picture by James
Heilman, MD
Streptococcal pharyngitis is caused by Group A
Streptococcus. It accounts for 95% of
all cases of bacterial pharyngitis. It
is most common in children ages 5 to 10 years old and most commonly occurs
between the months of October to April.
Mode of Transmission: spread by direct person-to-person
contact via droplets of saliva or nasal secretions. Up to 20% of school children can be
carriers. Pets may also be carriers.
Please watch carefully for the following symptoms:
- Temperature of 101 to 104 degrees F.
- Sore throat with severe pain on swallowing.
- A beefy, red pharynx (throat)
- Enlarged, edematous tonsils and uvula.
- Swollen glands along the jaw line.
- Tonsillar exudate: in other words, white patches on the tonsils.
- Generalized malaise and weakness.
- Headache.
- Abdominal discomfort.
- Nausea, and sometimes one incidence of vomiting that does not appear to be the flu (occurs from swallowing the Strep. bacteria.
- Up to 40% of small children have symptoms too mild for diagnosis.
- Fever abates in 3 to 5 days; nearly all symptoms subside within a week.
Treatment:
- Penicillin or erythromycin for infection - DO NOT SKIP DOSES OF MEDICATION - TAKE IT ALL!
- Analgesics/antipyretics for pain and fever (non-aspirin type due to complications of Reye's Syndrome)
- ISOLATION from other children for 24 hours after antibiotic treament. NO SCHOOL FOR 24 HOURS AFTER ANTIBIOTICS BEGIN BECAUSE STREP IS VERY CONTAGIOUS.
- FINISH THE ANTIBIOTIC PRESCRIPTION even if the symptoms subside.
- Properly dispose of soiled tissues.
- GOOD HANDWASHING.
Incubation and Communicability:
Infection occurs through person-to-person spread from
nose and throat secretions of infected persons or carriers; rarely, indirect
contact through objects. Outbreaks may follow ingestion of food contaminated by
an infected food handler’s nasal secretions or streptococci present on skin.
Incubation is short, usually 1-3 days, rarely longer
A person is contagious:
In untreated,
uncomplicated cases, 10-21 days;
In untreated
conditions with purulent discharges, weeks or months
In treated cases,
only 24 hours after treatment has begun.
Exclusion from School:
Until 24 hours after treatment has begun and no fever is
present [has been fever-free for 24 hours without medication]. If your child is still tired, his/her throat
is very sore, and he/she is not able to sit in school the whole day, it may be
advisable to keep him/her home that extra day to recuperate!
Complications: acute otitis media and acute sinusitis
occur most frequently. Scarlet fever
develops in some people, especially when Strep. Throat goes untreated. Rarely:
bacteremic spread may cause arthiritis, endocarditits, meningitis,
osteomylitis, or liver abscess.
Post-streptococcal sequalae:
acute rhematic fever or acute glomerulonephritis. Reye's syndrome is also a known complication.
