Streptococcal Disease (Streptococcal Sore Throat, Scarlet Fever)

CAUSE:

Group A Beta Hemolytic Streptococci

SIGNS AND SYMPTOMS:

In general, strep throat is a mild infection, but it can be very painful. The most common symptoms of strep throat include:

• Sore throat that can start very quickly
• Pain when swallowing
• Fever
• Red and swollen tonsils, sometimes with white patches or streaks of pus
• Tiny, red spots (petechiae — pronounced pi-TEE-kee-eye) on the roof of the mouth (the soft or hard palate)
• Swollen lymph nodes in the front of the neck

Other symptoms may include a headache, stomach pain, nausea, or vomiting — especially in children. Someone with strep throat may also have a rash known as scarlet fever (also called scarlatina). Within 12 hours of onset of rash can develop. Most common in children aged 5 to 15 especially during the months of October to April. Strep throat is rare in children younger than 3 years of age.

INCUBATION PERIOD:

Time from contact to the development of signs and symptoms usually 28 to 72 hours after close contact. Incidence is highest among small children.

MODE OF TRANSMISSION:

Usually by direct or intimate contact via airborne droplets, i.e.: sneezing and coughing. Occasionally transmitted via contaminated food. Treated cases usually do not transmit after 48 hours. Untreated cases can transmit as long as 21 days.

DIAGNOSIS:

Only a rapid strep test or throat culture can determine if group A strep is the cause. A doctor cannot tell if someone has strep throat just by looking at his or her throat.

A rapid strep test involves swabbing the throat and running a test on the swab. The test quickly shows if group A strep is causing the illness. If the test is positive, doctors can prescribe antibiotics. If the test is negative, but a doctor still suspects strep throat, then the doctor can take a throat culture swab. A throat culture takes time to see if group A strep bacteria grow from the swab. While it takes more time, a throat culture sometimes finds infections that the rapid strep test misses. Culture is important to use in children and teens since they can get rheumatic fever from an untreated strep throat infection. 

PREVENTIVE MEASURES:

Stressing the need for completing the antibiotic prescription, bed rest and isolation from others until antibiotic treatment is effective,  hand washing and properly disposing of soiled tissues. Call your doctor if you or your child are not feeling better after taking antibiotics for 48 hours.

PERIOD OF COMMUNICABILITY:

If untreated, uncomplicated cases 10-21 days.

IMPLICATIONS FOR SCHOOL:

Exclude those with respiratory illnesses or skin lesions from food handling. Exclude student from school for at least 24-48 hours, until antibiotic therapy begins. Student must have a note from a healthcare provider to return to school.