Tonsillitis: symptoms, treatment, how long it lasts and whether it is contagious

The NHS says tonsillitis itself is not contagious, but most of the infections that cause it, such as colds and flu, are. NHS inform says the same: tonsillitis is not contagious, but the infections that cause it are.

To stop these infections spreading, the NHS suggests staying at home and avoiding contact with other people if you or your child have a high temperature or do not feel well enough to do usual activities, using tissues when coughing or sneezing and throwing them away, and washing hands after coughing or sneezing.

The NHS says tonsillitis can feel like a bad cold or flu. The tonsils at the sides of the throat will be red and swollen. Symptoms in children and adults can include the following, and sometimes more severe symptoms occur.

The NHS says symptoms usually go away after 3 to 4 days but can last longer. It says tonsillitis usually gets better on its own after a few days. NHS inform says symptoms usually get better within 3 to 4 days and that it usually gets better on its own within a week.

NICE Clinical Knowledge Summaries says a sore throat due to a viral or bacterial cause is self-limiting, with symptoms resolving within 3 days in 40% of people and within 1 week in 85% of people, regardless of whether the cause is a streptococcal infection.

The NHS says that most children and adults get viral tonsillitis, which clears up on its own, and for bacterial tonsillitis a GP may prescribe antibiotics. A GP will usually wait for swab test results to tell which type you have. NHS inform says there is no specific treatment for tonsillitis, and that if tests show a bacterial cause a short course of antibiotics may be prescribed. If oral antibiotics do not help and symptoms are getting worse, a GP may refer you to hospital for intravenous antibiotics.

The NHS suggests the following ways of easing symptoms yourself. A pharmacist can give advice and suggest treatments such as lozenges containing a local anaesthetic, antiseptic or anti-inflammatory medicine, throat sprays (although there is little proof they help) and antiseptic solutions.

• get plenty of rest

• drink cool drinks to soothe the throat

• take paracetamol or ibuprofen (do not give aspirin to children under 16)

• gargle with warm salty water (half a teaspoon of salt in a glass of warm water); children should not do this

NHS inform says tonsillitis is inflammation (redness and swelling) of the tonsils, which are 2 small glands on either side of the throat. In young children they help to fight germs. It is common in children, teenagers and young adults.

The NHS says it is usually caused by a virus, such as a cold, but it can also be due to a bacterial infection such as strep throat. NHS inform says bacterial cases are typically caused by group A streptococcus bacteria.

The NHS describes tonsillitis as a common childhood illness. For a sore throat in a child aged under 5, the NHS advises seeing a GP, while a pharmacist can help for a child aged 5 or over. Children with a sore throat can also get a high temperature and appear less active. Children should not gargle with salty water, and aspirin must not be given to children under 16.

The NHS says complications of tonsillitis are very rare. Sometimes an abscess filled with pus forms between the tonsils and the wall of the throat, called quinsy. NHS inform adds obstructive sleep apnoea as a possible complication.

Call 999 or go to A&E if you have 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 your mouth, which are signs of quinsy, the NHS says. 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 it is very rare for someone to need their tonsils taken out, and that it is usually only done for severe tonsillitis that keeps coming back. NHS inform says a tonsillectomy is usually only recommended if you have had several severe episodes over a long period and repeated episodes are disrupting normal activities.

NICE Clinical Knowledge Summaries lists specialist assessment for recurrent tonsillitis (more than 7 episodes in one year, 5 per year for 2 years, or 3 per year for 3 years) as the point at which tonsillectomy may be considered.

The NHS sore throat page says that some medicines for sore throat are not safe for everyone, for example if you are pregnant, and to always check the leaflet or speak to a pharmacist before taking them. If you are pregnant with a sore throat that is severe or not improving, speak to your GP, midwife or pharmacist.

The NHS says to see a GP if the symptoms of tonsillitis do not go away within 1 week or you keep getting throat infections. NHS inform says to speak to your GP practice if symptoms last longer than 4 days and are not improving, are severe (such as being unable to eat or drink or having difficulty breathing), or you keep getting throat infections. A GP can usually tell by asking about symptoms and looking in the throat, and may arrange a throat swab, or a blood test for glandular fever if symptoms are severe or will not go away.

Most tonsillitis can be managed with a pharmacist or GP. The NHS says a pharmacist can give the same antibiotic treatment as a GP for a sore throat, if needed, for those aged 5 or over. Private GP, ENT consultations and tonsillectomy are available for people who choose to pay or have insurance, but surgery is only usually considered after repeated severe episodes, so ask for the criteria being applied to you.