Strep throat symptoms: What are the first signs and how to treat it? - USA TODAY

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As colder weather blows in, changes in temperature mean it's the season of sore throats. But not all sore throats are made equal — some are caused by viruses while others are caused by bacteria.

Such is the case with strep throat, a dreaded illness which, while medically mild, can be painful.

While the United Kingdom has reported the deaths of six children due to strep A, U.S. health officials on Tuesday said there hasn't been a "notable increase" in streptococcal disease here. 

Regardless, it's always good to be prepared. Here's everything you should know about strep throat, from symptoms to treatment to spread. 

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What are the first signs of strep throat? 

The first symptoms of Strep Throat are often a sore throat, pain when swallowing, and a fever, Dr. Kristin Moffitt, an infectious disease physician at Boston Children's Hosptial shared in an email with USA Today. 

The CDC reports that other common symptoms of strep include:

• Red, swollen tonsils, with white spots and pus at times
• Petechiae: small, red spots on the roof of the mouth
• Swollen lymph nodes on the neck

While these are the most common symptoms, strep infections can also cause vomiting, stomach pain and nausea, as well as headaches, especially in children. 

Does strep throat cause coughing? How about congestion? 

Neither coughing nor congestion are common symptoms of strep throat. 

"Children and teenagers with strep throat do not usually have symptoms of cough or congestion. These symptoms would be more typical of infection with a respiratory viral infection," Dr. Moffitt explains. 

Is there a strep throat rash?

Sometimes. In certain cases, a strep infection can result in a rash — referred to as "scarlet fever."

"Some children with strep throat can develop a sandpaper-like rash; this is suggestive of a diagnosis of scarlet fever," Dr. Moffitt explains.

Group A streptococcus, which causes strep throat, can also sometimes produce a toxin that causes a rash — red skin with a rough feel to the touch. The rash is likely to first appear on the neck, underarm, and groin, the CDC reports. Over time though, it can spread to the rest of the body. 

How do you get strep throat?

Strep throat is a highly infectious bacterial infection. It is spread from person to person through direct contact, and through respiratory droplets, the CDC reports. In short, you get strep throat from spending time with someone who already has it. 

In rare cases, strep can be spread through food that is improperly handled. 

A person can catch strep throat by:

• Breathing in respiratory droplets that contain the bacteria
• Touching a surface that has that bacteria living on it, and then touching their nose or mouth
• Sharing food or drink with a person who has strep throat 
• Touching a sore that someone infected with strep has on their skin 

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What is the strep throat incubation period?

The incubation period for streptococcal pharyngitis is 2 to 5 days, Dr. Moffitt reports. 

What is recurrent strep throat?

There is no vaccine for strep throat, which means it's possible to get it more than once. You are also not immune once you've had the infection, making recurring strep even more plausible.

The best way to prevent again reinfection is to practice good hygiene. For small children, if recurrent strep throat emerges, some doctors may recommend tonsil removal. The surgery, called a tonsillectomy, is usually only recommended if your child is getting strep seven or more times in one year. 

Is strep throat a bacterial infection? 

Yes.

While many other types of sore throats can be traced to viruses, strep throat is caused by a bacterial infection in the throat and tonsils, the CDC says.

What bacteria causes strep throat?

Strep throat is caused by group A streptococcus, or strep A, according to the CDC.

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Strep A vs. B

"There are dozens of different types of streptococcal bacteria that can infect humans," Dr. Moffitt explains.

Group A strep is one has a specific carbohydrate attached to the surface of the bacteria. Group B Strep is a different bacteria with a different carbohydrate on its surface and causes different infections -- it is not a common cause of strep throat.

Group B streptococcus  can cause serious medical complications in people of all ages, but especially newborns, the CDC reports. The bacteria, which mostly lives in the gastrointestinal and genital tracts, causes GBS disease.

The types of infections most commonly resulting from GBS are bacteremia, sepsis, pneumonia, and meningitis in newborns. GBS bacteria rarely causes meningitis in adults. If any of these infections become invasive, they can become quite severe, resulting in hospital stays and sometimes death. 

How long does strep throat last?

This depends on treatment.

Once antibiotics are taken, symptoms should improve within 48 hours, the Mayo Clinic reports. 

Can strep throat heal on its own?

Yes. Strep throat can be healed without antibiotics. 

"Strep throat can resolve on its own without antibiotics in several days," Dr. Moffitt shares, "however antibiotics are recommended to treat strep throat for many reasons. Antibiotics reduce the duration of symptoms and the length of time that someone with strep throat can infect others."

Dr. Moffitt also stresses that antibiotics reduce the chances of complications such as abscesses of the throat or rheumatic fever which, while rare, can be very serious, and infect the heart. 

What is strep pyogenes?

Streptococcus pyogenes refers to group A strep, the strain of bacteria that causes strep throat.

It also causes scarlet fever, the rash that sometimes accompanies strep throat.

Is strep throat a virus?

No.

While many other types of sore throats can be attributed to viruses, strep throat is a bacterial infection that occurs when the throat and tonsils are infected with bacteria from group A streptococcus. 

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How long does a strep test take? 

There are two types of tests: a rapid strep test and a throat culture.

"A rapid strep test can be resulted in minutes," Dr. Moffitt says, "If this is negative, sometimes a throat swab will be tested by culture to see if the bacteria that causes strep throat grows. This can take 1 to 2 days, but is slightly more sensitive than the rapid tests."

If the rapid test comes back positive, antibiotics can be prescribed right away, but if it's negative, you may still not be in the clear. The throat culture may end up catching an infection the rapid test failed to detect. 

Is strep airborne?

It can be. 

"Strep throat is most often spread by respiratory droplets from an infected person to someone they come into close contact with," Dr. Moffitt reports. So, if a person coughs, talks, or sneezes near you and is already infected, you may run the risk of an infection.

How to get rid of strep throat: What are the treatments?

Strep throat is treated with antibiotics. Patients should start to feel marked improvement in their symptoms within 48 hours of taking antibiotics. 

Medication will both limit spread of the disease to others and prevent further complications such as rheumatic fever. 

The Mayo Clinic also advises taking over-the-counter pain medications such as aspirin or ibuprofen to relieve symptoms, as well as getting plenty of rest, hydrating, gargling with warm salt water, eating soothing foods, and using a humidifier. 

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How long does strep live on surfaces? 

"While Group A Strep can be recovered from some surfaces, it is not highly infectious from a surface unless that surface was recently contaminated with respiratory droplets from an infected person," Dr. Moffitt explains. 

This makes it extra important to watch utensils and surfaces after a person known to be infected with strep uses them to prevent the spread. 

Streptococcus pyogenes have been found to live on inanimate surfaces for months. 

How long is strep contagious? 

It depends. 

"People with strep throat can infect others until about one day after starting antibiotics," Dr. Moffitt says, "If untreated, people with strep throat can infect others for several days, perhaps even weeks."

How to prevent strep throat

The best way to prevent strep throat is the same as with other respiratory infections, Dr. Moffitt explains.

Best practices include:

• Good hand washing, especially after sneezing or coughing and before eating
• Staying away from people with symptoms.
• Avoiding shared utensils and sharing drinks

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