Dear Dr. Mom,
I have a situation with strep that is making me crazy! My 12 year old has had strep at least 12 times in the past 8 months. Each time we treat with antibiotics. We’re REALLY good about following the dosing directions. Yet, at least half the time, the first round of antibiotics doesn’t clear it up and we have to do it again with another type of antibiotic. We always have his throat swabbed again after the meds are done to be sure we beat it, but within 2-3 weeks, he has it again!
He already had his tonsils taken out – and that was before he’d ever had strep throat. Both his dad and I have had our throats swabbed and we come up clean. I’m concerned that he seems to be taking antibiotics all the time.
—Susan
This does sound very frustrating for you and your son. Twelve infections in that short amount of time does seem extremely excessive especially in light of his tonsillectomy and adherence to antibiotic treatment. With that being said, I do wonder why he keeps getting tested at the end of each antibiotic course. Is this because he remains symptomatic? Meaning, does he have continued sore throat and fever?
The reason I ask is because your son could be a carrier of the bacteria that causes strep throat. The bacteria, known as streptococcus pyogenes (or group A strep), can remain in the oropharynx (throat) of up to 20% of school age children. These “carriers” are often asymptomatic and repeat testing is generally unnecessary. In addition, these children do not need to be treated with additional antibiotics if they remain asymptomatic.
The only children who should be tested again for group A strep following treatment for strep throat are:
- Children who continue to have symptoms of strep throat following completion of antibiotic therapy.
- Children with a history of rheumatic fever (this is a complication of untreated acute strep throat)
- Those children whose household contacts are having recurrent and documented strep throat infections.
In the cases of the children above, they should be treated with a stronger antibiotic should their repeat strep test come back positive.
If your son falls in neither one of those categories (no history of rheumatic fever and no recurrent strep throat among household contacts) and he is asymptomatic at the end of treatment, he does not need to be re-tested for group A strep.
So, how can you know for sure if your son is simply a carrier?
- You can ask your son to be tested for strep during a time when he has no symptoms. This may have already been done. If his test was positive during an asymptomatic interval, then he is most likely a carrier.
- You can have your son’s ASO titers checked. This is a blood test. Typically, ASO titers are high during an acute infection. If his titers are very low, this points to him being a carrier. Keep in mind, this test is not necessary. It can be done if you and your doctor are still unsure of his carrier status.
The problem that group A strep carriers can run into during cold and flu season is that they can often have sore throats that are due to these viruses and not strep. If your son happens to get tested during this time and he is a carrier, he may mistakenly be diagnosed with strep throat and be treated yet again with antibiotics.
In order to distinguish a true strep throat infection versus a viral infection, keep in mind that strep throat usually causes severe sore throat, fever, headache, and sometimes stomach ache and nausea. There is typically the absence of viral and flu symptoms such as runny nose, congestion, cough, and/or body aches and fatigue.
Work closely with your son’s doctor. Ask him about the possibility of your child being a carrier of group A strep. If it is determined that your son is a carrier, don’t worry. Being a carrier is not a lifelong condition, nor is it a serious one. Carriers are unlikely to spread this bacteria to household contacts and they are not at a higher risk for developing complications associated with strep throat.
The bottom line is this: Stop having your son tested for strep throat if he is not having any symptoms. Realize that being a carrier of group A strep does not mean that he is contagious to those around him. He is only contagious if he is having an acute strep throat infection (fever, sore throat, etc).
I hope this helps you in your quest to solve your son’s strep throat dilemma.
Every Wednesday I will be answering a question from You! Please submit your parenting or health related question to mommamd4two(at)aol(dot)com. I’m looking forward to hearing from you and featuring your question.
Wow! Really interesting question. My oldest daughter also gets strep all the time, every since the 1st grade. In fact it is the only illness she ever gets. She doesn't always have all the symptoms, but I know as soon as she gets one the rest are soon to follow.
Fortunately for us the antibiotics work well.
Hello,
I was wondering what antibiotics you have used for the strep throat that really worked??
Thank you,
Susan
I had no idea some people carry it always!
My daughter had two bouts of strep throat and some kind of viral infection with 103 fever and within a month! I'm definitely worried that her tonsils could be what's causing her problems.
If this child isn't a carrier, but truly getting recurring bouts of strep throat, I wonder if the problem is with his toothbrush. We've been very careful about replacing my daughter's toothbrush during her strep throat attacks. Not doing so could cause recurring infections!
@Cheryl D: Good point about taking measures to prevent true recurrences. Changing the toothbrush after a bout of strep throat is a good preventive measure.
Thank you for these great posts!
I'm the mom who wrote the original question. The reasons my pediatrician swabs him AFTER the antibiotic is finished are:
1. To see if he's a carrier. The pedi tells me that a negative strep shows that my son is not a carrier.
2. Because several times my son has gotten very sick again right after the end of his anitbiotic and we've needed to go on a second, stronger course of meds to really kick the strep.
We always change the toothbrush after my son has been on the antibiotic for 24 hours. We do not have any pets (I'm told that pets can be carriers). And, there have been times when my son had a sore throat, had a strep test, and it turned up negative. So – I'm thinking that he's NOT a carrier (right?)
Any further thoughts or suggestions?
Thanks for bringing this up, I went through a period of time in college with constant positive strep tests before an urgent care DR finally relayed this information to us.
To the mom with the original question: This isn't the answer you want to hear, but I went through a period of time where the exact same thing happened to me as a child. I had strep more times than I could count on one hand in one years time as a kid. Eventually we started the shots instead of oral antibiotics, for whatever reason that made a difference or it just got better. It's hard to know which it was. But it did eventually stop.
I'm sorry you and your kiddo are going through this. Strep is horrible stuff!
This is great advice here, Melissa!
I *always* had strep when i was little- & this post makes me wonder if I'm a carrier?
I think that this is so timely with so many sicks going aroundandaroundandanround right now. Thanks so much for the great info!
@SusanF: Sounds like you have a wonderful pediatrician working with you and your son. You are right, he may not be a carrier from the info you just provided.
Resistant strains of the strep bacteria are rare but possible. I wonder if he might benefit from the penicillin shot as @Amanda had to, next time he comes down with a case of strep?
I hope this phase in your son's life is short lived and I sincerely appreciate you sharing this question with us.
What an interesting post. I had no idea that a child could be a carrier and test positive for strep without really having the infection. Good to know how to handle situations like this. Thanks for the heads-up
I had strep throat once and it was horrible pain! I can't imagine how rough it would be to keep getting it 12 times in 8 months! Poor kid.
Thank you for your very informative post Melissa – I love that you do this every week!
My 11 yr old son has had strep 9 times in 12 months. He is on Cefdinir, 5th day, and still complaining of a raging sore throat. He is scheduled to have his tonsils and adenoids out on June 2nd, but I worry that if we don't find where he is getting it, it will continue even without tonsils/adenoids. I don't understand why he is in such pain after 5 days on such a strong antibiotic.
So glad I stumbled upon this post, and your blog, while doing a Google search for strep carriers. My 2 year old has had strep 4 or 5 times this year already, so we're looking into whether he, or I might be a carrier. We've both tested negative for it once, so I am still trying to figure out if he could still be a carrier, or if he's just unlucky and getting sick too much! I have bookmarked your blog though. Thanks for the info!
My son had his tonsils and adenoids out on June 2nd. He is 11. He was just diagnosed with strep for the 2nd time since school started. He took omnicef. He felt horrible the whole time on the antibiotics. Sore throat lasted almost the whole time as did stomach aches. Today they gave him a penicillin shot which they said would last for 1 month. We are going back to have him retested in 2 wks. He is NOT a carrier. We have had the dog and family tested. He has had several negative tests between episodes. He is so upset (as am I) that he went through the pain of having his tonsils and adenoids out and is still getting strep. ANYONE ELSE HAVE ANYTHING SIMILAR?
My daughter is 8 and had strep a few times a year up until last year when she had it 4 times, along with ear infections. She also has had negative swabs so I don’t think she is a carrier. She tends to get a stuffy head along with the strep. At the end of last year she had her tonsils/adnoids removed. She was a loud breather/snorer so I don’t think that surgery was a mistake. We are now a month and a half into another school year and she has strep for the second time now. Similar to the MOM story above. I’m at a loss of what to do..
My son had strep 9 times last yr before we had his tonsils/adenoids removed in June. He is still complaining of an intermittent sore throat and intermittent stomach ache 9 days after the pennicillin shot. He is very stuffy off/on also, but don’t know if that is because I stopped his allergy medicine to try and figure out if that had anything to do with it. We just had an environmental company come and check our house for recommendations to improve the quality of air that could be causing allergies, reducing immune system and his ability to fight infections, ie. strep. They recommended $77k worth of changes, plus new carpet ($9k), plus new vaccum cleaner ($500), new washing machine ($900+) etc. etc. I’m willing to do whatever to get my son healthy and stop the strep! Every time he looks at me and says his throat hurts, it breaks my heart!
Does your child have a lot of stomach aches also? My son sleeps with our dog. They recommended that he not do that too.
just curious if your son is still having issues?
mine had his tonsils out in nov 2012 after having a positive strep test monthly feb-may, he would seem to be better and then about 2 weeks after the antibiotic wore of symptoms again. there have been times he has had a negative test as well. in may when he had the 5th positive test they gave a penicillin shot which seems to do the trick and then 30 days from that he had symptoms again, but a negative test and i insisted they do the 48 test and that came back negative too. he went 4 months without strep and in oct had it again. finally had his tonsils out and now he has strep 2 months later! hes been on amoxicillin and its been 7 days and he has had a headache now for 10 days. the NP we are seeing now (we moved out of state a month ago) i feel is not taking this seriously at all. doesnt even want to send us to an ENT. any advice from anyone?
My daughter is 11 and this is her 2 battle with strep in 4 wks. She is also immune suppressed and takes weekly infusions so now they are wondering if she is a carrier. The swab 4 wks ago was negative but the culture came back positive. This time the swab was positive and still waiting on culture results. So, they started her on antibiotics AGAIN and are going to retest her next week, while on the antibiotic, to see if she tests positive again. If so, then it is on to 3-4 weeks of stronger antibiotic. Needless to say I can sympathize with the mom and her original question, it is very frustrating! My daughter has also gotten scarlet fever with it AGAIN as well and is fighting with the rash as well – nerve racking to say the least.
My son will be 4 next month & has had Strep at least 10 or 12 times since he was 2. I myself kept Strep as a teenager & always wondered if I was a carrier, & if so could I have passed it on to him? I have been debating on taking him to an ENT & seeing about having his tonsils removed (as I’ve heard this will help with the recurring Strep infections)?? I’m not sure what I should do, any input would be greatly appreciated!!
My son has also had several episodes of strep, Just recently his sister tested positive in a screening to see if there was a family carrier. They are both on antibiotics now. I have two questions. #1 If my daughter is a carrier and is treated with antibiotics, will that keep my son from getting strep? #2 If he gets it again, should his meds be changed for a different kind or stronger dose? He has been taking Z-pac since he developed a rash that we thought might be an allergic reaction, now I believe it was scarlet fever, as he has had that several times after this first rash.
[…] Strep Throat Dilemma […]
My son is 2 1/2 he kept getting strep over and over before he was two. He was hospitalized a lot because of dehydration. He ended up getting his tonsils out right after he turned two. He had strep every month thought he was a carrier. But would he run a fever and have a red sore throat and even a stomach ache from being a carrier? He’s been treated with amoxicillin we found he is allergic. So they tried other stuff I’m not sure. Last couple times he had the shots in his legs to see if that helps. A yellow antibiotic. It seems to come back wks later. Why? I hated seeing him hurt and get shots and I.vs from this. Plz help. Thx
My 6 year old son had hs tonsils removed 3 years ago. He also has a penicillin allergy. Last week, he was diagnosed with strep, put on Zithromax, 24 hours after finishing it, he ad a fever and sore throat again. Another positive culture. Now he’s on omnicef and were on day 5… He still has a sore throat. He’s not a carrier, in fact, this is the first time we have ever dealt with strep. He had the tonsillectomy bc of recurring ear infections.
Anyone?? I’m beginning to worry
My 7 year old daughter had her tonsils and adenoids removed just before her third birthday. Poor little thing, only 5th percentile in weight, had strep every month and it was taking 2-3 rounds of antibiotics to cure an episode. She also had sleep apnea that scared the daylights out of me. After she had them removed she gained 10 pounds in 6 months and was much happier and healthier. Ever since she started kindergarten she gets strep at least once a year still. Lately, she has been getting step once a month. She knows immediately when she has strep now. Therefore, we get her to the doctor within hours of her first symptom and she suffers much less. The doc said if she gets it again that we will need to test family member and even possibly the dog.
I have been reading many of your posts and am thankful to hear of some suggestions. I haven’t come across anyone, however, with a similar situation, so I’m hoping to find someone who has at least a few similarities. I have five children, ages 13 down to 7, and four of the five have had their tonsils and adenoids out dating back seven to four years ago. We had not been to the doctor’s at all last school year. this year, however, between the five children, we have had 16 cases of strep, one in September and the remaining 15 between November, 2011 and now(May, 2012). Our dog has been tested, my husband and I have been tested and we all came up negative. The kids have had periods where they came up negative, so they are considered not to be carriers. Recently, four of the five finished their antibiotics, and because of the recurring strep, we tested them the following day, and they were all positive. We throw away their tooth brushes, their sports’ mouth guards, etc., and have been diligent with their not sharing anything. Ironically, they are at the point, that they are not always showing an symptoms at all — but the tests continue to come up positive. We have a scheduled appointment with an infectious disease doctor at CHOP in Philadelphia at the end of this month, but in the meantime, I am still researching as much as I can. The only coincidence is that our dog was diagnosed with Addison’s disease, which is an autoimmune disorder, where the cells of the adrenal glands are destructing, resulting in our dog not being able to produce natural steroids, a couple months before this all started. If I google strep with Addison’s, they are mentioned together in some infectious disease articles. Any insight, advice is greatly appreciated! appointment
Hi Joan. So sorry to hear about your kids and their issues with strep. We are having similar problem with our seven year old having recurring strep. We have an appointment with an ent and are considering infectious disease dr. Our ped suggested my son could have a staph infection along with strep that makes the antibiotic not effective. We are worried about that now. How was your appointment with infec disease dr? Did you get any answers?
I am in the same boat as many on here. My kidst are 3, 2 and 1 and we are battling recurrent strep. We throw away tooth brushes each time, but re-test keep coming positive even just a few days off meds. My 3 year old just tested positive again. Think I might give her shot this time. Yikes!
Each child has had a negative test at some point so dr says they are not carriers. So sick of giving my kids antibiotics. The damage that must be occuring to their immune systems. At least I have them on Probiotics now too. We have an apt with a local ENT in Cleveland next week. So hoping he can shed some light on things for us.
All of these these stories are heartbreaking. Moms feel helpless. I have a 3 yr old son that had strep 6 times + from december to march. In march, he had his tonsils and adenoids removed plus ear tubes placed in his ears. Keep in mind he isn’t in school. 3 weeks ago,he had strep agin took antibiotic and was better for a week. Now, we have a appointment with the pediatrician tonight bc the signs are there for strep again. I am at a loss. He has been on every medicine and had the surgery. Know is oing to be a advocate for your child besides you. All the flags are there,something isn’t right. Toothbrushes thron out lysol everything…is the house too clean? Is he a carrier ? Is immune system compromised now??? You better believe these questions will be asked tonight. I m sorry if I didn’t answer questions but this is the first blog I read that made me feel that we are not alone..
Hi My son is 3 years old and had strep about 10 times this winter.We tried all kind of antibiotics and nothing is helping it go away.We tried first a few times Amoxil,Then we heard of a method of doing double dose with a doctor shulmen behind this Zitromax.Yes the strep went away as long he was treated the day he stopped taking this medicine he got it back.He does not even complain that his throat hurts or have fever.The only problem is he starts having behavioral issues.My son was a good boy before this whole strep thing and I am going out of my mind on what to do If you can help me with an idea I would greatly appreciate it
Hi, I have a son who got strep throat the first week of school. he is allergic to peniccillin so was put on a z-pack for that. Week he was running fever up to 104 and after he finished the meds he still did not feel well, I took him back to his doctor and he ordered a chest x-ray which was normal. And a CT scan of his sinus’s and thar showed he had a sinus infection he ws then put on Omnicef after taking that he still was sick. Running fever evrery day! but now he was having lower abdominal pain after taking him back to the doctor I was told hes liver and pancreas felt swollen my son also showed symtoms of mono after blood work was done it showed to be negitve. My son has seen an infectious disease doctor. She put him on antibotics for a long period of time and he still was sick infact so sick that for months he did nothing, then he saw an Ent she said to use nose spray which I was already doing. Then we saw a Gastroenterologist he said do to the stomach pain we should do a colconoscopy my son was 9yrs at the time and a scope down his throat biopsy was done and evrything was normal. Then the doctor wanted to do a pill cam to go futher down his intesines after test it showed to be normal as well next doctor was rheumatologist she examined him his joints have been sore he also has not pysical activity at this point he has also gained 25pounds so she said due to the weight gain he does not have cancer she had run up and down the hall and jump I could I could tell that the little bit made him tired, she said to just watch he might get better. That night he was running 104temp and was hurting he was very sore just from that little bit of actvity I took him to his doctor and he said maybe its a virus just let it run its cours after aweak his fever lowered my son has missed a whole school year! I have done everything I can think of I see him and he is sad he wants to be well I have searched the internet to see if anyone can help! my son was a happy healthy boy until he got strep! to be sick fot 10 months and have no idea what could help him is braking my heart! I went to see the gastroenterologist 2 waeks ago and he told me that my son could be sick forever! I looked at my son and tears were in his eyes, as they were in mine,the doctor said that there have been reports of children remaining sick after having strep and he showed some things on the internet. And what they said is there is no cure! no treament! Iam at a loss he gave a script for folic acid and B12 and Elavil which I have not given to him. I have another doctors appt for him in the morning with a new ENT to see if he has any ideas. please if anyone knows or has heard about this please respond. Thanks!
Hi, I’m not sure if 16 is too old. I figured I would give it a try. My son has got strep throat for the third time in one month. He first was treated with Amoxicillian 2X a day 875 mg on 5/27/12 then he was given Cefadroxil 500mg 2X day on 6/9/12. Now he was put on Rifampin 300mg 2x a day on 6/30/12. He has not had a case of strep throat since he was 8 years old. No one in my house has had it either. We also don’t have dogs. What is your take on this? Thank you,
Well, I have multiple children who are asymptomatic to strep, have given it to others, and the undiagnosed, asymptomatic strep led to a life altering autoimmune disorder. So, my family is proof that you should treat strep infections, whether they accompany traditional symptoms or not.
Even in this link it states “The streptococcus infection which leads to rheumatic fever may be asymptomatic in a third of all cases.”
Hence why it is important to clear a carrier with clindamycin or Azithromycin. This protects not only the “carrier” but anyone they may infect.
http://arthritis.about.com/od/othercond/a/rheumaticfever.htm
I have to disagree with your stement that strep carriers are not contagious. I believe they are just less contagious than someone with symptoms. You can ask any mom of a child with PANDAS and they would agree.
It’s so good to find communities of people who share your problems! My son, soon to be 8, has suffered from recurrent strep (A) throat & nose since he was three. He (and we the rest of the family who also occasionally get strep throat, but not nearly as frequently and persistently as him) have taken countless antibiotics courses, and often 2 or 3 in a row as the symptoms have come back a few days after a course. However in the last year he hasn’t had the really bad illness symptoms. He has however had a slight cough (only at bed time; falls asleep fine), accompanied by the usual “breath of death” and “pistacchio filling” nose… (we try and joke about this…) for a while now, weeks or even months; he seems fine in himself; full of energy, eats well and is happy. He has just tested positive for strep A and DR wants him to take antibiotics. What to do?
My son turned 2 last week. His 1st strep throat was around 9 months old. His Dr. had only seen 3 children with strep before 1 year old. Well today is his 5th case of strep. My husband is blaming me that his bottle or pacy isnt clean enough. I think either he or someone in our family is a carrier and keep getting him sick. We couldnt get his fever of 103 down below 101.2 and by the time we got him to the sunday drs he had 103.9 after fever medicine. What a pain in the butt!
This post is really helpful. Our son had his tonsils and adenoids removed when he was 6. He’s 9 now. He get strep a lot. At one point when he was 6 he had PANDAS symptoms. Thanks to God, he tested positive for strep at that time and our Ped new exactly what it was. I did too because I was up all night looking for an answer on google. We treated the strep and he was back to normal. I have a good solution for testing for strep.
You can buy a box of 25 strep tests for $38.00 online so you can check it yourself whenever you have a doubt. Get peace of mind and save on having to go to the Dr. because you know if they have it or not.
This has been a life saver for us, luckily our Pediatrician understands PANDAS and even takes our test results as valid (if it’s positive) since it’s the same test they use…
Unfortunately, we haven’t solved the recurring strep issue. It seems like tonsils and adenoids out is one very good first step – medically I believe it reduces strep infections. However, they can grow back. Our sons has grown back partially. Maybe we need to do it again? Thoughts on that would be helpful.
http://www.amazon.com/Rapid-Response-Strep-A-STR-15S25-Strips/dp/B001DD04SQ/ref=sr_1_1?ie=UTF8&qid=1351306801&sr=8-1&keywords=strep+test
If you have kids exhibiting tick or OCD like behaviors then research PANDAS, it’s not mentioned enough and I think more people’s kids have it than we realize.
http://www.youtube.com/watch?v=9TX0ypCRT-0
I had a fairly easy time as a child as far as colds and whatnot until the age of 9. Every single year, once a year since then I get strep. It’s the only time I get sick. I’ve had a doctor suggest I was a possible carrier a year ago. I’ve not been properly tested to find out for certain. I also have psoriasis. Which I’ve read up on. It’s supposed to be genetic, but can also be a side effect of strep. Since I’ve already had my bout with strep this year, should I take the time to go get tested to see if I’m a carrier?
My son had his tonsils and adenoids out June 2011. He has only had strep 2 times since then and seemed to end only once they gave him the agonizing penicillan shot. HOWEVER, he continues to get very painful sore throats and stomach aches. They keep treating it for allergies even though he only tested positive for Tree Pollen which doesn’t exist at this time of year. They had him take FLONAISE (generic version) nasal spray and after a week, he was diagnosed with oral thrush. They did not take a culture. It was a visual diagnosis. When he started taking DIAFLUCAN for 12 days, he started feeling better within 1 day and was happy again! HOWEVER, the sore throat, stomach ache and now bad headache started back. Strep negative. Advil and Tylenol don’t help the pain. ENT did a scope and saw remnents of the adenoids that were removed and they had pus on them. They started him on AUGMENTIN yesterday and he felt worse this morning. I have this gut feeling that it is still FUNGAL and that he needs the DIAFLUCAN again, but they won’t give it to him. He goes to the GI next week. I feel so sorry for him.
Has anyone else had anything like this????
Desperate MOM
My sister’s son and all of his classmates kept getting sick with strep and the teacher finally realized that one kid in her class was not getting sick. It turned out that this kid was a carrier and he was infecting the other children. This may be a possiblity for some of you that are looking for answers.
My daughter, when she was in kindergarten got strep and scarlet fever three times in a row before she came home school with impetigo from a rugburn from the classroom storytelling carpet. The pediatrician had us ask the school to thoroughly wash the carpet and the infection finally stopped recurring. The pediatrician said the strep and the impetigo were connected.
I recently retired from working in mainstream medicine for 20 years. I was under the impression that “asymptomatic carrier” meant “able to transmit the disease although not having symptoms.” The article implies carriers are NOT contagious, but I’ve heard otherwise. I have CFIDS (chronic fatigue immune dysfunction syndrome) and recently came down with a terrible case of strep throat despite the fact that I had no known infectious contacts. Upon doing the research I learned about “asymptomatic carriers” and recalled that my 16-year-old stepdaughter has had strep several times despite undergoing tonsillectomy, and she commented to me that she had it a few weeks ago and was treated with a full course of antibiotics and was “cured.” She was my only possible contact.
My lo is now 12 mo old and has had at least 8 I 9 true strep infections since he was 3 mo old. He is not a carrier (antibiotics work and when he gets it again he usually also comes down with an ear infection) anyway he has also had scarlet fever 2x now and today had a complication to omnicef and the er dr refuses to treat his strep. Should I go ahead any have his tonsils removed? I also have a 3 yr old that gets strep just as often as the baby and he isn’t a carrier either nor is anyone else in our family. Don’t he need anitbotics for it?
Also I want to add that my three year old is autos
Level 1 (formally known as aspergers), ADHD and also has pandas. Could this be the cause of the baby constantly also getting strep?