A teacher wakes up with a throat so sore that swallowing water hurts. She has a fever. She has no cough and no runny nose. Two of her students were out with strep last week. Strep is more common in children, but adults get it too, and parents and teachers are exposed all the time. Strep throat in adults is caused by bacteria, so it is handled differently from the viral sore throats that make up most cases.
Reading the Symptoms
Group A Streptococcus bacteria cause strep throat. It tends to come on fast, with a sore throat, pain when swallowing, fever and swollen glands at the front of the neck. The tonsils may look red and swollen, sometimes with white patches or streaks of pus, and small red spots can show up on the roof of the mouth. What the teacher does not have is also telling. A cough, a hoarse voice or a runny nose points more toward a virus.
The Swab and What It Decides
Antibiotics do nothing against viruses, and most adult sore throats are viral. So the next step is a test. A rapid strep test uses a throat swab and gives a result in minutes. If it comes back negative but strep still seems likely, the provider may send a throat culture to a lab. Testing first means antibiotics are used only when they help. When strep is confirmed, a provider usually prescribes an antibiotic such as penicillin or amoxicillin, and there are other options for people allergic to penicillin. The medicine should be taken exactly as directed, and the course finished as instructed. Treatment shortens the illness and lowers the risk of complications such as rheumatic fever.
Getting Back to the Classroom Safely
Strep spreads through droplets from coughs and sneezes and through shared cups and utensils. Handwashing and separate cups help protect others at home. The CDC says people with strep can go back to work or school once they no longer have a fever and have taken antibiotics for at least 12 hours. A provider can confirm the timing for her. Some symptoms should not wait for any of this. Trouble breathing or swallowing, drooling, a muffled voice or severe pain on one side of the throat need urgent attention, since they can signal an abscess near the tonsil.
Adults in Southfield, Michigan can learn about rapid strep testing from NovaHealth Urgent Care.
This article is general information, not medical advice. If symptoms are severe, call 911.