Strep Throat

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It’s the time of year that most parents of elementary school children dread. Between October and April (depending upon where you live) one of the most common maladies of childhood illness seems to show its ugly face way too often. It’s 4 in the morning and you child wakes up with a fever (usually on Fridays) complaining of a sore throat, headache and stomach ache. As you dispense the Advil you take a small penlight and try to look in the back of their throat to see if the imposing little white specks that are often telltale of strep are visible. If they do have strep you are certain to catch a whiff of that certain stagnant smell that goes beyond morning breath and lack of dental hygiene – just another common indicator that Strep throat is now floating around your home! Yikes!

According to the CDC strep throat infections affect well over half of all school age children each year. It is as common as or even more so than the common cold and if left untreated can be potentially dangerous. In the last few years with doctors really cracking down on the amount of antibiotics being handed out unnecessarily, many parents (especially those who have been doing this for a while) feel caught in the middle. If its strep throat, it is definitely worth taking your child to the doctor because you will get a prescription and a diagnosis; but if its not - then not only do you waste a co-pay, come home with nothing to treat your child with but you also risk picking up more germs and viruses while waiting and visiting the pediatrician. Not to mention you are left to worry until the fever breaks. Being able to spot the signs of strep can be very helpful - but keep in mind as children get older and have had the infection more their symptoms become less and less of a nuisance and often strep can go undetected at all unless they are swabbed by a physician.

Signs of strep throat include headache (mostly from the fever), stomachache, white puss pustules in the back of the throat, swollen or enlarged glands, foul smelling breath (hard to explain, but when you smell it you know), vomiting and cramps. Many kids develop a form of strep that is called scarlet fever which sounds scarier than it really is. Scarlet fever is quite simply strep infection that is combined with a rash of flat red spots that can cover the body. The rash is painless and looks ominous but there is no need to worry. Some kids may complain about their back hurting or have flu-like aches and pains with a voidance of all the other symptoms. Older children especially may have nothing but a fever and headache. Fevers with strep can range from 99.8 to 105.6 degrees and according to the American Academy of Pediatrics do not denote anything to the seriousness of the infection. An infection quite simply is based on your child’s immune system and their internal thermostat. Every child reacts differently.

There is some practical advice that parents can follow when it comes to our children being ill. First of all, talk to your child’s teacher. Most likely they know if a table mate or class mate has been recently diagnosed with strep or some other virus. The school nurse is also normally aware of how many kids are out and should have a decent idea of what they have. If your child has been around someone with strep, chances are that’s what they got. Strep throat is spread through spit, snot, sneezing etc… all the things that a classroom is full of! If other children in your home have had strep within the past week, again chances are it is floating around your home. The incubation period is roughly 1 to 5 days from exposure. Plus, it would be too easy if all your kids got sick at once and could be taken care of with one visit to the doctor and drug store! If you are anything like me, you will begin to toss around the idea of sharing the medications and curing them all….Trust me not only does it not work, it can alter the results of a rapid strep test. Antibiotics will not prevent strep throat infection. Often if a child with a virus is given antibiotics they will develop a rash. Many pediatricians (at least mine does) will automatically call in more prescriptions if one of my kids has had strep and another ends up with a fever within 5 days. Bless his soul! It’s worth a call to ask.

The sooner you start anti-biotics the sooner they will get well. With strep throat they normally lose their fever and can return to school within 24 hours of the first dose. If you make the decision to wait a day or two the strep infection can get worse and react more slowly to antibiotics. Probably the best thing to do is if you suspect strep for any of the reasons mentioned above is to take your child to the doctor and have their throat cultured. It’s painless and quick to give a diagnosis.

If you are having one of those years where it seems your child is catching every virus or bug that is going around it is sure to cause worry and frustration. You know it’s a bad year when you keep the thermometer in your purse at all times. This is common with school age kids and is just an implication that they are building up their immune system. If you are really concerned be frank with your pediatrician and from experience, I can suggest that it is a good idea to ask for a spot mononucleosis test. Mononucleosis is becoming extremely common in young children (under third grade) and can be a factor in their calamity of illnesses. Johns Hopkins University published a study a few years ago that stated mono is rapidly becoming an elementary school illness and that children who suffer from mono are prone to increased illnesses, swollen glands, repetitive infections, fatigue and weakness. Many pediatricians are not testing for it routinely and if yours doesn’t - make sure to request it, especially if your child is sick often.

Strep throat can be serious, leading to damage of the internal organs and even in rare instances hospitalization. Each year pediatricians are finding that it is becoming more and more difficult to treat as it becomes resistance to some of the common antibiotics. One of the ways that we can help is by having our children checked the moment we suspect strep, keeping them home from school when they are ill and forcing them to finish the complete round of antibiotics prescribed if they do in fact have strep. If your child is diagnosed - sharing it with a teacher or care giver can help other parents to remain aware. Hand washing is essential and teaching our children about the spread of germs can make them more efficient in stopping the spread of viruses like strep. As a parent, you never want your child to be sick but unfortunately that is unrealistic. If they have strep throat whether it is the first time or the tenth, rest assured that within a few days they will be feeling much better. Even on Friday night at 4am when we are the most helpless in helping our children it is best to remain calm, wait until daylight and let a walk in clinic check them for strep. Chances are, if it is strep they will be bouncing back off the walls by Sunday and back at school on Monday!

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