Strep Throat/Scarlet Fever


Strep throat is a bac­te­r­i­al infec­tion that caus­es a sud­den, severe sore throat, usu­al­ly with fever and with­out the cough or run­ny nose of a cold. It is most com­mon in school-age chil­dren but affects adults too. Unlike most sore throats, which are viral, strep needs antibi­otics, to ease it and to pre­vent rare com­pli­ca­tions. A quick throat swab con­firms it. 

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What is strep throat?

Strep throat is an infec­tion of the throat and ton­sils caused by bac­te­ria called group A strep­to­coc­cus (group A strep). It is one of the few sore throats that is bac­te­r­i­al rather than viral, which mat­ters because strep needs antibi­otics while viral sore throats do not.

It is most com­mon in chil­dren ages 5 to 15, and it is a fre­quent rea­son kids miss school, but adults get it too, espe­cial­ly par­ents and oth­ers around school-age chil­dren. The tricky part is that strep and a viral sore throat can look sim­i­lar. Here is how they usu­al­ly differ:

Fea­tureStrep throatViral sore throat
How it startsOften sud­denOften grad­ual
Cough, run­ny nose, hoarsenessUsu­al­ly absentOften present
Throat and tonsilsVery sore, red, some­times with white patchesSore, may be red
FeverCom­monSome­times, often milder
Oth­er signsSwollen neck glands, headache, stom­achache in kidsCold-like symp­toms
What it needsAntibi­otics, after a pos­i­tive testSest and com­fort care, no antibiotics

Because you can­not reli­ably tell them apart by look­ing, a quick test is the only sure way to know.

What are the symp­toms of strep throat?

Strep throat symp­toms usu­al­ly come on quick­ly. Com­mon signs include:

  • A sud­den, painful sore throat
  • Pain when swallowing
  • Red, swollen ton­sils, some­times with white patch­es or streaks of pus
  • Fever
  • Swollen, ten­der lymph nodes in the neck
  • Headache, and in chil­dren, stom­achache or nausea
  • Tiny red spots on the roof of the mouth

Strep throat usu­al­ly does not come with a cough, run­ny nose, or hoarse voice. If those cold symp­toms are present, a viral infec­tion is more like­ly. In young chil­dren, strep can also show up as fussi­ness, trou­ble eat­ing, and fever.

When should I see a doctor?

Because strep needs antibi­otics and a viral sore throat does not, the main step is get­ting test­ed when strep is like­ly. Here is how to tell what to do.

Get test­ed with a provider or imme­di­ate care visit

See a provider if you or your child has a sore throat with fever, painful swal­low­ing, swollen neck glands, or white patch­es on the ton­sils, espe­cial­ly with­out cough or cold symp­toms. A quick throat swab can con­firm strep in min­utes so the right treat­ment can start. Chil­dren with a sore throat and fever are worth test­ing, since treat­ing strep helps pre­vent rare complications. 

Find same-day pedi­atric or pri­ma­ry care 

Walk into a Duly Imme­di­ate Care Center

Get urgent or emer­gency care

Some throat symp­toms need fast care. Seek urgent or emer­gency care for any of these:

Throat warn­ing signs that need urgent care

  • Trou­ble breath­ing or swallowing
  • Drool­ing, or being unable to swal­low saliva
  • Dif­fi­cul­ty open­ing the mouth
  • A muf­fled voice with severe one-sided throat pain, which can sig­nal an abscess
  • A stiff neck or a very high fever

What caus­es strep throat and how does it spread?

Strep throat is caused by group A strep bac­te­ria, which spreads eas­i­ly through res­pi­ra­to­ry droplets when some­one coughs, sneezes, or talks, and by shar­ing food, drinks, or uten­sils. It is most com­mon in late fall through spring and spreads quick­ly in schools and house­holds. Some­one with strep is con­ta­gious until they have been on antibi­otics for about 24 hours, which is why stay­ing home until then, and until the fever is gone, helps pro­tect others.

How is strep throat treated?

Strep throat is treat­ed with antibi­otics, usu­al­ly peni­cillin or amox­i­cillin (with oth­er options for those aller­gic to peni­cillin). Antibi­otics ease symp­toms a bit faster, make you non-con­ta­gious soon­er, and, impor­tant­ly, pre­vent the rare com­pli­ca­tions of untreat­ed strep. It is impor­tant to fin­ish the full course, even once you feel bet­ter, to ful­ly clear the infection.

Eas­ing symptoms

  • Aceta­minophen or ibupro­fen for pain and fever
  • Plen­ty of flu­ids, and cold or warm drinks that feel soothing
  • Rest
  • For old­er chil­dren and adults, salt-water gar­gles, throat lozenges, or warm tea

Most peo­ple feel bet­ter with­in a day or two of start­ing antibi­otics and can return to school or work after 24 hours on antibi­otics and once the fever is gone. Why treat strep at all? Untreat­ed strep can occa­sion­al­ly lead to prob­lems like rheumat­ic fever, which can affect the heart, or kid­ney inflam­ma­tion, both of which antibi­otics help pre­vent, par­tic­u­lar­ly in children.

Can you pre­vent strep throat?

You can­not pre­vent every case, but good habits low­er the risk and slow the spread. Wash­ing hands often, cov­er­ing coughs and sneezes, and not shar­ing cups, uten­sils, or food all help. If some­one in the house has strep, using sep­a­rate drink­ing glass­es and wash­ing them in hot, soapy water reduces spread. Replac­ing a tooth­brush after a few days on antibi­otics is a sim­ple extra step.

Who treats strep throat?

Most strep throat is han­dled by a pedi­a­tri­cian or pri­ma­ry care provider. Pedi­atric, inter­nal med­i­cine, and fam­i­ly med­i­cine providers, with the nurse prac­ti­tion­ers and physi­cian assis­tants on their teams, can do the throat swab, con­firm strep, and pre­scribe antibi­otics, often in a sin­gle quick vis­it. Imme­di­ate care vis­its make test­ing and treat­ment easy to access.

An ENT (ear, nose, and throat or oto­laryn­gol­o­gist) spe­cial­ist may get involved in some situations:

  • Fre­quent or recur­ring strep and tonsillitis
  • A throat abscess, or
  • When ton­sil removal is being considered

For chil­dren or adults who get strep again and again, an ENT can dis­cuss whether remov­ing the ton­sils might help. Your provider coor­di­nates care and refers to ENT when it would. 

Strep Throat FAQ | Duly Health and Care

Fre­quent­ly asked questions

How do I know if it’s strep throat or just a sore throat?

You often can­not tell for sure with­out a test, but some clues help. Strep tends to come on sud­den­ly with a very sore throat, fever, and swollen neck glands, and usu­al­ly with­out a cough or run­ny nose. A sore throat with a cough, con­ges­tion, or hoarse­ness is more like­ly viral. Because strep needs antibi­otics, a quick throat swab is the only sure way to know.

Does strep throat need antibiotics?

Yes, if a test con­firms strep. Antibi­otics ease symp­toms, make you non-con­ta­gious soon­er, and pre­vent rare but seri­ous com­pli­ca­tions like rheumat­ic fever, which is why strep is treat­ed even though many sore throats are not. If a strep test is neg­a­tive, the sore throat is like­ly viral and antibi­otics will not help, so they should not be used.

How long is strep throat contagious?

With­out treat­ment, strep can be con­ta­gious for one to two weeks. Once antibi­otics have been tak­en for about 24 hours and the fever is gone, a per­son is gen­er­al­ly no longer con­ta­gious and can return to school or work. Fin­ish­ing the full course of antibi­otics still mat­ters, even after feel­ing better.

Can adults get strep throat?

Yes. Strep is most com­mon in school-age chil­dren, but adults get it too, espe­cial­ly par­ents and peo­ple who work around chil­dren. The symp­toms and treat­ment are the same: a throat swab to con­firm it and antibi­otics if it is pos­i­tive. Adults with a sore throat plus fever and no cold symp­toms are worth testing.

Where can I get test­ed for strep throat in Chicagoland?

Duly Health and Care offers pedi­atric and adult pri­ma­ry care, fam­i­ly med­i­cine, video vis­its, and imme­di­ate care across the Chica­go sub­urbs, where a quick throat swab can con­firm strep and treat­ment can start the same vis­it. For recur­ring strep or ton­sil prob­lems, Duly ENT spe­cial­ists can help.

Strep Throat Care at Duly Health and Care

A sore throat is one of the most com­mon rea­sons fam­i­lies come in, and find­ing out quick­ly whether it is strep takes the guess­work out of treat­ment. Duly pedi­atric and pri­ma­ry care providers can do a fast throat swab, start antibi­otics only when they are need­ed, often in a sin­gle vis­it through pri­ma­ry care or imme­di­ate care. When strep keeps com­ing back or ton­sils are a recur­ring prob­lem, they will coor­di­nate your cae with Duly ENT specialists.

With pedi­atric and adult pri­ma­ry care, fam­i­ly med­i­cine, and ENT exper­tise across the Chica­go sub­urbs, plus video and imme­di­ate care, relief is easy to reach for the whole family. 

Find same-day pedi­atric or pri­ma­ry care 

Walk into a Duly Imme­di­ate Care Center

Med­ical­ly reviewed by Duly Health and Care Pedi­a­tri­cian, Brett Hurli­man, MD — Last reviewed June 2026

Strep Throat/Scarlet Fever Care Team