Amidst an increase in multiple respiratory viruses like RSV, the onset of flu season, and continued pandemic concerns, ERs, urgent care centers, and doctor’s offices are seeing an uptick in visits, prompted by every sore throat, sniffle, and sneeze and accompanying parental concern. But one infection, in particular, has been sending parents and kids to see their doctors in droves.
It’s known as Group A Streptococcal pharyngitis. But you know it by its household name: strep throat.
Symptoms often include:
- sore throat
- fever
- pain when swallowing
- bright red throat with pale spots
- swollen lymph nodes
- nausea
The illness typically presents without common respiratory symptoms like cough, congestion, or runny nose and is largely seen in children between the ages of 5 and 15.
In fact, it remains one of the leading causes for pediatric visits nationwide.
But frequent swabs for infection could ultimately do more harm than good.
“As much as we wish tests that were readily available to us would provide answers and direct treatment – they frequently don’t,” says Dr. Keyvan Rafei, founder of Culex Wellness.
The expectation when testing for strep throat, is that the results will tell doctors and parents clearly if a child is or is not infected. The reality is that interpretation is much more complicated.
Strep Carriers Cause Confusion
There are perhaps 10 times more microbes in the human body than human cells. These help to keep us – and our immune systems – healthy and hearty.
For some individuals, however – and for reasons that science has yet to understand – strep can be a bacteria that is continuously present in the mouth.
These people are considered strep carriers, and approximately 10-15 percent of all children fit the bill.
Though not at risk for problems that stem from strep infection – like rheumatic heart disease – these carriers can nonetheless present with sore throat symptoms, be tested, receive a false-positive, and be prescribed antibiotics for a viral infection that simply won’t respond to treatment, no matter what.
The Problem with Prescriptions
Did you know? Non-invasive strep throat eventually resolves itself in a little as a week’s time, without intervention.
However, there are two reasons medical science leans toward treatment, almost predominantly. Local complications – such as tonsilitis or peritonsillar abscess – can occur if a strep infection begins in the throat but goes further and deeper into the tissue.
By and large, the main ideology for treating strep throat is the prevention of rheumatic heart disease, a dangerous inflammatory condition that can develop if and when strep throat and scarlet fever aren’t addressed properly.
While the risk for rheumatic fever is very low in the United States, “better safe than sorry” remains the presiding school of thought.
While antibiotics CAN cut down on the timeframe in which a child is contagious (“all clears” are typically given within 24 hours after starting a 10-day course), antibiotics are not without their own side effects. Allergic reactions, diarrhea, and other impact a percentage of children.
The real problem, however, is that the antibiotics prescribed to be taken by mouth affect the entire body. After wiping out a strep infection, the antibiotic travels throughout the bloodstream to all of the other places where bacteria reside. There, they can inadvertently eliminate healthy, helpful bacteria our bodies rely on, while allowing resistant bacteria to multiply and take their place.
The danger is that when blind testing for strep, physicians have no way of truly knowing whether the infection is present or if the patient is a strep carrier in who this bacteria continuously resides. With no way to tell the two apart, doctors – bound by duty – prescribe antibiotics to avoid potential complications. But was that antibiotic necessary?
Culex Wellness believes in doing right by our patients, which involves remaining ever-vigilant in prescribing antibiotics only when they are absolutely necessary, and not abusing our medical resources.