Strep throat: symptoms, is it contagious, how long it lasts and treatment

The NHS lists the symptoms of a sore throat as the following. It says the symptoms are similar for children, but children can also get a high temperature and appear less active.

NHS inform says strep throat may come with swollen glands in the neck and tonsillitis. The NHS lists, for tonsillitis, red and swollen tonsils, swollen and painful glands in the neck, pus-filled spots or white patches on the tonsils, a high temperature, headache, earache, feeling sick and feeling tired.

• A painful throat, especially when swallowing.

• A dry, scratchy throat.

• Redness in the back of your mouth.

• Bad breath.

• A mild cough.

• Swollen neck glands.

The NHS lists strep throat as a bacterial throat infection and one of several possible causes of a sore throat, alongside laryngitis, tonsillitis and glandular fever. NHS inform explains that Group A Streptococcus, also known as strep A, are bacteria commonly found on the skin or in the throat, and that infection commonly presents as a mild sore throat (strep throat) or skin and soft tissue infections such as impetigo and cellulitis.

The NHS says strep A can also cause scarlet fever, and that most strep A infections are mild and easily treated but some are more serious.

Yes. The NHS says strep A infections are spread by close contact with an infected person. They can be passed on through coughs and sneezes or from a wound. In some people the bacteria live in the body without causing symptoms, but they can still pass the bacteria on to others.

NHS inform says strep A is spread through respiratory droplets and direct skin contact. The NHS says that if you or your child has a strep A infection, or are prescribed antibiotics for strep A, you should stay away from nursery, school or work for 24 hours after starting antibiotics, which helps stop the infection spreading.

To reduce the chance of catching or spreading it, the NHS suggests avoiding close contact with someone you know is infected, washing your hands often with soap and water, covering your mouth and nose with a tissue when you cough or sneeze, and binning used tissues quickly. NHS inform advises not sharing food, utensils, cups, towels or bed linen.

The NHS says most strep A infections get better on their own after about a week, and that sore throats normally get better by themselves within a week. For tonsillitis, the NHS says symptoms usually go away after 3 to 4 days but can last longer.

The NHS says to see a GP if a sore throat does not improve after a week, if you often get a sore throat, or if you have a lump in your mouth or neck, or a mouth ulcer that lasts for more than 3 weeks.

The NHS says you do not normally need antibiotics for a sore throat because they will not usually relieve your symptoms or speed up your recovery. You will only be given antibiotics by a pharmacist or GP if you could have a bacterial infection. NHS inform says most strep A infections are relatively mild illnesses that clear up on their own, and that sore throats are more commonly caused by viruses; a runny nose with the sore throat suggests a virus.

NICE guidance uses scoring tools, FeverPAIN or Centor, to identify people who are more likely to benefit from an antibiotic. It says not to offer an antibiotic prescription if the score is low, to consider no prescription or a back-up prescription for intermediate scores, and to consider an immediate or back-up prescription for high scores. It says antibiotics make little difference to how long symptoms last, shortening them by about 16 hours on average, and that most people feel better after 1 week with or without antibiotics.

NICE's first-choice antibiotic is phenoxymethylpenicillin for 5 to 10 days, with alternatives for people allergic to penicillin. A prescriber will decide what is suitable for you.

The NHS says that for tonsillitis a doctor can usually tell by asking about symptoms and looking in your throat, and may arrange a swab test, where a cotton bud wipes the back of the throat, to see if bacteria are causing it. A GP will usually wait for the results to tell which type you have, and may arrange a blood test for glandular fever if symptoms are severe or will not go away.

NHS inform says that strep A tests are not available for self-testing at home through the NHS in Scotland, and that your GP or other healthcare professional will advise if you or your child need to be tested. It also says it is not uncommon to have strep A bacteria on the skin or in the throat without being unwell, and those people usually will not need antibiotics.

The NHS says tonsillitis is usually caused by a virus such as a cold, but it can also be due to a bacterial infection such as strep throat. The same distinction applies to sore throats more broadly.

NHS inform says that in rare cases people may go on to develop post-streptococcal complications such as rheumatic fever or glomerulonephritis, and that strep A can very rarely cause more serious conditions known as invasive group A strep (iGAS). The NHS says serious strep A infections need to be treated in hospital with antibiotics.

For tonsillitis, the NHS says complications are very rare but pus can collect between the tonsil and the wall of the throat (quinsy). It says to call 999 or go to A&E for a severe sore throat that quickly gets worse, swelling inside the mouth and throat, difficulty speaking, being unable to swallow, difficulty breathing or difficulty opening the mouth.

The NHS says to see a pharmacist if you need help for a sore throat or your child is aged 5 or over, and that a pharmacist can give the same antibiotic treatment as a GP if you need it. See a GP if your child is under 5 and needs help.

Ask for an urgent GP appointment or get advice from NHS 111 if you or your child have a sore throat and you are worried, have a very high temperature or feel hot, cold or shivery, have signs of dehydration or have a weakened immune system. For tonsillitis, the NHS says to get help from NHS 111 now if you have pus-filled spots on your tonsils or a sore throat so painful it is difficult to eat or drink.

The NHS says to call 999 or go to A&E now if you or your child have difficulty breathing or are unable to swallow, are drooling, are making a high-pitched sound as you breathe, or have severe symptoms that are getting worse quickly. For young children with strep A it also lists pauses in breathing, blue or grey skin, tongue or lips, and being floppy and unwilling to wake up.

On the NHS, a pharmacist is often the first stop for a sore throat for adults and for children aged 5 and over, with GP or NHS 111 for children under 5, or if symptoms are severe or not improving. Swab tests are at the GP's discretion.

Private GPs and urgent care clinics can offer same-day assessment. They follow the same prescribing principles, so it is reasonable to ask whether a bacterial infection is likely and what the benefits and side effects of an antibiotic would be. Surgery to remove the tonsils is very rarely needed, and the NHS says it is usually only for severe tonsillitis that keeps coming back.