Streptococcal Infection

Streptococcal sore throat (strep throat) and a strep throat with a rash (scarlet fever) are common infections in children.

Cause

Streptococcus bacteria (Group A beta-hemolytic strep).

Symptoms

Strep throat - Starts suddenly with fever, red sore throat, and swollen glands. Headache may occur. Nausea, abdominal pain, and vomiting may be more common in children.

Scarlet fever - A very fine raised rash (feels like sandpaper) is present. The rash blanches with pressure. The rash appears most often on the neck, chest, elbow, and groin, and in the inner thigh and folds of the armpit. Later on, there may be peeling of the skin on the fingertips and toes.

These illnesses are usually not serious; however, rare problems such as rheumatic fever (which can damage heart valves) or kidney disease may develop if children do not receive proper antibiotic treatment.

Spread

Coughing or sneezing tiny droplets into the air and another person breathes them in.

Incubation

It usually takes 2 to 5 days from the time a person is exposed until symptoms start.

Contagious Period

Until 24 hours after antibiotic treatment begins.

Exclusion

Childcare and School: Until 24 hours after antibiotic treatment begins and the child is without fever.

Children without symptoms, regardless of a positive throat culture, do not need to be excluded from childcare or school. Persons who have strep bacteria in their throats and do not have any symptoms (carriers) appear to be at little risk of spreading infection to those who live, go to childcare or school, or work around them.

Check with your local environmental health department to see if people with skin lesions need to be excluded from food handling.

Diagnosis

Recommend parents/guardians call their healthcare provider. Strep may be identified in the throat either by using a rapid strep test, which can provide results the same day, or by throat culture.

Treatment

Oral or injectable antibiotics may be prescribed. Treatment may be dependent on how severe the infection is and will help prevent more serious illness such as rheumatic fever.

Prevention/Control

• Cover nose and mouth when coughing or sneezing or cough/sneeze into your sleeve. Dispose of used tissues.
• Regular and thorough handwashing is the best way to prevent the spread of communicable diseases. Wash hands thoroughly with soap and warm running water after contact with secretions from the nose or mouth.
• Clean and sanitize mouthed objects and surfaces at least daily and when soiled. (See pgs 35-41)
• Recommend a new toothbrush for the person with strep after they are no longer contagious.