{"id":34559,"date":"2023-07-16T20:30:00","date_gmt":"2023-07-16T20:30:00","guid":{"rendered":"https:\/\/www.lifeandnews.com\/articles\/?p=34559"},"modified":"2023-07-18T13:22:29","modified_gmt":"2023-07-18T13:22:29","slug":"strep-throat-can-easily-be-confused-with-throat-infections-caused-by-viruses-here-are-a-few-ways-to-know-the-difference","status":"publish","type":"post","link":"https:\/\/www.lifeandnews.com\/articles\/strep-throat-can-easily-be-confused-with-throat-infections-caused-by-viruses-here-are-a-few-ways-to-know-the-difference\/","title":{"rendered":"Strep throat can easily be confused with throat infections caused by viruses \u2013 here are a few ways to know the\u00a0difference"},"content":{"rendered":"\n<p><a href=\"https:\/\/theconversation.com\/profiles\/allen-shaughnessy-1445305\">Allen Shaughnessy<\/a>, <em><a href=\"https:\/\/theconversation.com\/institutions\/tufts-university-1024\">Tufts University<\/a><\/em><\/p>\n\n\n\n<p>\u201cMy sore throats, you know, are always worse than anybody\u2019s.\u201d<\/p>\n\n\n\n<p>So declares Mary to Anne in \u201c<a href=\"https:\/\/jasna.org\/austen\/works\/persuasion\/\">Persuasion<\/a>,\u201d Jane Austen\u2019s 1817 book. Most of us can relate to this feeling. There is no such thing as \u201cjust a sore throat.\u201d The pain, headache, fever and aches associated with a sore throat can make you feel terrible.<\/p>\n\n\n\n<p>While sore throats can occur at any time of year, strep throat is <a href=\"https:\/\/www.cdc.gov\/groupastrep\/surveillance.html#\">more common in the fall, winter and early spring<\/a>.<\/p>\n\n\n\n<p>I am a <a href=\"https:\/\/facultyprofiles.tufts.edu\/allen-shaughnessy\">professor of family medicine<\/a>, a pharmacist and an expert on evidence-based medicine. My work involves the evaluation of research performed by others, and I have been following and analyzing research findings on strep for the past 30 years.<\/p>\n\n\n\n<p>Many people incorrectly assume that all sore throats are due to strep throat, a bacterial infection of the pharynx, the middle throat area behind the nose and mouth, and patients often come to our family medicine office wanting to be checked and treated for strep with antibiotics.<\/p>\n\n\n\n<p>However, neither testing nor treatment is always needed for a sore throat. Regardless of the cause, rest and pain relievers form the cornerstone of sore throat treatment.<\/p>\n\n\n\n<p>Here\u2019s some guidance on whether and when testing is necessary.<\/p>\n\n\n\n<h2>Bacterial versus viral sore throats<\/h2>\n\n\n\n<p>Most <a href=\"https:\/\/www.cdc.gov\/antibiotic-use\/sore-throat.html\">sudden-onset sore throats<\/a> are caused by viruses \u2013 the same ones that cause the common cold, the seasonal flu and COVID-19. There are <a href=\"https:\/\/www.nih.gov\/news-events\/nih-research-matters\/understanding-common-cold-virus#\">more than 200 viruses<\/a> that can cause sore throat and other symptoms related to the common cold.<\/p>\n\n\n\n<p>But bacteria can also be the culprits behind a sore throat. One of the most common examples is <a href=\"https:\/\/www.cdc.gov\/groupastrep\/diseases-hcp\/strep-throat.html#\">strep throat<\/a>, or <a href=\"https:\/\/www.cdc.gov\/streplab\/groupa-strep\/index.html\">group A pharyngitis<\/a>.<\/p>\n\n\n\n<p>Strep is caused by certain strains of <em>Streptococcus pyogenes<\/em> bacteria. There are many species of strep; other common forms of strep that cause different infections in humans include \u201c<a href=\"https:\/\/www.cdc.gov\/groupbstrep\/index.html\">group B strep<\/a>\u201d and \u201c<a href=\"https:\/\/www.icliniq.com\/articles\/infectious-diseases\/group-d-streptococcus-infections\">group D strep<\/a>.\u201d Group A strep usually lives peacefully among the many other types of bacteria growing on our skin and doesn\u2019t cause any problems, until we get a break in the skin such as a cut or a scrape. This allows it to overwhelm the immune system\u2019s ability to keep it in check.<\/p>\n\n\n\n<figure class=\"wp-block-image\"><a href=\"https:\/\/images.theconversation.com\/files\/536145\/original\/file-20230706-18-5qdns0.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip\"><img src=\"https:\/\/images.theconversation.com\/files\/536145\/original\/file-20230706-18-5qdns0.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip\" alt=\"A teenage girl is lying on a sofa, feeling unwell and holding a thermometer in her mouth to check her temperature.\"\/><\/a><figcaption>Fever, headache and confusion can be symptoms of a severe case of strep. <a href=\"https:\/\/www.gettyimages.com\/detail\/photo\/sick-teenager-resting-at-home-and-monitoring-royalty-free-image\/1482421648?phrase=strep+throat&amp;adppopup=true\">RealPeopleGroup\/E+ via Getty Images<\/a><\/figcaption><\/figure>\n\n\n\n<p>Group A strep can also live in the back of the throat \u2013 up to 30% of people without any evidence of a sore throat will have <a href=\"https:\/\/doi.org\/10.3389\/fcimb.2019.00137\">this strain in their throat<\/a>. <a href=\"https:\/\/www.cdc.gov\/groupastrep\/diseases-public\/strep-throat.html#\">Up to 3 in 10 children and 1 in 10 adults<\/a> feeling sick with a sore throat due to a virus or other cause will test <a href=\"https:\/\/doi.org\/10.1371\/journal.pntd.0006335\">positive for group A strep<\/a>. That means that people with a sore throat caused by a virus could also be positive for strep, even if it\u2019s not causing the symptoms.<\/p>\n\n\n\n<p>Not all group A strep bacteria are the same, though. Some varieties are better at evading the immune system than others and can grow quickly. Others produce byproducts that can cause a sore throat and sometimes lead to <a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/tonsillitis\/symptoms-causes\/syc-20378479\">tonsillitis<\/a>, an infection of the tonsils, or cause ear or <a href=\"https:\/\/www.cdc.gov\/antibiotic-use\/sinus-infection.html\">sinus infections<\/a>.<\/p>\n\n\n\n<p>Still other strep strains produce a toxin that can cause a characteristic <a href=\"https:\/\/www.cdc.gov\/groupastrep\/diseases-public\/scarlet-fever.html\">skin rash<\/a> or lead to effects on the <a href=\"https:\/\/www.cdc.gov\/groupastrep\/diseases-public\/rheumatic-fever.html\">heart<\/a>, <a href=\"https:\/\/www.cdc.gov\/groupastrep\/diseases-public\/post-streptococcal.html\">kidneys<\/a> or even the <a href=\"https:\/\/www.nimh.nih.gov\/health\/publications\/pandas\">brain<\/a>.<\/p>\n\n\n\n<p>Rarer still, group A strep can enter the bloodstream and cause <a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/toxic-shock-syndrome\/symptoms-causes\/syc-20355384\">toxic shock syndrome<\/a>, a life-threatening, overwhelming infection. These latter conditions are examples of invasive strep, meaning that the infection is in parts of the body typically free from germs; they <a href=\"https:\/\/www.cdc.gov\/groupastrep\/igas-infections-investigation.html\">seem to be on the rise<\/a> after a marked <a href=\"https:\/\/www.cdc.gov\/groupastrep\/igas-infections-investigation.html\">reduction in their occurrence during the COVID-19 pandemic<\/a>. https:\/\/www.youtube.com\/embed\/W50S0dCCFPs?wmode=transparent&amp;start=0 Like other illnesses that made a comeback after COVID-19 prevention measures were relaxed, strep cases have returned to pre-pandemic levels.<\/p>\n\n\n\n<h2>To test or not to test<\/h2>\n\n\n\n<p>Doctors or other clinicians can easily test for strep by using a swab to collect a bit of the fluid from the back of the throat. This sample can identify group A strep in about a minute.<\/p>\n\n\n\n<p>While researchers have been studying group A strep <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK333430\/\">for over 75 years<\/a> and there are thousands of research papers focused on infections caused by strep, there is still <a href=\"https:\/\/www.nice.org.uk\/guidance\/ng84\/chapter\/Summary-of-the-evidence\">controversy<\/a> over whether it needs to be tested for and treated.<\/p>\n\n\n\n<p>To decide whether to test for group A strep, clinicians use a set of criteria based on <a href=\"https:\/\/www.mdcalc.com\/calc\/104\/centor-score-modified-mcisaac-strep-pharyngitis\">five questions<\/a> that can help determine whether strep testing is needed. These are:<\/p>\n\n\n\n<p>\u2013 How old is the patient? Strep throat is most common in children <a href=\"https:\/\/www.cdc.gov\/groupastrep\/diseases-public\/strep-throat.html#\">between ages 5 and 15<\/a> and least common in <a href=\"https:\/\/www.cdc.gov\/groupastrep\/diseases-hcp\/strep-throat.html#\">adults over age 45<\/a>.<\/p>\n\n\n\n<p>\u2013 Are the tonsils swollen or do they have a white or yellow coating? Both conditions often accompany strep. However, this question alone isn\u2019t definitive, since viruses can also affect the tonsils.<\/p>\n\n\n\n<p>\u2013 Are the <a href=\"https:\/\/www.verywellhealth.com\/cervical-lymph-nodes-2252142\">cervical lymph nodes<\/a> swollen or tender? Normally these bumps, which are in the front of the neck along the sides of the windpipe, cannot be seen or felt, but are often palpable when strep is present.<\/p>\n\n\n\n<p>\u2013 Does the person have a fever? Lack of a fever makes strep less likely.<\/p>\n\n\n\n<p>\u2013 Does the person have a cough? A cough is indicative of a viral cause and makes strep the less likely cause of the sore throat.<\/p>\n\n\n\n<p>While none of these questions alone can provide a clear answer, taken together they can tell your clinician whether strep is more or less likely.<\/p>\n\n\n\n<p>Using this scoring tool, an adult with a sore throat but without changes to the tonsils or lymph nodes, without a fever and with a cough has only a <a href=\"https:\/\/www.mdcalc.com\/calc\/104\/centor-score-modified-mcisaac-strep-pharyngitis\">1 in 40 chance, or 2.5%, of having strep throat<\/a>. For such patients, a strep test is not necessary.<\/p>\n\n\n\n<p>On the other hand, when a first grader meets all five of these criteria, there is a 50% chance that strep is causing his or her sore throat. Based on recent research I have reviewed, by using these questions <a href=\"https:\/\/doi.org\/10.7326\/0003-4819-159-9-201311050-00003\">adults can determine<\/a> when strep is the likely cause of a sore throat.<\/p>\n\n\n\n<p>In the <a href=\"https:\/\/www.nice.org.uk\/guidance\/ng84\">United Kingdom<\/a> and <a href=\"https:\/\/doi.org\/10.1370\/afm.741\">other European countries<\/a>, doctors do not routinely test for strep. Antibiotic treatment can at times <a href=\"https:\/\/www.cdc.gov\/antibiotic-use\/community\/pdfs\/aaw\/au_arent_always_the_answer_fs_508.pdf\">cause allergic reactions, rash, diarrhea, stomach upset, yeast infections and other side effects<\/a>. Authorities in these countries feel any benefit of testing and treatment does not outweigh these risks.<\/p>\n\n\n\n<h2>Treatments for strep<\/h2>\n\n\n\n<p>Once group A strep is confirmed, doctors may prescribe an antibiotic treatment.<\/p>\n\n\n\n<p>Penicillin or amoxicillin are the most commonly prescribed antibiotics for strep. These medicines will not reduce pain or tiredness but may help symptoms resolve earlier, typically by <a href=\"https:\/\/www.nice.org.uk\/guidance\/ng84\/chapter\/Summary-of-the-evidence\">about a day<\/a>. Doctors may also suggest use of a pain reliever such as acetaminophen or ibuprofen to help relieve symptoms.<\/p>\n\n\n\n<p>Antibiotic treatment does not seem to lower the likelihood of <a href=\"https:\/\/doi.org\/10.1136\/bmj.38503.706887.AE1\">spread of the infection between children<\/a> \u2013 which is common in schools and dormitories \u2013 <a href=\"https:\/\/doi.org\/10.1136\/bmj.f6867\">or adults<\/a>.<\/p>\n\n\n\n<p>Health care practitioners recommend staying home until fever has subsided. They also recommend taking the full course of antibiotics, even if the symptoms have abated.<\/p>\n\n\n\n<p>With sore throats causes by viruses \u2013 against which antibiotics are ineffective \u2013 few treatments exist aside from using pain relievers to help soothe immediate symptoms. For this reason and because <a href=\"https:\/\/www.cdc.gov\/antibiotic-use\/index.html\">antibiotic overuse is a major problem in the U.S.<\/a>, it is best not to assume that your sore throat is caused by strep and to treat it accordingly.<\/p>\n\n\n\n<p><a href=\"https:\/\/theconversation.com\/profiles\/allen-shaughnessy-1445305\">Allen Shaughnessy<\/a>, Professor of Family Medicine, <em><a href=\"https:\/\/theconversation.com\/institutions\/tufts-university-1024\">Tufts University<\/a><\/em><\/p>\n\n\n\n<p>This article is republished from <a href=\"https:\/\/theconversation.com\">The Conversation<\/a> under a Creative Commons license. Read the <a href=\"https:\/\/theconversation.com\/strep-throat-can-easily-be-confused-with-throat-infections-caused-by-viruses-here-are-a-few-ways-to-know-the-difference-207286\">original article<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Allen Shaughnessy, Tufts University \u201cMy sore throats, you know, are always worse than anybody\u2019s.\u201d So declares Mary to Anne in \u201cPersuasion,\u201d Jane Austen\u2019s 1817 book. Most of us can relate to this feeling. There is no such thing as \u201cjust a sore throat.\u201d The pain, headache, fever and aches associated with a sore throat can [&hellip;]<\/p>\n","protected":false},"author":44,"featured_media":34560,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[42],"tags":[14390,2897,1070,7696,14391,14387,7314,6748,3902,9538,14389,14392,14388,4073],"_links":{"self":[{"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/posts\/34559"}],"collection":[{"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/users\/44"}],"replies":[{"embeddable":true,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/comments?post=34559"}],"version-history":[{"count":2,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/posts\/34559\/revisions"}],"predecessor-version":[{"id":34573,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/posts\/34559\/revisions\/34573"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/media\/34560"}],"wp:attachment":[{"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/media?parent=34559"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/categories?post=34559"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/tags?post=34559"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}