Strep Throat Exposure

Is this your child's symptom?

• Close contact with someone who has a Strep throat infection.
• Close contact means living in the same house with the infected person. It also includes close physical contact such as having a kissing relationship.

Strep Exposure (Close Contact)

• Household Close Contact. Lives with a person whose Strep test was positive. This can be a sibling, parent, or other household member.
• Kissing relationship with someone (boyfriend, girlfriend) who has a positive Strep test.
• Close contact should be within 10 days of onset of symptoms in exposed child. Reason: time from contact to Strep symptoms usually is 2 to 5 days.
• Throat cultures and rapid Strep tests aren't urgent. Most can be done in your doctor's office.

Types of Limited Contact with Strep

• Contact with someone outside the home with a positive Strep test. This type of contact occurs at school.
• Sometimes, the contact is with someone who was treated for Strep without testing.
• If fever is gone, children taking antibiotics for at least 12 hours do not spread Strep to others.

When to Call for Strep Throat Exposure

Call 911 Now

• Severe trouble breathing (struggling for each breath; can barely speak or cry)

Call Doctor or Seek Care Now

• Stiff neck or can't move neck like normal
• Great trouble swallowing fluids or spit
• Trouble breathing, but not severe
• Fever over 104° F (40° C)
• Dehydration suspected. No urine in more than 8 hours, dark urine, very dry mouth and no tears.
• Your child looks or acts very sick
• You think your child needs to be seen, and the problem is urgent. Note: a Strep test alone is not urgent.

Contact Doctor Within 24 Hours

• Sore throat pain is severe and not better 2 hours after taking ibuprofen
• Age less than 1 year old
• Earache or sinus pain (not just congestion)
• Mild symptoms that could be from Strep throat. (Some are sore throat, cries during feeds, large lymph nodes in the neck, fever)
• Sores present on the skin
• You think your child needs to be seen, but the problem is not urgent (or needs a Strep test)

Contact Doctor During Office Hours

• You have other questions or concerns

Self Care at Home

• Strep contact but no symptoms

Care Advice

Treatment for Contacts With Symptoms (Pending a Strep Test)

1. What You Should Know About Strep Exposure and Sore Throats:
   • A Strep test is not urgent.
   • It could be a Strep throat or just a viral infection of the throat.
   • A sore throat is often part of a cold.
   • Until you get a Strep test, here is some care advice that should help.
2. Sore Throat Relief:
   • Age over 1 year. Can sip warm fluids such as chicken broth or apple juice. Some children prefer cold foods such as popsicles or ice cream.
   • Age over 6 years. Can also suck on hard candy or lollipops. Butterscotch seems to help.
   • Age over 8 years. Can also gargle. Use warm water with a little table salt added. A liquid antacid can be added instead of salt. Use Mylanta or the store brand. No prescription is needed.
   • Medicated throat sprays or lozenges are generally not helpful.
3. Pain Medicine:
   • To help with the pain, give an acetaminophen product (such as Tylenol).
   • Another choice is an ibuprofen product (such as Advil).
   • Use as needed.
4. Fever Medicine:
   • For fevers above 102° F (39° C), give an acetaminophen product (such as Tylenol).
   • Another choice is an ibuprofen product (such as Advil).
   • Note: Fevers less than 102° F (39° C) are important for fighting infections.
   • For all fevers: Keep your child well hydrated. Give lots of cold fluids.
5. Fluids and Soft Diet:
   • Try to get your child to drink adequate fluids.
   • Goal: keep your child well hydrated.
   • Cold drinks, milk shakes, popsicles, slushes, and sherbet are good choices.
   • Solids. Offer a soft diet. Also avoid foods that need much chewing. Avoid citrus, salty, or spicy foods. Note: Fluid intake is much more important than eating any solids.
   • Swollen tonsils can make some solid foods hard to swallow.
6. Return to School:
   • Your child may have a Strep throat infection. Wait for the result of the rapid Strep test. If it is negative, your child can go back to school.
7. Call Your Doctor If:
   • Your child becomes worse

Treatment for Contacts Without Symptoms

1. What You Should Know About Strep Exposure Without Symptoms:
   • Many children have contact with someone with Strep throat. Most will not come down with an infection. This is especially true if the contact occurs outside the home.
   • Strep tests are not needed for children without any symptoms.
2. Time It Takes to Get Strep Throat:
   • Time from contact to Strep symptoms usually is 2 to 5 days.
3. Return to School:
   • If your child has no symptoms, he does not need to miss any school.
4. Call Your Doctor If:
   • Your child gets any Strep symptoms in the next 7 days

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

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Last Reviewed: 10/11/2023

Last Revised: 12/30/2022

Copyright 2000-2023. Schmitt Pediatric Guidelines LLC.