KidStuff

STREP THROAT? Probably Not, But It Pays To Be Cautious

By Paul M. Marz, M.D.

It is fall and the kids are going back to school. Other than the fears of flu, new teachers, returning lost friends and current fashions, let’s look at the typical sore throat. Your grandmother and great grandmother will remember the time of Scarlet Fever and all it could mean to a family. We will chat about that part later.

So, as a child wellness observer, you notice a hesitation of speech, or refusal to eat much or drink anything. Is it the dreaded STREP THROAT?  Could be, but let’s take a look at some alternatives.

Lots of events take place in that area, like breathing, eating, laughing and talking. Allergy sufferers know all about post nasal drip and the dry scratchy irritated throat that can cause. As we move to a more health savvy population, the complaint of smokers throat/cough has thankfully dwindled. Working in an area of dust or chemicals can and does cause a temporary throat discomfort that rapidly clears. Next is a viral cause, and there’s quite a list of them that produce a sore throat. And lastly, there is a large list of bacteria that have been found as the source of the problem.

Well, if there are hundreds of problems that can cause the typical sore throat, why is strep separated from the herd? Explaining can take a while:

Take the normal happy healthy kid. Inside that capped tornado is a self-run defense system. This immune system is very much needed as it patrols the borders (skin), watches for intruders (viruses, fungi, and bacteria) and goes on search and destroy missions against anything that gets through that first line of defense. It works quite well as the millions of us people prove every day.

This “Bug Patrol” accepts that the normal parts of our own body are OK to be there, and goes after everything else. All those sore throats we get now and are identified as “not okay” and the battle to clean up the place begins. Those white spots on your tonsils could be the only evidence that there was a fight as the system is quite good at containment. Your immune system examines the invaders and builds a defense unit (an antibody), which it sends out to do its job.

This is all well and good, and so why worry? Well, let’s go back to that little strep bug. Not just any strep bug, but a certain special sub strain with troublesome characteristics that can give providers of medicine a headache. You see, this bug (Group A Beta Strep) has the unlikely configuration as to sort of look like you. Of course it’s not you specifically it looks like. When your immune system gets after it, the antibodies that are produced may sometimes get a bit off subject and attack something of you that you need. This complication has been known for years.

The targets of this unwanted attack can be important things like heart valves, or your joints. If your heart is involved, it is known as Rheumatic Heart Disease. When your joints hurt, it is known as Rheumatoid Arthritis.

And now you know why there is danger in that there sore throat. Can your health provider look in there at tell if you have the bad one? Sorry, but it doesn’t work that way. The only way to know for sure is that dreaded medical procedure, a throat culture.

How soon do I need to go have it done?  Well, if your sore throat lasts more than three days and is associated with fever, it would be time to have it checked. Any time you are not sure, a call or visit to your health care provider is always a good idea.

Now, you are the expert! You know what to look for and how long to wait. Remember, school starts all too soon.

(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.)