The difference between viral sore throat vs. strep throat

While you’re suffering through the pain of a sore throat, it may seem trivial to consider the source of your discomfort. After all, you’re concentrating on getting sips of water down, not the root cause of this illness.

But the type of sore throat you have impacts the treatment used to cure it. Read on to learn the difference between strep throat vs. sore throat and why it matters to help you get the best treatment.

What is a viral sore throat?

A viral sore throat (scientifically called pharyngitis) is a pain in the throat that can be caused by many different kinds of viruses and can be made worse by swallowing. It may or may not have other symptoms, such as fever, fatigue and swollen lymph nodes. 

Another common symptom of a throat infection is laryngitis or losing your voice. This is most often caused by a virus and is usually not that serious. However, it can be a nuisance. If the condition lasts longer than one week or is accompanied by fever, difficulty swallowing or breathing, visit your healthcare provider or local urgent care to determine the cause and begin treatment.

Causes

A viral sore throat causes inflammation of your throat and is often associated with other symptoms of upper respiratory viral infections such as fever, fatigue, cough, runny or stuffy nose and swollen glands.  There are many common viruses that cause pharyngitis, including rhinovirus, adenovirus, coronavirus ( COVID ) and flu ( influenza virus).

A sore throat can also be caused by allergens like pollen, dust and food, or sometimes bacterial infections. However, the most common culprits are flu and viral infections, which don’t respond to antibiotics.

What is strep throat?

A sore throat can be just the beginning of something more serious—strep throat (streptococcal pharyngitis). Let’s review the differences and when you need to take action and seek medical care.

Some signs of strep throat include swollen, white patches on the tonsils, scratchy throat and tonsils, moderate fever, headache, swollen glands (neck) and sometimes a mild rash.

Causes

Strep throat is a bacterial infection caused by streptococcus pyogenes, also called group A streptococcus. This bacteria is highly contagious. It can be spread via droplets when an infected person coughs or sneezes or from sharing food and beverages. 

Viral sore throat vs. strep throat symptoms

Sore throat symptoms are typically caused by inflammation due to a virus like the common cold. However, about 15 percent of sore throats are caused by bacteria called streptococcus or strep. Strep throat requires treatment with an antibiotic, while viral causes of sore throat do not.

Viral sore throat symptoms:

• Cough
• Fever
• Runny nose
• Hoarseness
• Body aches
• Mouth sores

Strep throat symptoms:

• Sudden onset sore throat
• Pain with swallowing
• Fever > 100.4
• Headache
• White spots (pus) on tonsils
• Swollen lymph nodes
• Recent contact with strep
• Tummy ache (in children)

Who’s at risk? 

Strep throat is most common in school-age children between 5 and 15 years old.

It’s estimated that approximately 15 percent to 40 percent of cases of sore throat in this age group are caused by strep bacteria. There are several million cases of strep illness in the United States each year.

Treatment

The treatment for a sore throat will depend on whether it's strep vs. viral. Only a healthcare provider can help determine the type of sore throat and provide the correct treatment. 

Viral sore throat treatment

A viral sore throat may or may not require additional treatment beyond rest and staying hydrated. Antibiotics should not be taken as a treatment for viral infections. 

Strep throat treatment

If you’ve been diagnosed with strep throat, your healthcare provider will prescribe antibiotics, which must be taken according to the instructions. Antibiotics can help prevent any worrisome complications like rheumatic fever, which can damage valves in the heart.

Sometimes, strep throat will go away by itself. Antibiotics can reduce symptoms by about a day; however, they don’t help the throat much more than over-the-counter medication. 

Once you’ve started taking antibiotics for strep throat, you’ll begin feeling better in a day or two. Call your healthcare provider if you don’t feel better after 48 hours.

Important prevention tips

To prevent the spread of infection, people with strep should stay home from work, school, or daycare until their fever is gone or until they’ve been on antibiotics for 24 hours.

It is also important not to prepare and share food or drinks with others and to wash your hands frequently. 

Strep can’t be diagnosed simply by looking at your throat. To detect the presence of the bacteria, your healthcare provider must do a strep test with a throat swab.

The traditional test for strep throat is a throat culture, which takes two to three days for results. By comparison, the rapid strep test can produce results within minutes.

If you need help assessing and treating a sore throat, come see the experts at any of our local urgent care centers. You can walk in or save your spot online. We’ll have you back to feeling better in no time.

Written by Sarah Thebarge, Physician Assistant