Dr. Mom: Strep throat no fun for kids, but it's manageable

Strep throat has been making its rounds at my son's school, and I've certainly been seeing it in the clinic lately.

My son had his fair share with two rounds of this bacterial infection. I hope we're done with it now.

While strep throat is fairly common among school-age children and teens, there are some common misconceptions among parents about symptoms, diagnosis and treatment.

Strep throat is a result of a bacterial infection with Group A Streptococcus. This bacteria hangs out in noses and throats, and is easily transmitted via sneezing, coughing, sharing eating utensils, and hand-to-mouth transmission. It is very common among children once they enter school and are in close quarters.

Once infected, children will soon come down with a fever (quite high, in some cases), headache, nausea, stomach pain, decreased appetite, sore throat, vomiting, and/or a telltale rash.

Some or all of these symptoms can be present in your child. Symptoms of strep throat, plus that sandpaper-type body rash, is known as scarlet fever. This should not be confused with rheumatic fever, a potentially serious complication of untreated strep throat.

A sore throat alone does not signify strep throat. In fact, most sore throats are the result of a viral infection and are typically associated with a runny nose and cough. These virus-related sore throats resolve on their own and do not require antibiotics.

By contrast, true strep throat, which must be diagnosed via a throat culture, needs a full 10-day course of antibiotic treatment. The reason for treating strep throat may be surprising to some parents.

Antibiotic treatment is given not only to clear your child's infection (spontaneous resolution is expected in three to five days without antibiotics) but also to decrease the spread and severity of the illness.

More important, it's given to decrease the likelihood that your child will suffer potentially serious complications such as rheumatic fever (a serious heart disease) and glomerulonephritis (kidney inflammation).

Completion of a full 10-day course of antibiotics is crucial to maximizing your child's chances that the bacteria is cleared and that the chance of recurrence is decreased.

That said, recurrent strep throat is frustrating, and in children ages 2 to 12, recurrence can occur in 25 percent to 40 percent of children in spite of appropriate antibiotic therapy and adherence.

There are many potential causes for recurrence: re- infection through repeated exposure, not completing the full course of antibiotics, or in some cases, it could mean your child is a strep carrier and his sore throat may actually be caused by a virus.

In any case, working closely with your child's pediatrician will help to determine the next course of action, whether it's simply to treat your child again or investigate the possibility your child is a strep carrier.

The take-home points are these: Not all sore throats are strep. Your child must be seen by a doctor for a clinical exam and throat culture if indicated. And, it's perfectly OK to wait the 24 hours it may take for that throat culture to come back.

In fact, some studies show that by allowing your child's body to mount an immune response, antibiotic therapy has greater chance for success.

Once strep throat is diagnosed, make sure your child adheres to the full course of antibiotics, and once your child is fever-free and on antibiotics for 24 hours, he or she is clear to return to school.

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