Sore Throat or Strep Throat? What to Know and When to Get Care

A sore throat is one of the most common symptoms of a respiratory illness, so it can be hard to nail down what’s causing it. Is it just a cold? Could it be strep throat? COVID-19? Something else entirely?

Brian Curtis, MD, vice president and chief medical officer, OSF Medical Group, shares how to tell the difference, what symptoms matter most and when it’s time to get checked.

What causes a sore throat?

A sore throat can happen for many reasons, not all of them serious or even related to illness.

Common causes of a sore throat include:

• Viral infections like colds, flu or COVID-19
• Bacterial infections like strep throat
• Allergies
• Dry air or air pollution
• Overuse of your voice from yelling or singing
• Smoking or vaping

What is strep throat?

Strep throat is a bacterial infection of the throat and tonsils caused by group A streptococcus. Unlike most sore throats, strep does require antibiotics.

It’s also highly contagious, especially in the two-five days after exposure and before symptoms appear.

“Washing your hands and avoiding sharing drinking glasses can help slow or stop the spread of contagious germs,” said Dr. Curtis.

Strep Throat Symptoms

Strep throat can look and feel different than a typical sore throat.

Common strep throat symptoms include:

• Sudden sore throat
• Pain when swallowing
• Low- or high-grade fever
• Headache
• Nausea, vomiting or stomach pain, especially in kids
• Loss of appetite
• Red, swollen throat or tonsils
• White patches or streaks on the tonsils

Cough and runny nose are not common with strep throat. If those are your main symptoms, strep is less likely to be the cause of your illness and you should speak with your primary care provider.

How is strep throat different from a regular sore throat?

Many viruses and bacteria can cause throat pain, and symptoms often overlap. That’s why it’s good to get tested if you think you have strep.

You’re more likely to have strep if:

• You have a sore throat with fever, but no cough
• Your throat looks red or has white patches
• Swallowing is painful

If you’re unsure, a provider can help determine whether testing is needed.

How is strep throat diagnosed?

Your provider will start by looking at your throat and tonsils and asking a few questions about your symptoms. If strep throat is suspected, they’ll perform a rapid strep test, which involves using a soft swab to take a sample of fluid from the back of your throat.

The swab only takes a moment, and results are usually ready during your visit. If the rapid test comes back negative but your symptoms still strongly point to strep, your provider may send a throat culture to the lab for a closer look. If you test positive, your provider will prescribe a treatment.

How is strep throat treated?

Even though strep throat may improve on its own in a few days, antibiotics are recommended for treatment. Taking antibiotics reduces severity, shortens sick time, prevents complications and stops the infection from spreading to others.

You’re generally not contagious 24 hours after starting antibiotics, and most people begin feeling better within one to three days.

At-Home Strep Throat Treatment

You can also ease symptoms by:

• Taking acetaminophen or ibuprofen for pain
• Drinking plenty of fluids, including warm or cold beverages
• Resting
• Eating soft foods that are easy to swallow
• Gargling warm salt water (Half a teaspoon per eight ounces of water)
• Eating cold or frozen desserts such as popsicles, ice or hard candy, which is not recommended for children under 5 years old)

Could my sore throat be COVID-19?

A sore throat can be a symptom of COVID-19, but it’s rarely the only symptom.

“Only about 5-10% of COVID-19 patients will have an isolated sore throat,” said Dr. Curtis.

COVID-19 is more likely if your sore throat comes with:

• Fever or chills
• Cough
• Body aches
• Fatigue
• Congestion
• Loss of taste or smell
• Shortness of breath

If you have more than one of the above symptoms, consider getting tested for COVID-19, especially if you’ve been exposed or will be around others.

When should you get medical care?

If your sore throat sticks around for more than five to seven days or you suspect you might have strep throat, it’s safest to get it checked out.

“When in doubt, it’s always okay to get checked, especially if your symptoms are interfering with daily life,” said Dr. Curtis.