Strep Throat in Children

Strep throat is a common childhood illness, but it can be heart-wrenching to watch your child suffer from a severe case. What may be worse is watching your kid get the nasty illness repeatedly without knowing why.

Not all sore throats are strep throat. Many times, a common virus can cause sore throats, cough and runny nose, which usually go away on their own without treatment. Strep throat can be common for children ages 5 to 15, but any age can develop strep. It makes you and your child miserable when it does occur, but treatment and prevention can help reduce the risk of catching strep repeatedly.

We spoke with Dr. Craig Kupiec, Pediatrician at INTEGRIS Family Care Edmond East, about everything you need to know about strep throat in children.

What is strep throat?

Strep throat is a bacterial infection in the throat. While the term is used broadly, it specifically reflects the presence of both infection and a specific bacteria, Streptococcus pyogenes. Strep can make anyone feel sick and horrible, but antibiotics can help get your little family member back to play quickly.

“Typically, strep throat presents with abrupt onset of sore throat, often accompanied by headache, or belly pain. Usually absent are congestion and cough symptoms,” said Dr. Kupiec.

“This is an important distinction as most often children can present with sore throats associated with the common cold virus.”

On exam, patients will often have swelling of tonsils and tender lymph nodes in the head and neck area. Diagnosing strep throat requires evaluation by a health professional for an accurate diagnosis. Less obvious signs of strep include tiny spots on palate and change in the texture of the tongue.

The most common signs of strep include:

• Sudden sore throat
• Pain when swallowing
• Swollen and red tonsils
• Fever
• Rash on the neck and chest
• Swollen lymph nodes in the neck
• Body aches
• Chills

Again, it’s important to have your child examined by a pediatrician as these symptoms do not automatically mean strep throat.

Why do kids get strep so often?

Kids often live more interconnected lives than older individuals. They frequently are in more physical contact with other children in adults in comparison to older people, which means they are exposed to step more than adults are. And strep is very contagious.

“They are often more inclined for some sort of oral contact - be it hands, liquids, hugging, kissing, etc. As such kids can spread the infection with this contact quite easily, though most often exposures can come from drinking after family members,” said Dr. Kupiec.

While strep throat is easily treated with antibiotics, if left untreated, it can cause serious problems for children, like abscesses or kidney problems.

“It is important to note kidney complications from strep are not related to the timely use of antibiotics. They can happen regardless of treatment timeline and generally resolve overtime on their own,” said Dr. Kupiec. “A common rash called scarlet fever may be associated with skin findings of Streptococcus pyogenes.”

How is strep throat treated?

When your child starts to complain of a sore throat and aches, your doctor will likely do a rapid strep test. The pediatrician will use a cotton swab to take a sample of the fluids at the back of the throat to be tested.

If the test is positive, then strep throat is generally treated with a tried and true antibiotic - Penicillin. However, as children generally don’t like injections, Amoxicillin is more commonly used for 10 days.  If an allergy to penicillin is present (discuss with health provider), an alternative like Azithromycin may be used.

“It should be noted however that cases of resistance are present with the use of Azithromycin, so it is never the primary preferred agent,” said Dr. Kupiec.

 See your pediatric provider if you are concerned about the presence of infection. Ibuprofen may help with swelling associated with infection and encourage plenty of liquids to maintain hydration.

Is there a PANDAS connection?

Lately, there has been a lot of talk about a mysterious disorder called PANDAS that seems to be associated with strep throat.

PANDAS is an ill-defined constellation of symptoms associated with strep infection known as pediatric autoimmune neuropsychiatric disorders that are usually seen with streptococcal infections. This is a subset of a pediatric acute-onset neuropsychiatric syndrome.

Pediatric acute-onset neuropsychiatric syndrome is a sudden onset of obsessive-compulsive symptoms, eating restrictions and other cognitive, behavioral, or neurological symptoms. The PANDAS Network, a national organization focusing on identifying and education related to PANDAS, says PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) occurs when strep throat causes the immune system to create inflammation on a child’s brain. This inflammation causes quickly developing severe symptoms of OCD, anxiety, tics, personality changes, a decline in math and handwriting abilities, sensory sensitivities, restrictive eating, and more.

“It is important to note that this diagnosis and syndrome is currently under significant investigation, is not common, nor expected during the typical clinical course and should always be discussed with a provider before confirming the syndrome,” Dr. Kupiec said. “Generally if you are concerned with this disorder, a developmental pediatrician, psychiatrist or neurologist should be involved in the evaluation and management. The neuropsychiatric symptoms should resolve after the acute infection.”

Preventing strep

The bottom line is that having strep throat is miserable for both you and your child. But you can help your kiddo feel better by giving them plenty of liquids. Avoid acidic drinks like orange juice or lemonade, which can irritate a sore throat, and choose soothing liquids like soups, tea or hot chocolate.

Prevent the spread strep throat to others by keeping your child’s dishes, eating utensils and glasses away from others and make sure he or she doesn’t share their food, towels, drinks or other items with others.

Handwashing is the most effective way to stop the spread of the disease in the home, as is proper sneezing or coughing etiquettes like sneezing into tissues or the elbow instead of the hands. Replace your child’s toothbrush once antibiotic treatment starts.

The good news is that most kids can go back to school and normal activities once they’ve been on antibiotics for at least 24 hours and don’t have a fever anymore. If you suspect strep throat or need additional information, call your INTEGRIS pediatrician today.