The hallmark symptom of strep throat is pain in the throat that develops quickly and lasts throughout the day. Swallowing foods and liquids may be especially uncomfortable.
Other signs and symptoms, which typically appear two to five days after coming in contact with the germ, include:
- Nausea, sometimes with vomiting, or general tummy ache
- Swollen glands
- Red throat
- Bad breath
- White patches or streaks of pus on the tonsils
- Fever that begins suddenly and is often highest on the second day
- Rash that starts on the neck and chest and spreads across whole body
- Loss of appetite
Deciding which child needs a throat swab to test for strep is a judgment call based on certain criteria, and Dr. Flaherty-Hewitt says she looks for particular symptoms as red flags.
“It’s hard when kids come in complaining of a sore throat, because it could be from a cold, or allergies, or the change of the season,” she notes. “But if they have mostly upper respiratory infection symptoms, we know it’s less likely to be strep. With strep, there is often no cough or respiratory symptoms. They are more likely to have a headache, nausea or just that their tummy feels a little off. Fever and swollen glands are other important considerations when considering strep throat.”
If your child develops a rash of red bumps that feels like sandpaper, that means strep has advanced to scarlet fever, also known as scarlatina. Scarlet fever is treated with the same line of antibiotics as strep but, since it means the infection has progressed, requires immediate attention.