How to Tell if That Sore Throat is a Virus or Strep

As cold and flu seasons settles in for the long winter ahead, instances of sore throat begin to pop up more frequently — but how do you tell if that achy throat is caused by a virus or strep?

Many people automatically think that their painful sore throat is due to strep. But according to Calvin Bell, MD, FAAEM, director of Memorial’s ExpressCare clinics, most sore throats are caused by viruses and not the streptococcal (strep) bacteria.

“The symptoms of sore throat from viral causes are very similar to those of strep throat,” Dr. Bell said. “They consist of throat pain, difficulty swallowing and sometimes difficulty speaking.”

Viral infections may be distinguished from strep infections if you are also experiencing a cough, runny nose, vomiting and diarrhea, as these symptoms are more common with viral infections. They are less common with strep unless you are suffering from a viral infection in addition to strep, Dr. Bell said.

Sore throats caused by a virus usually go away on their own in five to seven days. While there is no cure for a sore throat caused by a virus, there are some steps you can take to help you feel more comfortable. Dr. Bell suggests taking acetaminophen or ibuprofen, getting plenty of rest and drinking lots of fluids to prevent dehydration.

Most commonly, people with strep have a sore throat, fever and a whitish layer of pus on their tonsils and may also experience swollen, tender glands in their neck. In some instances, people with strep develop a fine, red rash on their bodies.

If you have any of these symptoms, Dr. Bell recommends a trip to your doctor for a strep test (a swab of the throat) to determine if you should be treated for strep throat. A rapid strep test will be performed, and, if the test is positive, antibiotics will be prescribed. Once treatment is started, most people start feeling better in just a day or two. If the test is negative, treatment with acetaminophen or ibuprofen will most likely be recommended and a culture will be taken to confirm the negative rapid strep test. The culture usually takes 24 hours to perform.

To avoid getting strep throat, stay away from anyone who has a strep infection. Don’t share toothbrushes or eating and drinking utensils. As with all infections, proper hand washing is the best prevention.

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