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Should Your Child See a Doctor?

Strep Throat Exposure

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Definition

  • Exposure to someone with a strep throat infection
  • Also called close contact
  • Living in the same house as someone (sibling, parent, or other household member) who has a throat culture or rapid-strep test that is positive for strep throat.
  • Kissing relationship with someone (boyfriend, girlfriend) who has a throat culture or rapid-strep test that is positive for strep throat. For this to be relevant, the last close contact to the infected person should be within 10 days of onset of symptoms in exposed child.

Return to School 

  • If your child doesn't have any symptoms, he does not need to miss any child care or school.
  • If your child has symptoms compatible with strep throat, he should avoid child care or school until results of a throat culture are known.

Other Types of Contact: 

  • Limited contact with strep: Exposed to someone outside the home with a positive strep test (e.g., at school).
  • Sometimes the contact is with a person who was treated for clinical symptoms of a strep infection without any culture or testing.
  • If the contact was with someone taking antibiotics for over 24 hours, they are not contagious.
  • Throat cultures and rapid strep tests aren't urgent. Most can be done in your doctor's office.

When to Call Your Doctor for Strep Exposure

Call Your Doctor Now (night or day) If

  • Your child looks or acts very sick
  • Great difficulty swallowing fluids or saliva
  • Difficulty breathing or working hard to breathe
  • Fever over 104° F (40° C) and not improved 2 hours after fever medicine
  • Signs of dehydration (very dry mouth, no tears with crying and no urine in more than 8 hours)
 

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If

  • You think your child needs an office visit or throat culture
  • Sore throat pain is severe and not improved 2 hours after taking ibuprofen
  • Age under 1 year old
  • Earache or sinus pain/pressure also present
  • Child with mild symptoms compatible with strep throat (e.g., sore throat, cries during feedings, puts fingers in mouth, enlarged lymph nodes in the neck, fever)
 

Call Your Doctor During Weekday Office Hours If

  • You have other questions or concerns
 

Parent Care at Home If

  • Strep contact but no symptoms AND you don't think your child needs to be seen
 

Home Care Advice for Strep Contacts

Treatment for Contacts WITH Symptoms (Pending A Throat Culture)

  1. Reassurance: A throat culture isn't urgent. It could be a strep throat or just a viral infection of the throat. A sore throat is commonly part of a cold. Here are some ways to keep your child comfortable until you get a throat culture.
  2. Local Pain Relief:
    • Children over age 1 can sip warm chicken broth or apple juice.
    • Children over age 6 can suck on hard candy (e.g., butterscotch) or lollipops.
    • Children over age 8 can also gargle warm water with a little table salt or liquid antacid added.
     
  3. Pain Medicine: Give acetaminophen (e.g., Tylenol) or ibuprofen for severe throat discomfort or fever above 102° F (39° C).
  4. Soft Diet: Cold drinks and milk shakes are especially good (Reason: Swollen tonsils can make some foods hard to swallow).
  5. Contagiousness: Your child may have a Strep throat infection and should avoid child care or school until the results of the throat culture are known.
  6. Call Your Doctor If:
    • Your child becomes worse
     

Treatment for Contacts WITHOUT Symptoms

  1. Reassurance: Most children exposed to someone with strep throat do not come down with it, especially if exposure occurs outside the home. Throat cultures are unnecessary for children without any symptoms.
  2. Incubation Period: Most children who do catch strep develop some symptoms 2 to 5 days after exposure.
  3. Contagiousness: Your child does not need to miss any daycare or school.
  4. Call Your Doctor If:
    • Your child develops any strep symptoms in the next 7 days
     

And remember, contact your doctor if your child develops any of the "When to Call Your Doctor" symptoms.


References

  1. American Academy of Pediatrics: Committee on Infectious Diseases. Group A Streptococcal Infections. In Pickering L, ed. 2009 Red Book. 28th ed. Elk Grove Village, IL: 2009.
  2. Dajani A, et al. Treatment of acute streptococcal pharyngitis and prevention of rheumatic fever. Pediatrics. 1995, 96:758-764.
  3. Danchin MH, Rogers S, Kelpie L, et al. Burden of acute sore throat and group A streptococcal pharyngitis in school-aged children and their families in Australia. Pediatrics. 2007;120(5):950-957.
  4. Gerber MA. Strep pharyngitis: Update on management. Contemp Pediatr. 1997;14(9):156-164.

Disclaimer

This information is not intended to be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Author and Senior Reviewer: Barton D. Schmitt, M.D.

Last Reviewed: 8/1/2010

Last Revised: 9/30/2010

Copyright 1994-2011 Barton D. Schmitt, M.D.

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