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Strep throat is caused by infection with a bacterium known as Streptococcus pyogenes, also called group A streptococcus. Some streptococcal infections are strep throat, scarlet fever and tonsilitis. The bacteria can also cause infections such as impetigo. 

How streptococcal infections spread

Streptococcal bacteria are in the saliva of an infected person. The bacteria spread in infected droplets when the infected person coughs, sneezes or talks. People can get a streptococcal infection if they touch or kiss the hands or face of someone or if they share dishes or cups with someone who has a streptococcal infection.

Children with a streptococcal infection should not return to the childcare centre or school until they have completed 24 hours of antibiotic treatment and only when they feel well enough to participate in regular activities.


Strep throat

Children with strep throat may have some or all of these signs:

  • a very sore throat
  • A temperature of  38.5ºC or higher
  • headache and stomach ache
  • swollen tender glands in the neck
  • vomiting
  • swollen tonsils (tonsillitis)
  • sores around the nose
  • loss of appetite

Children younger than three years with streptococcal infection rarely have a sore throat. They may have a discharge from the nose, bad breath, fever, irritability and loss of appetite.


A child can get strep throat more than once. A doctor can determine if a child has strep throat by taking a swab from the throat and testing it.

Usually, the doctor will treat the infection with an antibiotic such as penicillin. The child should feel better in a day or two after starting the antibiotic but should take all the medicine so that the infection does not return. The antibiotic will also stop streptococcal bacteria from spreading to others.

If strep throat is not treated, it can become a more serious disease called rheumatic fever.


Streptococcus can cause the tonsils at the back of the throat to become red and swollen. For these cases of tonsillitis, a doctor will prescribe antibiotics. If tonsillitis has been caused by a virus, the doctor will not prescribe antibiotics. Viral tonsillitis usually lasts 4 to 10 days.

Scarlet fever

Scarlet fever is also a streptococcal infection. It is much like strep throat except for two unusual signs.

  1. A child with scarlet fever often has a whitish, furry-looking tongue that later becomes strawberry-red.
  2. Then a red rash that feels like sandpaper appears all over the body. This rash is caused by a poison that is made by streptococcal bacteria. After 3-7 days, the rash fades, and the skin peels.

A child usually gets scarlet fever only once because the body becomes immune. Now that antibiotics are used to treat streptococcal infections, scarlet fever is not common. It is found most often in children between the ages of 8 to 10 but can occur at any age. Doctors usually prescribe antibiotics and lots of rest.


What to do at home if your child has a streptococcal infection

  • If your child has been in contact with someone with a streptococcal infection, watch your child for signs of infection.
  • Wash your hands often when looking after a child with streptococcal infection.
  • Wash your hands before you prepare or eat any food. Teach children to wash their hands often.
  • Teach children to cover their mouths with a tissue or sleeve (not their hand), when they cough or sneeze.

Talk to your doctor if your child has a sore throat with other signs such as a temperature of 38.5º C, vomiting or a rash. Ensure your child takes all the antibiotics the doctor prescribes so that the streptococcal bacteria are completely killed. Otherwise, the infection may come back.