spread to other areas of your body. As a complication, the same GAS bacteria can also infect the skin and cause sores, which is known as impetigo when it happens.

Tests from throat swabs are routinely used to confirm strep throat.

Mononucleosis or mono is caused by the EBV (Epstein-Barr virus). Mono does not cause enlarged, red and patchy tonsils but rather an enlarged spleen and severe fatigue, absent in strep throat. 

Various viruses can cause sore throats at any age. They are typically characterised by cough (dry or wet), hoarseness, raspy voice, runny nose, blocked nose, and sneezes. Quite typically, strep throat involves painful swallowing and high fever, but none of the above symptoms.

Common colds are viral in origin and occur in infants, children, adolescents, and adults. Unlike strep throat, they may or may not include a sore throat and cause runny nose, sneezing, mild coughing, headaches, fatigue, and a mild fever.

Strep throat is contagious. Thus, the best way to prevent this is hygiene. 

• Sanitise your hands using soap and water for at least 20 seconds before meals and after coughing or sneezing. If soap and water aren’t handy,  alcohol-based hand sanitisers may be the next best option. 
• Use a tissue when coughing or sneezing and discard the tissue immediately. Sneeze or cough into your elbow if you don’t have a tissue. 
• Avoid sharing cups or utensils and kissing and hugging anyone who’s sick. 

Dr Vijay Monteiro, MBBS, MS, adds, “Strep throat is a common bacterial infection. Surgeons usually don’t get involved unless complications like abscesses around the tonsils arise. Otherwise, strep throat is usually treated with medications targeted for bacterial infections, and most people recover quickly with rest, fluids, and medication. It's important to finish all prescribed medicines to prevent serious complications.”

Routine treatment involves medications as prescribed by the doctor. Some anecdotal evidence suggests that regular warm saline gargles, soft, warm foods, complete rest, drinking immune-boosting concoctions like ‘kadha’ with antiseptic ingredients like ginger, pepper, lemon, etc., using room humidifiers, and taking mild over-the-counter sore throat relief lozenges may help.

Strep throat is a frequent issue among adults but should be taken seriously. If ignored, it can result in complications like tonsillitis, sinus infections, and in rare instances, serious conditions such as rheumatic fever. Getting a timely diagnosis, following the proper medication regimen, and ensuring adequate rest are essential for a quick recovery. If symptoms continue or worsen, visit a doctor for a proper diagnosis and treatment plan.

No. Strep throat is a complicated bacterial infection of the throat that requires your doctor’s help with diagnosis, medicines, and dos and don’ts.

According to doctors, strep throat lasts about 7-10 days, but symptoms start improving on the third or fifth day.

Yes, strep throat is highly contagious and spreads through touch, sneezing, etc, from an infected person.

Yes, strep throat can lead to complications such as ear infections, sinus infections, meningitis, and pneumonia.

Strep throat can be prevented through practising personal hygiene. Using disposable tissues when coughing or sneezing is necessary. Washing hands before eating and avoiding contact with those mildly infected can help.

If the fever is sudden, the child complains of difficulty swallowing, the throat looks reddish, or there are mild stomach aches, the parent must take the child to the doctor.