Labcorp and its Specialty Testing Group, a fully integrated portfolio of specialty and esoteric testing laboratories.
To determine if your sore throat is strep throat, an infection caused by group A streptococcus (GAS) bacteria
When you have a sore throat that starts quickly and lasts more than a week and/or you have other symptoms, such as a fever of 101° F or higher or reddened throat and/or tonsils with white or yellow patches or streaks
A healthcare practitioner uses a tongue depressor to hold down your tongue and then inserts a swab into your mouth and rubs it against the back of your throat and tonsils. The swab may be used to do a rapid strep test in a doctor's office or clinic, or it may be sent to a laboratory. A second swab may be collected along with the first one. This extra sample may be used to perform a throat culture as a follow-up test, when necessary.
No test preparation is needed. The test should be performed before antibiotics are prescribed.
The bacteria Streptococcus pyogenes, also known as group A beta-hemolytic streptococcus or group A strep (GAS), causes strep throat, the most common bacterial cause of inflammation and soreness of the back of the throat (pharyngitis). Strep tests include rapid strep tests and throat cultures that detect these bacteria in a sample taken from the back of your throat.
While most sore throats are caused by a virus and will resolve without treatment within a few days, some people with sore throats have strep throat. Strep throat is most common in children and teens ages 5 to 15 years old. It is important to diagnose and treat strep infections promptly with antibiotics because they are very contagious and complications can develop.
A rapid strep test and/or a throat culture is used to diagnose group A strep as the cause of symptoms so your healthcare practitioner can prescribe the proper antibiotics for treatment.
Strep tests are used to determine whether your sore throat is strep throat, an infection of the throat and tonsils caused by group A strep (GAS).
A healthcare practitioner will typically order a strep test when you have a sore throat and other symptoms that suggest strep throat. There is a higher suspicion of strep in children with sore throats and when you have been in close contact with someone who has been diagnosed with strep throat. You or your child should see a healthcare provider and get tested when you have signs and symptoms such as:
Testing may not be done when you also have symptoms more closely associated with a viral infection, such as:
Treatment lasts about 10 to 14 days, depending on the antibiotic prescribed. Although your symptoms may improve or disappear before you have taken all of your antibiotics, you should complete your full course of treatment by taking all of the pills that were prescribed.
You should complete at least 24 hours of antibiotics before close contact with others.
Usually after one full day of therapy and absence of significant fever, your child could return to school. However, a few small studies have found that children may return to school as soon as 12 hours after taking their first dose of antibiotic provided they no longer have a fever and their symptoms have improved.
Other family members, including adults, can be infected by the bacteria. Your healthcare provider may test all family members who have sore throats and may test children under the age of 3. In most cases, it is not necessary to test other family members who do not have symptoms.
You can stop the spread of strep throat by good hand washing, especially after coughing and sneezing and before preparing food or eating. If you have a sore throat, you should be seen by a healthcare provider who can perform tests to find out whether the illness is strep throat. If the test result shows strep throat, you should stay home from work, school, or daycare until 24 hours after taking an antibiotic.
Yes. Although antibodies may protect those who have had previous strep infections, there are so many different strains of the bacteria that it is unlikely you will be immune to all of them. You can potentially get strep throat again and again. The best way to decrease the risk of transmission to others is to minimize close contact with others when ill and wash hands often and thoroughly with soap and water or alcohol-based hand scrub.
Antistreptolysin O (ASO) is a blood test used to help diagnose a current or past infection with group A strep (Streptococcus pyogenes). It detects antibodies to streptolysin O, one of the many strep antigens. This test is rarely ordered now compared to thirty years ago. For an acute strep throat infection, the ASO test is not helpful; the rapid strep test or throat culture should be used. However, if a healthcare practitioner is trying to find out if someone had a recent strep infection that may not have been diagnosed, this test could be helpful. In addition, it may be used to help diagnose rheumatic fever or glomerulonephritis, which occurs weeks after a strep throat infection when the rapid strep and throat culture would no longer be positive.
Yes. Group A strep can also cause infections such as impetigo and, rarely, more serious conditions such as toxic shock syndrome or necrotizing fasciitis (the so-called "flesh-eating bacteria"). For more details, see the article on Wound and Skin Infections.
Group C and group G strep, normally found in animals, can rarely cause sore throats in humans. However, these bacteria do not pose a risk for the serious secondary complications associated with group A strep. Antibiotic treatment for group A strep will be effective against these bacteria as well.
During influenza season, the early symptoms of influenza, such as fever, chills, headache, sore throat, and muscle pain, may mimic strep throat. To differentiate between strep and influenza, a rapid strep test and a rapid influenza test may be done at the same time.
Most people with strep throat would eventually recover without antibiotic treatment, but they would be contagious for a longer period of time and are at a greater risk of developing secondary complications.
Strep throat is most common in children and teens ages 5 to 15. Some school children may be carriers, people who have the bacteria but who have no symptoms. Carriers can still spread the infection to others.
Recent antibiotic therapy or gargling with some mouthwashes may affect the rapid strep test results.
Sources Used in Current Review
(Updated September 7, 2018) Kahn, Z. Group A Streptococcal Infections. Available online at http://emedicine.medscape.com/article/228936-overview. Accessed August 2020.
(September 28, 2018) Strep Throat. Available online at http://www.mayoclinic.org/diseases-conditions/strep-throat/basics/definition/con-20022811. Accessed August 2020.
(November 1, 2018) US Centers for Disease Control and Prevention. Strep Throat: All You Need to Know. Available online at https://www.cdc.gov/groupastrep/diseases-public/strep-throat.html. Accessed August 2020.
IDSA Updates Guideline for Managing Group A Streptococcal Pharyngitis. Am Fam Physician. 2013 Sep 1;88(5):338-340. Available online at https://www.aafp.org/afp/2013/0901/p338.html. Accessed August 2020.
(Content Review: October 2017) Group A Streptococcal Disease. ARUP Consult®. Available online at https://arupconsult.com/content/streptococcal-disease-group. Accessed September 2020.
(September 1, 2018) Dithi Banerjee, PhD, and Rangaraj Selvarangan, BVSc, PhD, D(ABMM), FIDSA. The Evolution of Group A Streptococcus Pharyngitis Testing. Clinical Laboratory News. Available online at https://www.aacc.org/cln/articles/2018/september/the-evolution-of-group-a-streptococcus-pharyngitis-testing. Accessed September 2020.
Sources Used in Previous Reviews
Thomas, Clayton L., Editor (1997). Taber's Cyclopedic Medical Dictionary. F.A. Davis Company, Philadelphia, PA [18th Edition].
Pagana, Kathleen D. & Pagana, Timothy J. (2001). Mosby's Diagnostic and Laboratory Test Reference 5th Edition: Mosby, Inc., Saint Louis, MO.
(2005 October 11). Group A Streptococcal (GAS) Disease (strep throat, necrotizing fasciitis, impetigo). CDC, Division of Bacterial and Mycotic Diseases [On-line information]. Available online at https://www.cdc.gov/groupastrep/index.html.
Vincent, M., et. al. (2004 March 15). Pharyngitis. American Family Physician [On-line journal]. Available online at http://www.aafp.org/afp/20040315/1465.html.
Kazzi, A. and Wills, J. (2005 April 21, Updated). Pharyngitis. eMedicine [On-line information]. Available online at http://www.emedicine.com/emerg/topic419.htm.
Gerber, M. and Shulman, S. (2004 July). Rapid Diagnosis of Pharyngitis Caused by Group A Streptococci. Clinical Microbiology Reviews, July 2004, p. 571-580, Vol. 17, No. 3 [On-line journal]. Available online at http://cmr.asm.org/cgi/content/full/17/3/571.
Homeier, B. (2005 September, Reviewed). Strep Throat. KidsHealth for Parents, Nemours Foundation [On-line information]. Available online at http://kidshealth.org/parent/infections/lung/strep_throat.html.
Pagana, K. D. & Pagana, T. J. (© 2007). Mosby's Diagnostic and Laboratory Test Reference 8th Edition: Mosby, Inc., Saint Louis, MO. Pp 912-913.
Forbes, B. et. al. (© 2007). Bailey & Scott's Diagnostic Microbiology, 12th Edition: Mosby Elsevier Press, St. Louis, MO. Pp 265-278.
Smith, D. S. (Updated 2008 September 3). Streptococcal screen. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003745.htm. Accessed May 2009.
Sharif, I. (2008 November). Strep Throat. TeensHealth, The Nemours Foundation [On-line information]. Available online at http://kidshealth.org/teen/infections/bacterial_viral/strep_throat.html#. Accessed May 2009.
Nainggolan, L. (2009 March 6). AHA Updates Advice on Strep Throat, Preventing Rheumatic Fever. Medscape Today from Heartwire [On-line information]. Available online at http://www.medscape.com/viewarticle/589223. Accessed May 2009.
Vorvick, L. (Updated 2009 March 14). Strep throat. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/000639.htm. Accessed May 2009.
(2009 February 26). Diagnosing, treating strep throat key to preventing rheumatic heart disease. American Heart Association News Release [On-line information]. Available online at http://americanheart.mediaroom.com/index.php?s=43&item=682. Accessed May 2009.
Mayo Clinic staff (2008 June 26) Strep throat. MayoClinic.com [On-line information]. Available online at http://www.mayoclinic.com/print/strep-throat/DS00260/DSECTION=all&METHOD=print. Accessed May 2009.
(2012 September 10). Bad Sore Throat? It's Probably Not Strep, Most Likely Viral. IDSA [On-line information]. Available online at http://www.idsociety.org/2012_Strep_Throat_Guideline/. Accessed September 2012.
Shulman, S. et. al. (2012 September 9). Clinical Practice Guideline for the Diagnosis and Management of Group A Streptococcal Pharyngitis: 2012 Update by the Infectious Diseases Society of America. Clin Infect Dis. (2012) doi: 10.1093/cid/cis629. [On-line information]. Available online at http://cid.oxfordjournals.org/content/early/2012/09/06/cid.cis629.full. Accessed September 2012.
Khan, Z. and Salvaggio, M. (2012 August 1). Group A Streptococcal Infections. Medscape Reference [On-line information]. Available online at http://emedicine.medscape.com/article/228936-overview. Accessed September 2012.
Delgado, J. and Fisher, M. (Updated 2012 September). Streptococcal Disease, Group A - Group A, Strep. ARUP Consult [On-line information]. Available online at http://www.arupconsult.com/Topics/StrepA.html. Accessed September 2012.
Mayo Clinic staff (2010 June 26). Strep throat. Mayoclinic.com [On-line information]. Available online at http://www.mayoclinic.com/print/strep-throat/DS00260/DSECTION=all&METHOD=print. Accessed September 2012.
Ben-Joseph, E. (Reviewed 2011 October). The Scoop on Strep Throat. KidsHealth from Nemours [On-line information]. Available online at http://kidshealth.org/kid/ill_injure/sick/strep_throat.html#. Accessed September 2012.
Pagana, K. D. & Pagana, T. J. (© 2011). Mosby's Diagnostic and Laboratory Test Reference 10th Edition: Mosby, Inc., Saint Louis, MO. Pp 939.
Choby B. Diagnosis and Treatment of Streptococcal Pharyngitis. Am Fam Physician. 2009 Mar 1;79(5):383-390. Available online at http://www.aafp.org/afp/2009/0301/p383.html. Accessed September 2012.
(May 2, 2012) Center for Disease Control and Prevention. Get Smart: Know When Antibiotics Work, Sore Throat. Available online at http://www.cdc.gov/getsmart/antibiotic-use/URI/sore-throat.html. Accessed September 2012.
Kahn, Z and Salvaggio, M. (2015 3 September, Updated). Group A Streptococcal Infections. Available online at http://emedicine.medscape.com/article/228936-overview. Accessed on September 7, 2015.
Mayo Clinic Staff. (2012 20 December, Updated). Strep Throat. Available online at http://www.mayoclinic.org/diseases-conditions/strep-throat/basics/definition/con-20022811. Accessed on September 7, 2015.
US Centers for Disease Control and Prevention. (2014 20 October, Updated). Is It Strep Throat? Available online at http://www.cdc.gov/Features/strepthroat/. Accessed on September 7, 2015.
Medscape Medical News. (2015 2 April). Rapid Group A Strep Test Clears FDA. Available online at http://www.medscape.com/viewarticle/842544. Accessed on September 7, 2015.
Lean W, Arnup, S, Danchin M, and Steer A. Rapid Diagnostic Tests for Group A Streptococcal Pharyngitis: A Meta-analysis. Pediatrics. 2014;134(4). Available online at http://pediatrics.aappublications.org/content/early/2014/09/02/peds.2014-1094. Accessed on September 7, 2015.
Alere i Strep A. [Package Insert]. Alere Scarborough, Inc., Scarborough, Maine. July 2015.
Medscape Medical News. (2015 2 September). Strep Throat: Treated Kids Can Return to School in 12 Hours. Available online at http://www.medscape.com/viewarticle/850338. Accessed on September 7, 2015.