Learn the answers about how you get strep throat, how it is treated and what you might not know about the infection with a Q-and-A with Dr. Michal Dynda, an assistant professor of family and community medicine at Southern Illinois University School of Medicine and a staff physician at SIU Center for Family Medicine.

Q. what is strep throat?

A. Strep throat is an infection of the pharynx with a specific type of bacteria called Group a beta-hemolytic streptococcus, or GABHS. It accounts for about 15 to 30 percent of cases in children and 5 to 20 percent in adults. unfortunately, viral infections are still the most common cause of sore throats.

Q. Can you carry the strep without being sick?

A. Yes, you can be a carrier of streptococcus and have minimal, if any, symptoms. usually, the individual is at low risk to none of the developing immune mediated complications. Prolonged treatment is not indicated. However, if symptoms are present, then treatment should be started.

Q. how will a doctor know if you have strep throat?

A. your doctor will correlate your symptoms to determine if this is, in fact, strep throat or a viral infection, as both share common symptoms. Your doctor will pay particular attention to the following symptoms:

• Sudden onset of fever that is greater than 100.4 degrees.
• Absence of cough.
• Swollen and tender glands.
• Enlarged tonsils.
• recent exposure to someone who has strep throat. 

Cough, conjunctivitis, diarrhea and nasal drainage are common features of a viral infection. your doctor may also opt to swab your throat and use a rapid antigen detection test to determine if your symptoms are caused by the streptococcus bacteria.

unfortunately, these tests can vary in their sensitivity, which can range in accuracy from 70 to 95 percent. The accuracy depends on the kit itself and the technique used by the health care professional while obtaining the sample. As a gold standard, all swabs with a negative rapid strep test should be sent for culture.

Q. how is strep throat treated?

A. Luckily, strep throat is easily treated. The main treatment is penicillin V or amoxicillin for 10 days.  For individuals with penicillin allergy, the physician may opt to treat you with erythromycin or cephalexin, also for 10 days. another option is azithromycin (well known to patients as Z-pak) because of its short duration. However, its use is discouraged because of increasing resistance. 

Most strep throat cases will self-resolve in about 1 to 2 weeks time. But adding the antibiotic treatment decreases the course and potential of further complications.

Q. Can a person who has had a tonsillectomy get strep throat?

A. Tonsillectomy does not mean you will never get strep throat. However, it will reduce your risk of catching it. unfortunately, this topic is still widely debated. Children are more likely to undergo this procedure, especially if they have recurrent bouts of confirmed strep throat, in order to minimize their chance of medical complications. It is very important that if streptococcus is suspected, a culture be performed to confirm the diagnosis.

Q. where to go for more information?

A.Centers for Disease Control and Prevention: cdc.gov/getsmart/antibiotic-use/URI/sore-throat.html

Reference: aafp.org/afp/2009/0301/p383.html

Dr. Michal Dynda is an assistant professor of family and community medicine at Southern Illinois University School of Medicine and a staff physician at SIU Center for Family Medicine.