Strep Throat Symptoms in Adults

By the time strep throat symptoms in adults appear, you’re already contagious. Here's what to expect in terms of treatment and recovery.

strep throat symptoms in adults

Strep throat symptoms in adults call for a throat culture to determine whether you actually have strep, which is contagious. Untreated, it puts you at risk of rheumatic fever and kidney damage, among other complications.

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Strep throat symptoms in adults usually mean a visit to a doctor is in order. The organism that causes strep throat symptoms in adults is highly contagious and can lead to a painful sinus infection as well.

The Centers for Disease Control and Prevention (CDC) says a person with strep throat should stay home until his fever has ended or, usually, 24 hours after starting antibiotics. Left untreated, step throat can have rare but serious complications, such as rheumatic fever, kidney damage, tonsil/throat abscess, scarlet fever, and toxic shock syndrome. Untreated strep throat is contagious for two to three weeks, according to experts.

Strep Throat Symptoms in Adults

One of the most noticeable strep throat symptoms in adults is that the sore throat comes on quickly and lasts 48 hours or more (a viral, non-strep sore throat usually starts with a little irritation and lasts only a day or two). Other common strep throat symptoms in adults include:

  • Enlarged tonsils
  • Fever of 101°F or higher
  • Headache
  • Inflamed (red) throat
  • Loss of appetite
  • Nausea
  • Painful swallowing
  • Rash (scarlet fever)
  • Red spots in the mouth and throat
  • Stomachache
  • Swollen neck glands
  • Uvula inflamed, swollen, and may have whitish patches
  • Vomiting
  • White/yellowish patches on tonsils

If your symptoms involve a cough with mucus, watery eyes, runny nose, or vocal changes, chances are it’s not strep throat. These symptoms are more likely to have a viral cause. Strep throat is caused by a bacterial infection. Viruses cannot be controlled with antibiotics, but bacteria can.

The Guilty Bacteria

Strep throat, a.k.a. streptococcal pharyngitis, is caused by the group A Streptococcus bacterium called Streptococcus pyogenes. The bacteria are highly contagious and responsible for scarlet fever, toxic shock syndrome, cellulitis, and impetigo, as well as strep throat.

“Humans are the primary reservoir for group A strep,” according to the CDC. “There is no evidence to indicate that pets can transmit the bacteria to humans. The incubation period of group A strep pharyngitis is approximately two to five days.”

In other words, if you were near someone with strep throat a couple of days ago and the symptoms are appearing, well, guess what? You probably have the bacteria now, too. You can catch it by breathing in respiratory droplets containing the bacteria. The bacteria also can spread if the droplets land on a surface and you touch the surface and then touch your mouth, nose, or eyes. That’s why strep throat cases increase in the colder months, when everyone is pretty much crowded inside at school, work, and social gatherings.

ANNUAL CASES OF SORE THROATS

An article by John V. Ashurst and Laura Edgerley-Gibb for the National Center for Biotechnology Information, updated in 2018, says that sore throats in general account for approximately 12 million doctor visits per year (1 to 2 percent). Most of these cases are viral, however. Group A Streptococcus—the strep throat bacteria—are found in 5 to 15 percent of all adult cases of sore throat and 20 to 30 percent of children.

The Centers for Disease Control and Prevention estimates that 11,000 to 13,000 cases of invasive group A strep—cellulitis with blood infection, pneumonia, necrotizing fasciitis—are seen each year and that 1,100 to 1,600 people die from it. For non-invasive Group A strep cases—like strep throat and impetigo—several million cases occur each year.

Getting a Diagnosis

It’s difficult for a physician to positively diagnose strep throat without doing a throat swab for the bacteria. While the typical strep throat symptoms in adults do lead your doctor in the right direction, the rapid antigen/strep test they do with a throat swab sample is the deciding factor. Other problems—including Fusobacterium necrophorum—can have similar symptoms and cause severe sore throats.

In a 2015 analysis of 312 college students at University at Alabama at Birmingham, investigators found that F. necrophorum was detected in more than 20 percent of patients with sore-throat symptoms. They found only 10 percent for Group A strep.

“This is the first study in the United States that shows that F. necrophorum causes a significant number of cases of pharyngitis in this young adult population,” said Robert M. Centor, M.D., the study’s lead author. “It is also the first to show that F. necrophorum pharyngitis and streptococcus pharyngitis share similar clinical signs.”

If antibiotics are started within the first 48 hours of strep throat symptoms in adults, not only will you usually feel better, but you will have reduced the risk of complications. Although you become contagious days before symptoms develop (remember that the incubation period is two to five days), once you start on antibiotics, the contagious period usually is eliminated after 24 hours.

It’s extremely important to realize that even if you start to feel better before you finish your prescribed antibiotics, you must finish the complete prescription (usually 10 days). Stopping before that time can cause the bacteria to gain strength and return, and your risk of complications increases. Not completing antibiotic prescriptions also is believed to be one of the reasons for increasing drug resistance.

PlusCare.com lists these antibiotics as the most common prescribed by providers for strep throat:

  • Penicillin
  • Amoxicillin
  • Amoxicillin Clavulanate Potassium
  • Azithromycin
  • Clarithromycin
  • Clindamycin
  • Cefdiner

Remember, too, that if your physician says, “Please let us know how you’re doing,” it’s not just a polite comment to show that he or she cares. It matters in your recovery. If your symptoms don’t improve within five days—or worsen at any point—contact your provider immediately. You may need a different drug.

Home Therapy

In addition to taking an antibiotic, drink plenty of liquids. Water, soup, and herbal teas may help. Avoid caffeine, which will only further dehydrate you (remember that fevers are dehydrating).

On the positive side, strep throat is a good excuse to eat more ice cream! Cold drinks, ice chips, and ice cream can help soothe your throat. Throat lozenges, hard candy, cough drops, and throat spray can also help numb your throat a bit.
In addition, you should:

  • Gargle with salt water (a half teaspoon in a cup of water) to help remove mucous and bacteria.
  • Eat soft foods
  • Avoid smoking and avoid smoke
  • Use over-the-counter pain relievers
  • Eat marshmallows, says health.com, as the gelatin in them “coats and soothes”
  • Consume honey, which is both soothing and somewhat antibacterial
  • Get plenty of rest (of course!)

Strep Throat Prevention

Since most people are contagious before symptoms of strep throat in adults become obvious, it can be difficult to avoid the bacteria, especially in crowded areas. Some tips for prevention of strep throat are common, good hygiene practices we sometimes forget:

  • Wash your hands frequently.
  • Avoid touching surfaces in public areas with your hands; for instance, hit automatic door openers with your arm instead of your hands.
  • If your home is dry, as in dry heat from the furnace, you may want to install a humidifier of some type. The moist air can keep your mucus membranes moist, too. Dry mucus membranes are more susceptible to the bacteria.
  • Never share cups, forks, spoons, plates, and so on.
  • If you cough or sneeze, cover your mouth with your arm instead of your hands, and be sure you wash your hands frequently, to avoid spreading any bugs.
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