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Colds vs. Strep: How to Tell the Difference

A worried mom looks in her daughter's mouth, checking for signs of strep throat.

By Dr. Josephine Simorangkir, Pediatric Specialists

A sore throat in children can have many causes — viruses, bacteria, dry air, allergies, or simply drainage from a runny nose. However, when a sore throat is accompanied by fever, headache, and stomach pain or nausea, it may be more than a common cold. These symptoms could indicate strep throat.

What Is Strep Throat?

Strep throat is caused by group A streptococcus bacteria. Unlike a cold, symptoms often appear suddenly and usually without a cough or stuffy nose.

Strep throat is easily treated with antibiotics. If left untreated, it can lead to rheumatic fever, a rare condition that may cause serious complications. 

Signs your child may have strep throat:

  • Sudden sore throat
  • White spots on the tonsils
  • Tiny red spots on the roof of the mouth
  • Fever
  • Pain when swallowing
  • Swollen neck glands
  • Loss of appetite
  • Headache
  • Abdominal pain, nausea
  • Rash

Signs of a sore throat caused by a cold virus:

  • Runny nose
  • Cough
  • Sneezing
  • Red, itchy, or watery eyes

Be sure to contact your pediatrician if you suspect your child has strep throat. A quick test can confirm the infection. Since strep spreads easily, keep your child home if they test positive. After 24 hours of antibiotics, your child is no longer contagious and can return to school, as long as they are fever-free without the use of fever-reducing medication.

Comfort Tips for Any Sore Throat

  • Avoid throat sprays and cough drops for young children.
  • Offer plenty of fluids.
  • Use acetaminophen or ibuprofen for fever and pain (as directed by your doctor).

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About This Author

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Children’s Hospital of The King’s Daughters has been the region’s most trusted name in pediatric care for more than 50 years. As members of CHKD Health System, our pediatricians work closely with CHKD’s full range of pediatric specialists and surgeons. They also share a commitment to quality, excellence and family-centered care. With various locations throughout the region, a CHKD pediatrician is never far.

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