A sore throat is never pleasant. A sore throat that keeps getting worse and doesn’t seem to go away is even worse, as it could be strep throat. Doctors explain common symptoms of strep throat and explain how you can tell the difference between strep throat, a “regular” sore throat, and COVID-19.
In general, a sore throat caused by strep throat is going to be “much more severe” than your average sore throat, says Neil Bhattacharyya, M.D., a comprehensive ear, nose, and throat specialist at Mass Eye and Ear and a professor of otolaryngology at Harvard University. It’s also generally accompanied by other symptoms, like a fever and body aches.
Meet the Experts: Neil Bhattacharyya, M.D., a comprehensive ear, nose, and throat specialist at Mass Eye and Ear and a professor of otolaryngology at Harvard University; Omid Mehdizadeh, M.D., an otolaryngology and head & neck (ENT) surgeon at Pacific Neuroscience Institute; Arashdeep Litt, M.D., a board-certified physician specializing in internal medicine at Corewell Health; and Aline M. Holmes, D.N.P., R.N., treasurer of the American College of Medical Quality.
Below, doctors explain more about strep throat, including the common symptoms to watch for, how strep throat is treated, and signs that it’s time to see a doctor.
What is strep throat?
Strep throat is an infection in the throat and tonsils caused by bacteria called group A Streptococcus, aka group A strep, according to the Centers for Disease Control and Prevention (CDC).
Group A strep lives in the nose and throat and can easily spread to other people when an infected person coughs or sneezes. That creates small respiratory droplets that contain the bacteria that can be breathed in by others or land on a surface and then make their way into a person’s nose or mouth, the CDC explains.
What are the symptoms of strep throat?
These are the main symptoms of strep throat, according to the Mayo Clinic:
- Throat pain that usually comes on quickly
- Painful swallowing
- Red and swollen tonsils, sometimes with white patches or streaks of pus
- Tiny red spots on the area at the back of the roof of the mouth
- Swollen, tender lymph nodes in your neck
- Fever
- Headache
- Rash
- Nausea or vomiting, especially in younger children
- Body aches
How can you tell the symptoms of strep throat from a “regular” sore throat?
Sore throats are generally caused by either a virus or bacteria, explains Dr. Bhattacharyya. “You could say that a viral sore throat is a ‘regular’ sore throat,” he says.
In contrast, a sore throat caused by strep will be more painful. “The pain will be higher on the scale and it usually comes with a high fever,” he adds. People with strep throat also tend to have a whitish to yellowish discoloration over the tonsils in the back of the throat caused by inflammation, Dr. Bhattacharyya says.
Another tip-off that you could be dealing with strep throat is timing. “Bacterial infections tend to get worse after five days; Viral infections tend to improve after five days,” says Omid Mehdizadeh, M.D., an otolaryngology and head & neck (ENT) surgeon at Pacific Neuroscience Institute.
It’s also more common to have other symptoms if you have a viral sore throat, like a runny nose or congestion, Dr. Mehdizadeh says.
In most cases, a sore throat caused by COVID-19 is “pretty mild,” Dr. Bhattacharyya says, adding that people with a sore throat due to COVID-19 usually have other symptoms as well, like a cough, nasal congestion, or loss of taste and smell. “With strep throat, people come in and say, ‘My throat hurts—they don’t have a cough or nasal congestion,” he says. Arashdeep Litt, M.D., a board-certified physician specializing in internal medicine at Corewell Health, agrees. “Painful swallowing and swollen glands signal strep,” she says.
While it’s possible to have strep throat and another illness at the same time, Dr. Bhattacharyya says it’s not overly common.
How is strep throat treated?
Because strep throat is a bacterial infection, it’s usually treated with antibiotics like penicillin or amoxicillin, the CDC says. Still, your symptoms won’t necessarily disappear overnight.
To soothe your discomfort in the meantime, you can take acetaminophen for your fever and pain, says Aline M. Holmes, D.N.P., R.N., treasurer of the American College of Medical Quality. “I’ve had patients have success with throat sprays,” she says. “They have a localized numbing agent to take the edge off the pain.”
Dr. Litt also recommends using throat lozenges, drinking plenty of fluids, and getting rest. You can even gargle with a mixture of half hydrogen peroxide and half water twice a day for three to five days, Dr. Bhattacharyya says. “It tastes a little bad but it has an antibacterial function and is pretty soothing,” he explains. “I find it helps lessen the course of illness as well.”
While you probably won’t feel up for being out and about when you’re in the thick of the illness, Dr. Litt says that you should stay home from work or school until you no longer have a fever and have taken antibiotics for at least 12 hours to lower the risk you’ll infect someone else.
When should you see a doctor for strep throat?
If you have a sore throat and fever that’s lasted for more than 24 hours, Holmes recommends seeking medical attention. “Your provider can do a quick strep culture to diagnose you and then get you started on antibiotics,” she says. You’ll also want to see a doctor sooner rather than later if you have a fever over 101 degrees, feel like you’re getting dehydrated, have difficulty opening your mouth, or your voice is getting muffled (the latter is a sign of increased swelling in your throat), Dr. Bhattacharyya says.
If you’re feeling miserable and you suspect that you have strep throat, don’t sit on it—seeing your doctor as soon as possible will help get you on the path to feeling better quickly.
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