Can you get strep throat in summer

CDC estimates, in the most recent five years, approximately 14,000 to 25,000 cases of invasive group A strep disease occur each year in the United States. In the last five years between 1,500 and 2,300 people die annually due to invasive group A strep disease. Invasive group A strep disease can include:

• Cellulitis with blood infection
• Necrotizing fasciitis
• Pneumonia
• Streptococcal toxic shock syndrome (STSS)

Some group A strep infections cause invasive disease. Invasive disease means that germs invade parts of the body that are normally free from germs.

In contrast, experts estimate that several million cases of non-invasive group A strep illnesses occur each year. Non-invasive group A strep diseases include:

• Pharyngitis (strep throat), which causes an estimated 5.2 million outpatient visits and 2.8 million antibiotic prescriptions annually among US persons aged 0–64 years1
• Scarlet fever
• Impetigo

Complications of these group A strep infections, like post-streptococcal glomerulonephritis and acute rheumatic fever, are rare.

Globally, the burden from group A strep infections is even greater. For example, the World Health Organization estimates:

• 111 million children in the developing world have impetigo2
• 470,000 new cases of acute rheumatic fever occur each year2
• 282,000 new cases of rheumatic heart disease occur each year2

In 2015, there was an estimated 33.4 million cases of rheumatic heart disease.3

Surveillance systems

CDC does not track non-invasive group A strep infections.

CDC tracks invasive group A strep infections through Active Bacterial Core surveillance (ABCs), a population-based, active- and laboratory-based surveillance system. This means local and state health departments routinely contact laboratories to identify all cases, then report those cases to CDC.

Currently, the only nationally reported group A strep disease is STSS. Healthcare providers and laboratories should report cases to the appropriate health department. States then report these cases to CDC through the National Notifiable Diseases Surveillance System (NNDSS).

Antibiotic resistance

Through ABCs, CDC tracks data on group A strep isolate resistance to select antibiotics. Currently, GAS is not resistant to penicillin and amoxicillin, first-line antibiotics for strep throat. Nearly 1 in 4 invasive GAS infections now are caused by erythromycin- and clindamycin-resistant strains, limiting the patient’s treatment options.

Disease trends

Group A strep infections can occur any time during the year. However, some infections are more common in the United States in certain seasons:

• Strep throat and scarlet fever are more common in the winter and spring.
• Impetigo is more common in the summer.

Anyone can get a group A strep infection, but some infections are more common in certain age groups:

• Strep throat and scarlet fever are most common in children between the ages of 5 and 15 years.
• Impetigo is most common in children between the ages of 2 and 5 years.

References

1. Lewnard JA, King LM, Fleming-Dutra KE, Link-Gelles R, Van Beneden CA. Incidence of pharyngitis, sinusitis, acute otitis media, and outpatient antibiotic prescribing preventable by vaccination against group A Streptococcus in the United States. Clin Infect Dis. 2021;73(1):e47–e58.
2. Carapetis JR, Steer AC, Mulholland EK, Weber M. The global burden of group A streptococcal diseases. Lancet Infect Dis. 2005;5(11):685–94.
3. Watkins DA, Johnson CO, Colquhoun SM, et al. Global, regional, and national burden of rheumatic heart disease, 1990-2015. N Engl J Med. 2017;377(8):713-722.

Sore throats can be a common complaint in winter. As colder weather drives us inside and around more people, the common cold can more easily develop, and with it, a sore, scratchy throat.

How can you know if your sore throat needs medical attention?

“It is not uncommon to confuse a cold-related sore throat with the more serious strep throat, but there are differences,” said Family Nurse Practitioner Rosemary Schairer, of Samaritan Internal Medicine - Corvallis. “A sore throat is usually caused by a virus and will typically go away on its own as cold symptoms lessen, while strep throat is a bacterial infection that must be treated by antibiotics.”

A viral sore throat is typically accompanied by other cold-like symptoms, such as cough, sneeze, runny nose and a hoarse or raspy voice.

“A strep infection can make it feel very painful to swallow, and often comes with fever of 101-degrees or higher,” said Schairer. “Strep throat is far more common in children than adults.”

Group A streptococcus is the name of the bacteria which can cause several different types of infection, including strep throat, which is contagious. Someone can catch the infection by breathing in or touching infected droplets from a cough or sneeze, or by ingesting the droplets through shared eating utensils.

“Strep will often cause red and swollen tonsils, sometimes with white splotches, and/or tiny red spots on the roof of the mouth, which you may be able to see by shining a flashlight inside the mouth,” she said. “But everyone is different, and a person can have strep without these symptoms.”

If the sore throat causes trouble swallowing, lasts longer than 48 hours, or comes with a fever or rash, see your doctor.

“Strep will not go away on its own, and if not treated with antibiotics, can develop into something more serious, especially in children, so don’t delay getting medical attention,” said Schairer.

Testing for Strep

While at-home tests for strep are available, Schairer does not recommend them.

“At-home tests can often give a false negative which would delay the start of treatment. Since strep, if untreated, can lead to far more serious illness such as rheumatic fever or scarlet fever, I recommend going to the doctor to know for sure,” she said.

Testing can be done and analyzed right in your doctor’s office. If the test shows positive, antibiotics can be started right away. If it shows negative, your doctor may recommend a more extensive throat culture done at a laboratory, which would take a few days to learn the results.

“After starting antibiotics, our patients typically notice a decrease in symptoms within a day or two,” Schairer noted.

Please be aware that some symptoms of strep throat are similar to that of COVID-19, which is still active in our communities. If you are concerned that you may have the coronavirus, contact your health care provider to get COVID-19 testing and follow-up care as soon as possible.

Symptoms: Viral Sore Throat vs. Strep Throat

While these are common symptoms, everyone is different. You may have only one or two symptoms, but if you have any questions, contact your doctor for testing. Strep occurs more often in children than adults and can have serious consequences if not treated. 

Viral sore throat will go away on its own, while strep requires antibiotics. If your sore throat causes trouble swallowing, last longer than 48 hours and/or comes with a fever or rash, see your doctor.

Soothing the Pain

Whether cold-related or strep, a sore throat can be very uncomfortable. While waiting for your throat to heal, Schairer recommends trying these tips to relieve the pain:

• Gargle with warm salt water. Dissolve a half-teaspoon of salt in a cup of warm water, swish it around your mouth and lean your head back to gargle with it. When done, make sure to spit out the water rather than swallow it.
• Drink warm liquids. Try a cup of hot water with a teaspoon of honey, or a mild tea. Avoid citrusy liquids like orange juice, which can make the pain worse.
• Try an over-the-counter remedy. Some over-the-counter medications may temporarily relieve symptoms like cough or congestion. Throat sprays and lozenges may also help. Do not give throat lozenges to young children as they could cause choking.
• Ice cream may help. Sometimes cold helps sooth throat pain, so if you want an excuse to eat ice cream, this could be a good one. Sucking on ice chips may also bring relief.
• Get plenty of rest. Sleep is how the body rejuvenates and heals, so get plenty of it. It can also be a good time to watch movies, read a book, or just take it easy.

Prevention

Because both colds and strep are contagious, meaning that they can spread to others, or you can get re-infected a second time, it is a good idea to try and prevent them.

“Washing our hands frequently and thoroughly makes a big difference in limiting the spread of all types of viruses and infections,” Schairer explained. “It’s also important to cover our coughs and sneezes so that droplets don’t travel to others. And avoid using another person’s glass or eating utensils.”

Eating a well-balanced diet and getting regular exercise and good quality sleep, can also help keep the body’s immune system strong and able to fight off infections.

If you or your child has a sore throat that doesn’t seem to be getting better, contact your child’s pediatrician or go to your nearest urgent care clinic for medical attention.

Get ideas for what to eat when you’re feeling sick – comfort counts!
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