What is strep throat?
Strep throat is a disease caused by group A
What is scarlet fever?
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Scarlet fever is a fine red rash that makes the skin feel like sandpaper. Scarlet fever is caused by a toxin produced by a strep infection of the throat or another area of the body. The rash is usually quite prominent and redder in the skin creases like the armpits, groin area, elbow, and back of the knee. Sometimes, the area around the mouth has a pale appearance.
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Children who have scarlet fever are generally not any sicker than children who have strep throat.
What are the signs or symptoms?
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Some of the following symptoms may be present:
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– Sore throat
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– Fever
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– Stomachache
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– Headache
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– Swollen lymph nodes in neck
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– Decreased appetite
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Strep throat is much less likely if there is
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– Runny nose
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– Cough
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– Congestion
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Children younger than 3 years with group A streptococcal infection rarely have a sore throat. Most commonly, these children have a persistent nasal discharge (which may be associated with a foul odor from the mouth), fever, irritability, and loss of appetite.
What are the incubation and contagious periods?
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Incubation period: 2 to 5 days.
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Contagious period: The risk of spread is reduced when a person who is ill with strep throat is treated with antibiotics. Up to 25% of asymptomatic school-children and a small number of adults carry the bacteria that cause strep throat in their nose and throat and are not ill. In outbreaks, a higher proportion of children with no symptoms of illness may be carriers. The risk of transmission from someone who is not sick but is carrying the bacteria is low.
How is it spread?
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Respiratory (droplet) route: Contact with large droplets that form when a child talks, coughs, sneezes, or sings. These droplets can land on or be rubbed into the eyes, nose, or mouth. The droplets do not stay in the air; they usually travel no more than 3 feet and fall onto the ground.
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Contact with respiratory secretions or contaminated objects from children who carry strep bacteria.
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Close contact helps the spread of the infection.
How do you control it?
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Use good hand-hygiene technique at all the times listed in Chapter 2 of
Managing Infectious Diseases in Child Care and Schools: A Quick Reference Guide, 7th Edition . -
Have a health professional evaluate individuals with a severe sore throat with a rash and those who have only a severe sore throat that lasts longer than 24 hours.
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If cough/runny nose are major symptoms, strep is unlikely and testing for strep is not indicated.
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Testing for strep in children and adults who do not have symptoms is not indicated.
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Testing children younger than 3 years of age is not recommended (see Comments).
What are the roles of the educator and the family?
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Report the infection to the staff member designated by the early childhood education program or school for decision-making and action related to care of ill children and staff members. That person, in turn, alerts possibly exposed family and staff members to watch for symptoms.
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Antibiotics for infected individuals.
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Antibiotics are not helpful for individuals who are strep carriers without illness.
Exclude from educational setting?
Yes.
Readmit to educational setting?
Yes, when all the following criteria are met:
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12 hours after the first antibiotic dose has been given. Group A strep is highly reduced from the throat 12 hours after the first dose of antibiotic.
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When the child is able to participate and staff members determine they can care for the child without compromising their ability to care for the health and safety of the other children in the group.
Comments
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Most frequent cause of sore throat in children is viral infection, not strep throat.
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A rapid strep test, polymerase chain reaction (PCR) test, or throat culture is the only way to be certain of the diagnosis of strep throat, so children should not be treated with antibiotics without a test.
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Even without treatment, most children and adults with group A streptococcal infections recover fully without complications. Although rare, some cases may lead to ear infections, sinusitis, abscesses in the tonsils, infection of the lymph nodes (ie, tender and warm swollen glands) or a rare kidney disease called
poststreptococcal glomerulonephritis . -
A more rare but very serious complication of strep throat is the development of rheumatic heart disease, a condition that affects the valves and function of the heart. Children younger than 3 years are very unlikely to develop rheumatic heart disease. Therefore, testing these younger children is generally not recommended, especially if they show signs of a viral illness like runny nose or cough.
Disclaimer
Adapted from
The American Academy of Pediatrics (AAP) is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists, and pediatric surgical specialists dedicated to the health, safety, and well-being of all infants, children, adolescents, and young adults.
Any websites, brand names, products, or manufacturers are mentioned for informational and identification purposes only and do not imply an endorsement by the American Academy of Pediatrics (AAP). The AAP is not responsible for the content of external resources. Information was current at the time of publication. The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.