Kidstuff Kidstuff
By Paul L. Marz, M.D.
Brrr… It’s cold out there! Our children have been well and healthy, but now they’re back in school after the long holiday break. All’s well. Until….!
After the first week or two, you get the letter that parents have dreaded since time immemorial. You found it in your child’s book bag and it is addressed to the parents of the class. The first part is pleasant and innocent enough, but in the second paragraph… strep throat has been discovered in a few of our students….
What is Strep Throat and why would the school tell us about it? You’ve heard of it, yet exactly what does it mean?
After all, kids get lots of infections. They usually require nothing more than a kiss and a hug. Most causes of sore throat can safely and correctly be ignored. The most common sources of this discomfort are viral. You can look ’em up: You’ve got your adenovirus, your influenza virus, parainfluenza virus, Epstein-Barr Virus, and enteroviruses: All can cause sore throats and are more likely to do so in children less than three years old.
But, for the five-to-15 age range—your typical school child—there’s a greater chance it’s real Strep Throat.
Strep Throat actually is a bacterial infection. Actually, “Strep” is just a nickname, short for Streptococcus and it has lots of family members. The lab boys (and girls) have broken this family down into groups. They gave them the imaginative names like Group A, Group B, etcetera. But for this discussion we need only focus on a particular sub-set within Group A. That’s the nasty pest we are worried about, known formally as Group A, Beta Hemolytic Streptococcus, a.k.a. GABS.
Like any good whodunit, we have the culprit, but what’s the crime? Why are the germ police so worried about Strep Throat?
Well, here’s the scoop. This family of bugs within the Group A—a small part of the total family of Streptococcus—has the ability to confuse our immune system.
In the real world, your body takes on bacteria attacks every minute of every hour of every day. Since we live amid a never-ending ocean of bacteria, we need this defensive ability to survive. Most bugs, germs and viruses that will give us sore throats in the past, present and future can be handled by our bodies with no outside assistance.
Except for this one critter, GABS. Because if our body does try to handle it alone, we may sometimes regret it.
Our immune system is a finely tuned machine. It can separate the billions of cells in our body into those that belong and need protection, and those that are alien and need to be destroyed. Group A, Beta Hemolytic Streptococcus has the ability to confuse the immune system to attack some of the good parts of a healthy body.
Ask Grandma about Rheumatic Fever. She can tell you stories about this one if she was around in the ’40s. This disease is caused by the body going after itself following a GABS infection. Then there is Rheumatic Heart Disease, another problem that can change your life. GABS is responsible for this one, too. Don’t forget Rheumatic Arthritis. Some types of kidney disease also can result.
So now you may have a little understanding into why your doctor will not help you with the magic antibiotic for your sore throat if the test is negative for strep. Most likely the cause of your pain is a virus, and even if it is not, your body will whip it just as quickly anyway. The medical profession has tried for years to get the message out. Sore throat for three days…you NEED a throat culture to tell if the bad boy Strep is in town.
Ever hear of Scarlet Fever? This problem is caused by a few, rare sub-strains within this family of bugs. In a sense, it’s really just Strep Throat with a rash.
So, now, as you read the letter from the school, you don’t have to freak out. They’re just letting you know that your child’s complaint of a sore throat should not be ignored.
(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.)