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Is It Strep – or Just a Plain Old Sore Throat?

Sore throats can be a common complaint in winter. As colder weather drives us inside and around more people, the common cold can more easily develop, and with it, a sore, scratchy throat.

How can you know if your sore throat needs medical attention?

“It is not uncommon to confuse a cold-related sore throat with the more serious strep throat, but there are differences,” said Family Nurse Practitioner Rosemary Schairer, of Samaritan Internal Medicine - Corvallis. “A sore throat is usually caused by a virus and will typically go away on its own as cold symptoms lessen, while strep throat is a bacterial infection that must be treated by antibiotics.”

A viral sore throat is typically accompanied by other cold-like symptoms, such as cough, sneeze, runny nose and a hoarse or raspy voice.

“A strep infection can make it feel very painful to swallow, and often comes with fever of 101-degrees or higher,” said Schairer. “Strep throat is far more common in children than adults.”

Group A streptococcus is the name of the bacteria which can cause several different types of infection, including strep throat, which is contagious. Someone can catch the infection by breathing in or touching infected droplets from a cough or sneeze, or by ingesting the droplets through shared eating utensils.

“Strep will often cause red and swollen tonsils, sometimes with white splotches, and/or tiny red spots on the roof of the mouth, which you may be able to see by shining a flashlight inside the mouth,” she said. “But everyone is different, and a person can have strep without these symptoms.”

If the sore throat causes trouble swallowing, lasts longer than 48 hours, or comes with a fever or rash, see your doctor.

“Strep will not go away on its own, and if not treated with antibiotics, can develop into something more serious, especially in children, so don’t delay getting medical attention,” said Schairer.

Testing for Strep

While at-home tests for strep are available, Schairer does not recommend them.

“At-home tests can often give a false negative which would delay the start of treatment. Since strep, if untreated, can lead to far more serious illness such as rheumatic fever or scarlet fever, I recommend going to the doctor to know for sure,” she said.

Testing can be done and analyzed right in your doctor’s office. If the test shows positive, antibiotics can be started right away. If it shows negative, your doctor may recommend a more extensive throat culture done at a laboratory, which would take a few days to learn the results.

“After starting antibiotics, our patients typically notice a decrease in symptoms within a day or two,” Schairer noted.

Please be aware that some symptoms of strep throat are similar to that of COVID-19, which is still active in our communities. If you are concerned that you may have the coronavirus, contact your health care provider to get COVID-19 testing and follow-up care as soon as possible.

Symptoms: Viral Sore Throat vs. Strep Throat

While these are common symptoms, everyone is different. You may have only one or two symptoms, but if you have any questions, contact your doctor for testing. Strep occurs more often in children than adults and can have serious consequences if not treated. 

Viral sore throat will go away on its own, while strep requires antibiotics. If your sore throat causes trouble swallowing, last longer than 48 hours and/or comes with a fever or rash, see your doctor.

 Symptoms Viral Sore Throat Strep Throat
Congestion/runny nose/common cold symptoms X
Raspy sounding voice X
Painful to swallow X X
White patches in back of throat   X
Tiny red spots in mouth   X
Mild fever X X
Fever higher than 101-degrees   X
Swollen lymph nodes (just below earlobes)   X
Rash on neck   X
Red, swollen tonsils   X
Symptoms last for 48 hours or longer   X

Soothing the Pain

Whether cold-related or strep, a sore throat can be very uncomfortable. While waiting for your throat to heal, Schairer recommends trying these tips to relieve the pain:

  • Gargle with warm salt water. Dissolve a half-teaspoon of salt in a cup of warm water, swish it around your mouth and lean your head back to gargle with it. When done, make sure to spit out the water rather than swallow it.
  • Drink warm liquids. Try a cup of hot water with a teaspoon of honey, or a mild tea. Avoid citrusy liquids like orange juice, which can make the pain worse.
  • Try an over-the-counter remedy. Some over-the-counter medications may temporarily relieve symptoms like cough or congestion. Throat sprays and lozenges may also help. Do not give throat lozenges to young children as they could cause choking.
  • Ice cream may help. Sometimes cold helps sooth throat pain, so if you want an excuse to eat ice cream, this could be a good one. Sucking on ice chips may also bring relief.
  • Get plenty of rest. Sleep is how the body rejuvenates and heals, so get plenty of it. It can also be a good time to watch movies, read a book, or just take it easy.


Because both colds and strep are contagious, meaning that they can spread to others, or you can get re-infected a second time, it is a good idea to try and prevent them.

“Washing our hands frequently and thoroughly makes a big difference in limiting the spread of all types of viruses and infections,” Schairer explained. “It’s also important to cover our coughs and sneezes so that droplets don’t travel to others. And avoid using another person’s glass or eating utensils.”

Eating a well-balanced diet and getting regular exercise and good quality sleep, can also help keep the body’s immune system strong and able to fight off infections.

If you or your child has a sore throat that doesn’t seem to be getting better, contact your child’s pediatrician or go to your nearest urgent care clinic for medical attention.

Get ideas for what to eat when you’re feeling sick – comfort counts!
Compare the symptoms of the cold, the flu and COVID-19.