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School Nurse’s Guide to Strep Throat

The School Nurse’s Guide to GAS

I wanted to call this article “The School Nurse’s Guide to GAS.” But, I thought that if someone was really looking (and being serious) about strep throat that “GAS” wouldn’t be a term that would draw a school nurse to an article on Strep Throat. “GAS,” or group A streptococci, which causes bacterial pharyngitis — also known as strep throat — is what we’ll be talking about…and some other stuff, too.

My Pops, my grandfather, was a hoot. When I was in early elementary school, and I’d get a sore throat, he’d say, “Kevin, you been smooching girls again?” Then I’d get all red-faced, “Oh Pops! That’s gross!” Truth be known, I don’t think I ever had strep throat in my whole life. Even before I became a nurse, I had the curse of having a keen understanding of cooties and how those little dudes spread all around (I am a grade-A germaphobe who still doesn’t wear shoes in my house). Having a mother as a nurse probably had a role in that…but…anyway, let’s do some talking about strep throat…and keep reading…we’ll also discuss scarlet fever. Yes, if the child has strep throat, there’s a chance that they will develop scarlet fever and rheumatic fever…and rheumatic fever (did you know that rheumatic fever is NOT an illness?).

What Is Strep Throat

Strep throat, or “strep,” as some will call it, is caused by group A streptococcus bacteria (GAS). Remember that round or spherical-shaped bacteria are “cocci” like streptococcus, and the rod-shaped bacteria are “bacilli” like salmonella. Strep throat is actually called, “streptococcal pharyngitis.” This infection of the throat and tonsils is very contagious; we’ll talk about that next.

How Does Strep Throat Spread

We all have nice, moist throats to allow these aerotolerant, non-motile and non-sporing cocci to “do their thing.” And through this moist and juicy area of our bodies, a lot of forceful air moves…in and out…with respiratory droplets being “spat” this way and that even while just talking. These bacteria find their way into another’s moist throat either by their breathing in the droplets; touching something that has the bacteria and then touching their mouth, nose, or eyes; drinking after someone (water fountains); kissing (No, Pops! Not me!), or a number of other ways.

People who are contagious with strep throat may not even be sick or show symptoms of illness.

Symptoms of Strep Throat

A young-un shows up with sore throat that wasn’t there when they got to school a few hours ago (starts quickly), they complain of painful swallowing, they have a fever plus red and swollen tonsils with white patches or lines of pus-like residue (gross!), they have red spots on the roof of their mouth, and/or even swollen lymph nodes on the front of their neck. All or many of these symptoms may indicate you have a child with strep throat.

Strep throat symptoms:

Sore throat

Hurts when swallowing

Fever

Red and swollen tonsils with white patches or lines of pus-like residue

Red spots on the roof of the mouth

Swollen lymph nodes on the front of the neck

A child with a sore throat, cough, runny nose, and hoarse voice may have a viral infection and not strep throat. It may just be a cold. If the child shows up with a sore throat along with a runny nose, sniffling and sneezing, headache, coughing, and body aches, as well as a fever, the infection may be viral (with “maybe” being the key word).

Symptoms that may indicate the sore throat is viral (may):

Runny nose (though you may see a thick nasal discharge with strep throat in younger children).

Nasal congestion

Sneezing

Cough

Mild headache

Mild body aches

Fever

(https://www.webmd.com/cold-and-flu/sore-throat-cold-strep-throat-tonsillitis#1)

Incubation and Contagious Periods

RADT

In order to get a diagnosis for strep throat, a rapid strep test (RADT) or a throat culture is required. Strep throat is cured with antibiotic therapy. Most sore throats are caused by a viral infection. As a matter of fact, about 60%-80% of all bonafide sore throats (infection) are caused by a virus in relation to our school children. When our fellow teachers (adults) have a throat infection, then it’ll be viral about 85%-95% of the time. And we all know that antibiotics for viruses is like trying to give a shot with the backside of a syringe; it just ain’t gonna work. So, it’s important to know what’s causing the sore throat and other symptoms before deciding on a treatment plan of care (not that we school nurses are often involved in this process, but parents and even the older students would like to know). One RADT is called the Lateral Flow Test. It kinda uses the same principles as a home pregnancy test…but…well…is way different, too.

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