Having children means being exposed to nonstop illnesses. On average, young children get six to eight upper respiratory infections a year; in practical terms, that means a lot of missed school. One common illness that circulates among young children is strep throat, which is caused by Group A strep bacteria and is very contagious.
Strep throat is usually characterized by a fever, sore throat, pain with swallowing, and swollen tonsils, but it can also include symptoms like stomachache, headache, nausea, and vomiting. Since strep throat is caused by bacteria, it can be treated with an antibiotic. If left untreated, it can develop into complications like scarlet fever or rheumatic fever, which are rare but serious conditions.
Unlike some illnesses, where an infection triggers enough immunity to protect you against future infections, you can get strep throat more than once. Here’s what to know if you or your children keep getting strep.
Strep infections have been on the rise
If it seems like you or your child have been coming down with cases of strep throat more often, you aren’t alone—cases of strep throat have been surging since the end of 2022. “At the end of last year, we saw a huge surge in group A strep,” said Anthony Flores, a pediatric infectious disease specialist at UTHealth and Children’s Memorial Hermann Hospital. Although he hasn’t seen an increase in the number of severe infections, “the overall numbers are just much, much more,” he said.
Most likely what is happening, Flores said, is that there are a lot of younger kids who just haven’t been exposed to strep before, and are currently spreading it among their classmates, who then bring it home to their other family members. “Kids have been getting infected more frequently this year because the prevalence is much higher,” Flores said. In other words, your child is getting strep more often simply because there is just a lot more of it going around, rather than it being from a new strain that is more infectious.
Although kids are more likely to get strep throat, adults can get it too, especially if they have young children at home, or work in an environment with a lot of kids. Just as with kids, the more that adults are exposed to others with strep throat, the more likely they are to get sick.
Multiple strep infections may require a tonsillectomy
If you are getting strep multiple times in a year, it’s time to follow up with your doctor, both for treatment for the infection, and a possible evaluation for additional factors. Generally speaking, “if you have distinct episodes [of strep throat] separated in time, then it’s entirely possible that you have been reinfected,” rather than the antibiotic failing, Flores said. This is especially true during surges when cases are high, which leads to multiple chances of getting exposed. Although dealing with one case of strep throat after another isn’t fun, it usually isn’t dangerous.
“In the absence of some underlying condition that would predispose you to these types of infections, it’s unlikely that it would pose a serious harm,” Flores said. However, although the risk of serious harm is relatively low, it is still important to get checked out and to get appropriate treatment.
If you keep getting strep throat, one option is removing the tonsils, which is where strep bacteria preferentially grow. The American Academy of Family Physicians’ recommendation is to consider removing the tonsils in cases of seven or more instances of strep throat in one year, five cases or more per year for two consecutive years, or three infections or more, for three consecutive years. However, removing the tonsils won’t eliminate the possibility of getting strep throat, although it will reduce the likelihood of getting infected and lessen the severity of an infection.
Some people can be carriers of strep
The majority of people who develop strep will recover after a course of antibiotics and will be strep-free—at least until the next time they are infected. However, “there is a small group of people who are chronic carriers of strep,” said Mike Ren, a family physician at Baylor College of Medicine. Their bodies harbor low levels of strep bacteria without showing any symptoms. Unlike people who are actively sick with strep throat, carriers are much less likely to infect others and usually don’t require treatment. However, as Ren noted, carriers can go sometimes through periods of stress, whether from lack of sleep or other factors, which can lead to developing symptoms.
As Flores noted, if a person is a carrier for strep, but not showing any symptoms, it doesn’t necessarily mean they are contagious, and it is generally not recommended to treat asymptomatic carriers with repeated rounds of antibiotics.
