KidStuff

Sore Throats, By Whatever The Name, Seem To Follow A Scholastic Calendar

By Paul M. Marz, M.D.
Well we all know that school is back in session, the kids are off the beaches and the bike paths are clear. Even as early as the beginning of October, the presence of those little sore throats, and light coughs are in evidence. Yes, my friends, another season of wintertime illness is approaching. Today we will look at that perennial favorite—The Sore Throat, a.k.a. Pharyngitis.

Sore throat, with or without the fancy name, has been a plague for humanity since time immemorial. Pharyngitis means that something is bothering the pharynx, so what exactly is it?

We all are aware of what the mouth and the nose are. Yet somewhere back there they seem to connect together. This connection point is the beginning of the pharynx. This area contains structures that move air and food down to the separation point of the trachea or wind pipe and the esophagus in the base of the neck. Any irritation or infection in this area is labeled a sore throat or Pharyngitis. In there somewhere is the epiglottis, which is the valve that closes when you swallow, to keep your food out of the windpipe.
The cause of your sore throat can be:

• Allergic
• Environmental
• Infectious (Bacterial or Viral)

Allergic may be to due to post nasal drip irritation. Environmental causes may be smoke exposure, dust or chemical fumes, or it could be something too hot you ate or drank. We have discussed Viral Illness in the past. Those viral bugs are a nuisance as there is little, if any, treatment possible. For bacterial causes, there are many. The vast bulk of these we just ignore, as your body does a bang-up job clearing them out without help. For the average medical office, the familiar, classic strep throat is of importance.

In New England, Group A Streptococcus is quite familiar. It is also know as Strep pyogenes, for those who want the Latin name. We see more of this from early fall to spring. It seems to follow the school year with bursts of activity at the start and with every break in the school year.
Is strep any more dangerous than the other bacterial causes? No, not really. But how your body handles this specific infection is the real medically important problem.

Introducing Immunology 101.

Your body has this great system of defense. As the world’s viruses and bacteria invade our borders, your defense system flares into action. First the body decides that this is bad for you and captures one for study. The invader is broken up into pieces and a defense unit is designed to attack each piece. This is the immune system at its finest hour. Your body then manufactures millions of these “antibodies” and releases them into the blood stream where they seek out and attach to the specific part that they are designed to take out. [The science of vaccinations is based on this concept. If we give your child the “pieces” of a specific disease-causing bug, the body will build a defense and be ready if the real thing comes around.]

For the vast majority of invaders, this system works just great. But there is this little problem that only Group A Strep creates. It seems that when this specific bacterium is broken up, some of the pieces are quite similar to our own, home grown parts. These antibodies created to attack this specific strep are not too smart and will attach to YOUR parts. Have you heard of Rheumatoid Arthritis, Acute Rheumatic Fever or Rheumatic Heart Disease? These are the future problems that can be caused by the anti-strep antibodies. Your doctor knows this, so let’s go back to the health clinic.

Your little one is sick with a fever and sore throat and is seen by the doctor. Last time the child was in for a strep throat and the doctor gave you a prescription. This time the verdict is no strep, and there is no offer of antibiotics to cure the problem. As a parent, you are disappointed, even angry. The doctor will not treat your child!

However, it has been shown repeatedly that treatment or no treatment, the time it takes for your child to recover is the same!

All the antibiotic does is prevent your body from creating these “problematic” antibodies. Now you can see that a little understanding does take some of the mystery out of medicine. So, after reading this article, you know quality healthcare has been performed with, or without that antibiotic prescription.

(Dr. Marz, a board-certified pediatrician, is supervising physician for the Town of Barnstable school system. He practices with Bass River Pediatrics in South Yarmouth.)