Sore throat vs. Strep throat

Which one do you have, and what should you do about it?

By Audra Kolesar
Winnipeg Regional Health Authority
Published Friday, March 21, 2014

What is a sore throat?

Sore throat is a common symptom that ranges in severity from just a sense of scratchiness to severe pain. Pharyngitis is the medical term for sore throat.

How does a sore throat occur?

Sore throat is caused by inflammation of the throat (pharynx). The pharynx is the area behind the tonsils. A sore throat may be the first symptom of a mild illness, such as a cold or the flu, or of more severe illnesses, such as mononucleosis, strep throat or scarlet fever.

A sore throat that comes on suddenly is called acute pharyngitis. It can be caused by bacteria or viruses. A sore throat that lasts for a long time is called chronic pharyngitis. It occurs when a respiratory, sinus, or mouth infection spreads to the throat.

Sore throats can also be caused by:

Hay fever
Cigarette smoking or second-hand smoke
Breathing heavily polluted air or chemical fumes
Swallowing sharp foods that hurt the lining of the throat, such as a tortilla chip
Dry air
Heartburn (gastric reflux)

What are the symptoms of a sore throat?

Symptoms may include:

A raw feeling in the throat that makes breathing, swallowing and speaking painful
Redness of the throat
Fever
Hoarseness
Pus in your throat
Tender, swollen glands in your neck
Earache (you may feel pain in your ears even though the problem is in your throat).

How is a sore throat diagnosed?

Your health-care provider will ask about your symptoms and examine your throat. Your provider also will examine you for signs of other illness, such as sinus, chest, or ear infections. Just by looking at your throat, it is often hard for your health-care provider to decide whether a virus or bacteria is causing your sore throat. Your provider may swab your throat to test for strep infection. Some providers have a rapid strep test they can do in the office and get results in a few minutes.

How is a sore throat treated?

Usually, no specific medical treatment is needed if a virus is causing the sore throat. The throat most often gets better on its own within five to seven days. Antibiotic medicine does not cure viral pharyngitis. For acute pharyngitis caused by bacteria, your health-care provider may prescribe an antibiotic. For chronic pharyngitis, your provider will look for other causes.

How long will the effects of a sore throat last?

Viral pharyngitis often goes away in five to seven days. If you have bacterial pharyngitis, you will feel better after you have taken antibiotics for two to three days. You must take your antibiotic even when you are feeling better. If you don’t take all of it, your sore throat could come back.

What is the difference between a sore throat and strep throat?

Strep throat is a more serious type of sore throat. It is caused by bacteria called Streptococci. There are different types of streptococci. The type that causes serious sore throats and should be treated with antibiotics is called group A strep.

How does strep throat occur?

Strep and viral infections are very contagious. They are usually passed directly from person to person. Strep throat is common in school-age children. Children under two-years-old and adults not exposed to children are much less likely to get strep throat. It is most common from November through April, but it can happen any time of year.

What are the symptoms of strep throat?

A person with strep throat may exhibit some of the same symptoms as someone with a non-strep sore throat. Other symptoms of a strep infection may include:

Chills
Headaches
Fatigue
Swollen, tender lymph nodes (glands) in the neck
Loss of appetite.

How is strep throat diagnosed?

Your health-care provider will ask about your symptoms and examine your throat. Usually you will have a strep test. Your provider will rub a cotton swab against a tonsil in the back of your throat to get a sample of bacteria. The sample will be tested in the lab. The results will be available in a few minutes if the rapid antibody test is done, or in one to two days if the overnight culture test is used.

How is strep throat treated?

If your health-care provider suspects you have strep, he or she may prescribe an antibiotic before you have all the results from the lab tests. This medicine may be taken as pills or given as a shot. It is very important to take all of the prescribed medicine, even after the symptoms have gone away, to prevent the infection from coming back. Strep needs to be treated so you can prevent the serious problems it might cause, such as heart and kidney disease.

How long will the effects of strep throat last?

The symptoms of strep throat may go away as soon as 24 hours after you start treatment. The symptoms rarely last longer than five days.

Not getting treatment for strep throat or not taking all the medicine prescribed can lead to rheumatic fever. Rheumatic fever can damage the heart valves and affect your joints, kidneys and brain.

How can I take care of myself?

Follow the full treatment prescribed by your health-care provider.

For a sore throat:

Make sure you have enough fluids. Drink clear soup, cold drinks, and other clear, nutritious liquids. If eating hurts your throat, don’t force yourself to eat solid food. When you are able to eat more foods, choose healthy food to give you strength and to help fight the infection.
Do not smoke. Do not breathe second-hand smoke.
Gargle with salt water. (You can make a saltwater solution by adding a half teaspoon of salt to eight ounces of warm water.)
Suck on lozenges or hard candy.
Don’t talk a lot. Rest your voice.
Use a cool mist humidifier or vaporizer to add moisture to the air.
Put warm compresses on your neck.

If you have a fever, rest and limit your activities until the fever is gone. You can take acetaminophen, or ibuprofen, to reduce your fever and to relieve pain. Anyone under age 18 with a fever should not take aspirin because it increases the risk of Reye’s syndrome.

When should I see a health-care provider?

If you have a sore throat and are unable to swallow liquids, you need to be seen as soon as possible. If you have been exposed to someone with strep throat who has not completed their antibiotics and is considered contagious, and now have symptoms, you should see a provider within two days. If you have a sore throat and have not been exposed to strep throat, see your provider if your symptoms have not improved after seven days of home care.

How can I help prevent spreading strep throat or a viral throat infection?

The following suggestions may help you prevent the spread of your strep infection to others:

Avoid close contact with other people until you have been taking the antibiotic for 24 hours so they will not be exposed to the strep bacteria.
Use tissues when you cough and dispose of them carefully.
Hand washing is the best method of prevention. Wash your hands before you touch food, dishes, glasses, silverware, napkins, etc.
Wash your hands after you cough.
Be careful not to let your nose or mouth touch public telephones or drinking fountains.
Use paper cups and paper towels in bathrooms instead of shared drinking cups and hand towels.
Do not share food and eating utensils with others.

Audra Kolesar is a registered nurse and manager with Health Links – Info Santé, the Winnipeg Health Region’s telephone health information service.