Is it strep throat or just sore?

Sore throats can be caused by viruses or bacteria. When caused by bacteria it’s called strep throat. But how can you tell the difference, and does it really matter? Internal medicine specialist Jonathan Allred, MD, offered some tips on how to know if it’s strep throat or just sore.

How to know if your sore throat is from a virus

Sore throats caused by viruses are often accompanied by other symptoms, including a runny nose, cough or watery eyes, sinus pressure and occasionally fever. Unlike strep throat, symptoms will not improve with antibiotics. If your sore throat is caused by a virus, drink plenty of fluids and rest.

Is it strep throat? Here’s how to tell

Strep throat often presents with no cough, a fever greater than 100.5 degrees, white patches on the tonsils or dark spots on the roof of the mouth, and tender lymph nodes in the neck. It can cause headaches, body aches, a rash and stomach upset.

“Strep throat must be treated with antibiotics,” Dr. Allred said, “Make sure to see your doctor for a rapid strep test or throat culture.”

How contagious is strep?

Strep is highly contagious. Not only can you spread the bacteria to other people, but the bacteria can spread to other tissue in your body, causing a worse infection. There’s also a risk of rheumatic fever if it’s left untreated.

Generally, strep is spread to other people through respiratory droplets, such as when someone coughs or sneezes, or by touching something with the droplets on it. Even people who have strep but don’t have any symptoms can spread the illness.

How long is strep contagious?

“Strep throat is highly contagious, but once a person starts antibiotics, they’re typically no longer contagious after 24 hours,” said Dr. Allred. “Without treatment, the infection can spread to others for weeks, which is why testing and prompt treatment are so important.”

• Without antibiotics: A person with strep throat can be contagious for 2–3 weeks, even if symptoms improve.
• With antibiotics: People are generally no longer contagious about 24 hours after starting antibiotics, as long as their fever has resolved and they’re feeling better.

What can you do to relieve throat pain?

Whether your sore throat is caused by a virus or strep, there are a few home remedies to help you feel better. Take Tylenol or ibuprofen as needed for pain or fever, drink plenty of fluids, gargle with warm saltwater, and use throat lozenges.

When is it most likely to spread?

Strep throat spreads most easily:

• When symptoms are active (fever, sore throat)
• Through respiratory droplets (coughing, sneezing, sharing utensils)
• From close contact, including household and school settings
  Importantly, some people can spread strep even if they have mild or no symptoms.

When should you return to work or school?

“Most recommendations are to stay home until 24 hours after starting antibiotics, and once you’re fever-free without medication,” said Dr. Allred.

Why treatment for strep throat matters

Treating strep promptly ensures you’re not contagious for as long, reduces the risk of complications like kidney inflammation or rheumatic fever and helps your symptoms resolve faster.

To avoid getting sick in the first place, use these tips to prevent the spread of germs:

• Use good hand hygiene.
• Do not share cups or utensils.
• Cover your mouth when coughing or sneezing.
• Stay home from work or school if you have a fever of 100.4 or greater, even if it goes down with Tylenol or ibuprofen. You need to stay home until fever free for 24 hours.