Is it strep throat or just a sore throat?

It isn’t just respiratory illnesses like the flu that peak during the winter — strep throat becomes more common, too, as we gather together indoors. But sore throats can have many culprits, from the common cold to seasonal allergies.

How do you know if your sore throat is caused by a strep infection? And what should you do if you suspect you have strep?

Here, we break down what to know about strep throat, from how it spreads to how to get relief.

What is strep throat? 

Strep throat is a type of bacterial infection. The bacteria, known as group A streptococcus, can live in our skin and mucous membranes, which line the nose and throat.

Typically, the bacteria spreads from person to person through close contact — think coughs and sneezes that spray droplets into the air. You can catch strep throat by:

• Breathing in these droplets
• Touching a surface the droplets land on and then touching your mouth, nose or eyes
• Sharing items such as forks or spoons with someone who is infected

Anyone can get strep throat, but it most commonly affects children 5-15, according to the American Medical Association.

Symptoms of strep versus other illnesses

Many viruses can cause sore throats, so how can you tell the difference between an ordinary sore throat and a strep infection?

“The onset of strep symptoms often happens abruptly,” says Christine Bozich, MD, medical director of the MultiCare Mary Bridge Children’s Urgent Care Network. “In addition to sudden throat pain, you may see red, enlarged tonsils, and there may be little white dots in the throat as well.”

Beyond a sore throat, other common symptoms of strep include:

• Fever
• Fatigue
• Swollen glands in the neck
• Headache and body aches
• Nausa or vomiting
• Lack of appetite
• Stomach pain

If you’re experiencing a runny nose, or have pink or red eyes or a cough along with your sore throat — those are signs your symptoms may be due to a viral infection, not strep, Dr. Bozich shares.

Strep throat is rare in children under the age of 3. But when it does happen, those in this age group are more likely to experience nasal congestion, like a runny nose, unlike adults or older children.

Testing for strep throat

So why does the cause of a sore throat matter? If a virus is behind your sore throat, then you can often treat symptoms at home (see the section below about how to get relief). However, if you have strep throat, it’s important to seek medical care.

“Serious complications can happen if strep goes untreated,” Dr. Bozich says. “It can lead to painful abscesses in the throat, sinus infections, ear infections and conditions like rheumatic fever.”

If you suspect strep throat, schedule a visit at an urgent care location or with your primary care provider. Your provider will do a swab of your throat to confirm whether you have a strep infection. In some cases, you may need a throat culture, where the swab is sent to a lab to detect the presence of bacteria.

“Unfortunately, you can’t tell just by looking at a person’s throat whether they have strep,” Dr. Bozich says. “Even if someone has a history of strep infections, we need to confirm strep throat with a test to avoid prescribing unnecessary treatment.”

How strep is treated

Strep throat is treated with oral antibiotics. It’s important to finish the entire course of treatment as prescribed, even when you start feeling better. Stopping early can cause the infection to come back.

Once you’ve been on antibiotics for 24-48 hours, you are no longer contagious and can be around others, Dr. Bozich shares.

How to get relief at home

In addition to taking prescribed medications as instructed, there are steps you can take at home to relieve sore throat symptoms and support recovery:

• Use a cool-mist humidifier to help moisturize the throat.
• Drink plenty of fluids, either warm or cold, to stay hydrated.
• Mix approximately one tablespoon of honey and a squeeze of lemon with a mug of warm water and sip (do not give honey to children under the age of 1).
• Gargle with salt water (mix 1/4-1/2 teaspoon of salt with approximately 8 ounces of warm water).
• Take over-the-counter pain relievers such as acetaminophen (Tylenol) or ibuprofen (Advil) as needed (do not give children aspirin).
• Eat soft foods that are easy to swallow, such as applesauce, oatmeal or mashed yams.
• Avoid spicy foods, acidic beverages like orange juice and exposure to cigarette smoke, all of which can irritate the throat.

If you aren’t sure whether uncomfortable sore throat symptoms are due to strep, or if symptoms persist, we recommend erring on the side of caution and seeking care.