STREP THROAT STREPTOCOCCUS PYOGENES - Ontario Camps Association

STREP THROAT
STREPTOCOCCUS PYOGENES

WHAT IS STREP THROAT?

   A contagious disease caused by infection with streptococcal bacteria

   Specific bacteria= Group A Streptococcus (GAS) bacteria: streptococcus
    pyogenes

   This bacteria are often found in the throat or on the skin and are
    responsible for other illnesses as well as impetigo (skin infection)

WHAT IS STREP THROAT (cont’d)

   It is the most common cause of sore throat in school aged children and
    teens

   Causes inflammation and swelling of the mucus membranes lining the
    back of the throat and tonsils

   Some individuals may carry Group A Streptococcus in the throat or on the
    skin and not have any signs or symptoms

SIGNS AND SYMPTOMS:

   Throat pain that usually comes on
    quickly
   Painful swallowing
   Red and swollen tonsils sometimes with
    white patches or streaks of pus
   Tiny red spots on the soft or hard
    palate of the mouth
   Swollen, tender lymph nodes
   Fever, headache, rash
   Nausea or vomiting
   Body aches

VIRAL OR STREP?

Many of these signs and symptoms could be a viral infection or other illness.

VIRAL OR STREP?

VIRAL                                               STREP
   Sore throat is often the first sign of a cold      Sore throat is more severe and persists
   Sore throat from a cold often gets better
    or goes away within 1-2 days
   Accompanied by congestion, runny                   Painful inflammation or infection of the
    nose, red or watery eyes, cough and                 tonsils, the tissue masses located at
    sneezing
                                                        the back of the throat
   Other causes of sore throat are irritants in
    the air, allergies or dry air
   Antibiotics are not effective in treating          Treated with antibiotics
    viral illness

WHEN TO SEE A DOCTOR:

   A sore throat that is accompanied by tender, swollen lymph
    glands

   A sore throat that lasts longer than 48hrs

   A fever higher than 101F (38.3 C) in older children or fever that
    lasts longer than 48hrs

   Sore throat with a rash

   Problems breathing or swallowing

HOW DO YOU GET IT?

   Streptococcal bacteria are highly contagious

   It spreads through airborne droplets (coughing, sneezes, shared
    food/drinks)

   It also spreads through infected surfaces (door knobs, tables) and transfer
    them to your nose/mouth/eyes

   Spreads when groups of people are in close contact

   Tends to circulate in the late fall and early spring

CONTAGIOUS PERIOD:

   Contagious for about 2-3 weeks in people that do not take antibiotics

   Spreads via -direct contact (person-person)- mucus droplets
                -indirect contact (kissing, sharing utensils and drinking cups)

   Incubation period: 1-5 days after exposure to the bacteria

   No longer contagious 24 hours after antibiotics have been started

DIAGNOSIS:

   Physical exam looking for signs and symptoms of strep throat

   Rapid Antigen Test

   Throat Culture

RAPID ANTIGEN TEST:

   Throat swab that can detect strep bacteria in minutes by looking for
    substances (antigens) in the throat
   A positive test response occurs when a reaction occurs between a protein
    on the surface of the strep bacteria and chemicals in the test material
   Either living or dead strep bacteria will produce a positive reaction
   Most rapid tests have a sensitivity of 95%
   98% of positive tests correctly indicate the presence specifically of Group
    A Streptococcus bacteria
   2% false positive = similarity between surface proteins found on strep
    bacteria

THROAT CULTURE:

   The most traditional test

   Sterile swab rubbed over back of throat and tonsils to get a sample of
    secretions

   Sample is cultured in a lab looking for presence of the bacteria

LIMITATIONS:

Rapid Antigen Test                           Throat Swab
   5/100 people with strep throat will be      Can take as long as 2 days to get
    missed, therefore all negative swab          culture results= possible delay in
    specimens should be sent for culture         starting antibiotics
    to confirm the absence of strep
    bacteria                                    Access to a lab
   Responds only to the presence of the
    streptococcal bacteria (Group A)
    responsible for strep throat- other
    bacteria and viral causes are not
    detected
   Cost of test kit
   Accessibility

TREATMENT:

ANTIBIOTICS (Penicillin, Amoxicillin, Cephalexin)
   Reduce the duration and severity of symptoms
   Reduce the risk of complication and reduce spread of infection
   Improvement seen in 1-2 days
   An individual is no longer contagious after 24 hours after beginning
    antibiotics
   Entire dose of antibiotics must be completed
   Antibiotics will not help if a sore throat is caused by a virus

COMPLICATIONS:

   Strep bacteria may spread causing infections in:
        Tonsils
        Sinuses
        Skin
        Blood
        Middle ear (Otitis media)
        Kidneys (Glomerulonephritis)
        Brain (meningitis)

SCARLET FEVER:

   Bacterial illness that develops is some people who have strep throat
   Features a bright red rash that covers most of the body
   If left untreated can result in more serious conditions that affect the
    heart, kidneys and other parts of the body
SYMPTOMS:
   Red rash: looks like a sunburn and feels like sandpaper
   Red lines: folds of skin around the groin, armpits, elbows, knees and
    neck become a deeper red than the rash
   Flushed face:
   Strawberry tongue: looks red and bumpy and often covered with a
    white coating early in the disease

RHEUMATIC FEVER:

   A serious complication of strep throat if left untreated or inadequately
    treated by antibiotics

   Causes a persistent immune response from the body that triggers the
    immune system to mistakenly attack other organs in the body including
    the joints and heart vales causing arthritis and potential heart failure

POST-STREPTOCOCCAL
GLOMEULPNEPHRITIS (PSGN)

   Characterized by the sudden appearance of hematuria, proteinuria and
    red blood cell casts in the urine, edema and hypertension with or without
    oliguria
   Develops 10-14 days after strep throat infection
   Children less than 7 years old are at increased risk of developing PSGN
    after an episode of strep throat
   Typically resolves spontaneously after a few weeks and usually does not
    lead to permanent kidney damage

SELF MANAGEMENT:

      Get plenty of rest - sleep helps the body fight infection

      Drink plenty of water - keeping a sore throat lubricated
       and moist eases swallowing and helps prevent
       dehydration

      Eat soft and cold foods: easy-to-swallow foods are more
       soothing (broths, applesauce, popsicles, smoothies)

      Gargle with warm salt water: ¼ teaspoon salt to 8ozs of
       warm water- helps relieve throat pain

SELF MANAGEMENT:

   Use a humidifier: cool mist moisture eases discomfort

   Avoid irritants: cigarette smoke, fumes (paint, cleaning
    products)

   Throat losenges: provides temporary relief of sore throat (not
    recommended for young children)

   Over-the-counter (OTC) pain medications: Tylenol and advil-
    reduce fever and provide pain control

PREVENTION:

   Hand hygiene is the best way to prevent spread of infection

   Do not share personal items (drinking glasses, utensils)

   Cover your mouth

   Clean surfaces

QUESTIONS TO DISCUSS:

   If awaiting throat culture results, would you immediately start
    antibiotics based on physical examination or after getting a
    positive throat culture result?