During the “sick season” (fall and winter) a common complaint among children and their worried parents) is that a chid has a sore throat. While all children will at some point complain of a sore throat, most sore throats are due to a virus and are often the first sign of a cold.
Many parents worry that their child may have strep throat which is a bacterial infection and requires treatment with antibiotics. In fact, only about 10-20% of children with a sore throat will have strep. More and more parents are bringing their children in to the office right after they “hear” that someone is their child’s class has strep (thank you social media). In fact, their child may have not even complained about their throat until they were asked, “does your throat hurt”, or they may have only been sick for an hour or two.
How can you decide if your child might need to be seen at the pediatricians office if they have complained of a sore throat?
Strep throat is most common in school aged children 3-14 years of age. It it typically not seen in young children (who cannot even tell you that they have a sore throat) or in adults over the age of 45. With the advent of urgent care centers on every corner I am hearing more and more parents tell me “I have strep throat so I am worried about my child”, but when asked if they the parent are better on their medicine the majority say “not really”, and I am coughing and congested and not getting better. Their “strep throat” is more likely to have been the beginning of a cold.
Children with strep throat typically do not have a cough, but do have swollen or tender lymph nodes in their neck (just under their jaw), have a temperature over 100.4 and have swollen inflamed tonsils that may or may not have exudate (white patches), and are between 3 - 14 years of age.
By using these guidelines which are called the Centor Criteria your doctor is also deciding which patients should have a rapid (in office) strep test. Over testing (swabbing) with an in office rapid strep screen may lead to false positive results due to picking up the bacteria in a child’s (or adult’s) throat when they are simply carriers and do not have strep throat. Why is this important? Over testing, may lead to over prescribing antibiotics and no one wants their child to be taking antibiotics unnecessarily.
So, it is typically best to wait 24 hours or so after your child complains of a sore throat to take them to the pediatrician. History of the illness and clinical findings are the two things that will determine if your child needs a “strep test” and should not be decided simply because “there is strep in their class”. In our office all children are examined by the physician prior to having a throat swab.