Strep Throat Exposure

Is this your child's symptom?

  • Close contact with someone who has a Strep throat infection.
  • Close contact means living in the same house with the infected person. It also includes close physical contact such as having a kissing relationship.

Strep Exposure (Close Contact)

  • Household Close Contact. Lives with a person whose Strep test was positive. This can be a sibling, parent, or other household member.
  • Kissing relationship with someone (boyfriend, girlfriend) who has a positive Strep test.
  • Close contact should be within 10 days of onset of symptoms in exposed child. Reason: time from contact to Strep symptoms usually is 2 to 5 days.
  • Throat cultures and rapid Strep tests aren't urgent. Most can be done in your doctor's office.

Types of Limited Contact with Strep

  • Contact with someone outside the home with a positive Strep test. This type of contact occurs at school.
  • Sometimes, the contact is with someone who was treated for Strep without testing.
  • If fever is gone, children taking antibiotics for at least 12 hours do not spread Strep to others.

When to Call for Strep Throat Exposure

When to Call for Strep Throat Exposure

Call 911 Now

  • Severe trouble breathing (struggling for each breath; can barely speak or cry)

Call Doctor or Seek Care Now

  • Stiff neck or can't move neck like normal
  • Great trouble swallowing fluids or spit
  • Trouble breathing, but not severe
  • Fever higher than 104° F (40° C)
  • Dehydration suspected. No urine in more than 8 hours, dark urine, very dry mouth and no tears.
  • Your child looks or acts very sick
  • You think your child needs to be seen, and the problem is urgent. Note: a Strep test alone is not urgent.

Contact Doctor Within 24 Hours

  • Sore throat pain is severe and not better 2 hours after taking ibuprofen
  • Age less than 1 year old
  • Earache or sinus pain (not just congestion)
  • Mild symptoms that could be from Strep throat. (Some are sore throat, cries during feeds, large lymph nodes in the neck, fever)
  • Sores present on the skin
  • You think your child needs to be seen, but the problem is not urgent (or needs a Strep test)

Contact Doctor During Office Hours

  • You have other questions or concerns

Self Care at Home

  • Strep contact but no symptoms

Call 911 Now

  • Severe trouble breathing (struggling for each breath; can barely speak or cry)

Call Doctor or Seek Care Now

  • Stiff neck or can't move neck like normal
  • Great trouble swallowing fluids or spit
  • Trouble breathing, but not severe
  • Fever higher than 104° F (40° C)
  • Dehydration suspected. No urine in more than 8 hours, dark urine, very dry mouth and no tears.
  • Your child looks or acts very sick
  • You think your child needs to be seen, and the problem is urgent. Note: a Strep test alone is not urgent.

Contact Doctor Within 24 Hours

  • Sore throat pain is severe and not better 2 hours after taking ibuprofen
  • Age less than 1 year old
  • Earache or sinus pain (not just congestion)
  • Mild symptoms that could be from Strep throat. (Some are sore throat, cries during feeds, large lymph nodes in the neck, fever)
  • Sores present on the skin
  • You think your child needs to be seen, but the problem is not urgent (or needs a Strep test)

Contact Doctor During Office Hours

  • You have other questions or concerns

Self Care at Home

  • Strep contact but no symptoms

Care Advice

Treatment for Contacts With Symptoms (Pending a Strep Test)

What You Should Know About Strep Exposure and Sore Throats:

  • A Strep test is not urgent.
  • It could be a Strep throat or just a viral infection of the throat.
  • A sore throat is often part of a cold.
  • Until you get a Strep test, here is some care advice that should help.

Sore Throat Relief:

  • Age over 1 year. Can sip warm fluids such as chicken broth or apple juice. Some children prefer cold foods such as popsicles or ice cream.
  • Age over 6 years. Can also suck on hard candy or lollipops. Butterscotch seems to help.
  • Age over 8 years. Can also gargle. Use warm water with a little table salt added. A liquid antacid can be added instead of salt. Use Mylanta or the store brand. No prescription is needed.
  • Medicated throat sprays or lozenges are generally not helpful.

Pain Medicine:

  • To help with the pain, give an acetaminophen product (such as Tylenol).
  • Another choice is an ibuprofen product (such as Advil).
  • Use as needed.

Fever Medicine:

  • For fevers higher than 102° F (39° C), give an acetaminophen product (such as Tylenol).
  • Another choice is an ibuprofen product (such as Advil).
  • Note: fevers less than 102° F (39° C) are important for fighting infections.
  • For all fevers: keep your child well hydrated. Give lots of cold fluids.

Fluids and Soft Diet:

  • Try to get your child to drink adequate fluids.
  • Goal: keep your child well hydrated.
  • Cold drinks, milk shakes, popsicles, slushes, and sherbet are good choices.
  • Solids. Offer a soft diet. Also avoid foods that need much chewing. Avoid citrus, salty, or spicy foods. Note: fluid intake is much more important than eating any solids.
  • Swollen tonsils can make some solid foods hard to swallow.

Return to School:

  • Your child may have a Strep throat infection. Wait for the result of the rapid Strep test. If it is negative, your child can go back to school.

Call Your Doctor If:

  • Your child becomes worse

Treatment for Contacts Without Symptoms

What You Should Know About Strep Exposure Without Symptoms:

  • Many children have contact with someone with Strep throat. Most will not come down with an infection. This is especially true if the contact occurs outside the home.
  • Strep tests are not needed for children without any symptoms.

Time It Takes to Get Strep Throat:

  • Time from contact to Strep symptoms usually is 2 to 5 days.

Return to School:

  • If your child has no symptoms, he does not need to miss any school.

Call Your Doctor If:

  • Your child gets any Strep symptoms in the next 7 days

Copyright 2000-2025 Schmitt Pediatric Guidelines LLC. Date Updated: Mar 31 2025 13:41 Version 0.1

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starfish
February 12, 2026
There are cases of measles in NC, and we are aware of exposures in Chapel Hill, Durham, and Wake County. We can give the MMR dose early to families who want it. This applies to infants 6-12 months who have not gotten a dose yet or kids under 4-5 years who have not gotten their second MMR dose. At this time, the NC DHHS and health departments are not recommending this unless traveling or living in an area with sustained transmission. 2 doses of the MMR vaccine are highly effective (97%) at preventing measles infections. At CHCAC, children receive their first dose at 12 months of age and a second dose at 4 years of age, ensuring they are fully protected as soon as possible, in accordance with the most up-to-date AAP recommendations. Some infants aged 6 months to 11 months who travel internationally or in high-prevalence areas may need a dose to protect them; however, they still require the 1-year and 4-year-old doses as well. If you are ever concerned about a possible exposure to measles, please CALL before entering our office. DO NOT ENTER the office. NC DHHS keeps a list of areas with measles exposures here . This is a highly contagious illness, and special precautions must be taken to prevent spread. The virus can be present in the air for 2 hours after an infected person is in the room, and 90% of susceptible patients can be infected. As always, if you have questions, we are here to help make sense of it all!
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