As most parents know, the bacterial infection strep throat is most frequently seen in children five to 15 years old, although anyone can get it at any age.
In fact, parents of school-aged kids are one of the most likely groups outside of young children to contract strep throat, since they’re exposed to it when their kids get infected.
Fortunately, it’s rarely seen in children younger than three years old.
Strep throat is very contagious, and even those who are asymptomatic can spread it.
Because it can spread quickly, people with strep throat should stay away from friends and family until they’ve been on antibiotics for at least 24 hours and feel up to getting back to their routine.
In this article, I’ll go over the different strains of strep bacteria that cause strep throat infections.
Then, I’ll discuss what a strep test involves and when to get a strep test.
Next, I’ll cover the cost of a strep test and where to get one, and finally, I’ll tell you when it’s time to see a doctor.
What Is Strep Throat?
Strep throat is a common throat infection caused by streptococcal bacteria.
The first signs of strep throat are often a severe sore throat that comes on quickly, a fever higher than 101 degrees Fahrenheit, and swollen, painful lymph nodes.
Other symptoms of strep throat include:
- Pain while swallowing
- Swollen tonsils that are red or have yellow or white plaques
- Tiny red spots on the roof of the mouth
- Headache
- Rash
- Nausea or vomiting
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Strains of Strep
There are several different strains of Streptococcus bacteria that cause the infection, and each type can present differently and cause different side effects and complications.
Group A streptococcus
Group A streptococcus (GAS or group A strep) usually affects the throat and skin and is spread directly through mucus or contact with infected skin sores.
You can have GAS without showing symptoms.
Although group A strep infections are typically mild, they need attention because, in some cases, they can lead to serious illness.
In addition to strep throat, GAS can cause the following illnesses:
- Scarlet fever: This illness has symptoms similar to strep throat but can also include a bright red rash under the arms or in the groin area and a red, bumpy rash in the mouth known as strawberry tongue.
- Impetigo: Impetigo is a skin infection usually seen in children two to six years of age. It appears as a thick, yellow crust and most frequently affects the face.
- Post-streptococcal glomerulonephritis: Also known as PSGN, post-streptococcal glomerulonephritis is a complication of strep A infection and causes kidney problems.
All of the group A streptococcus infections are treated with antibiotics, but depending on the type of infection, the antibiotics may be systemic—like a pill or liquid—or topical, like an ointment.
Group B streptococcus
Group B streptococcus (GBS or group B strep) can affect people of any age and is found in the gastrointestinal tract.
Infection is much more common among older adults than young, healthy people.
GBS infection can also be spread from mothers to their newborns during birth or breastfeeding, though healthcare advances have minimized this possibility.
To prevent the spread of GBS from a new mother to her infant, antibiotics are given during the birthing process.
If a baby is infected with group B strep, they may become very sick and lethargic and have difficulty eating and drinking.
Group B strep can also cause urinary tract infections, pneumonia, joint and bone diseases, and other illnesses in adults.
As with group A strep, antibiotics are necessary to treat group B strep infections.
Groups C and G streptococci
Far less common and, consequently, less understood are groups C and G streptococci. These two variants are most commonly found in live animals, such as horses and cattle.
The virus can spread to humans through raw milk or contact with animals infected with strep. Groups C strep and G strep can live in human throats and on skin damaged by skin disorders, such as eczema.
Groups C and G strep can be treated with antibiotics if a person has symptoms, though asymptomatic infections are also common.
If you have been diagnosed with group C strep or group G strep, consult your doctor to see whether you require any treatment.
What Is a Strep Test?
A medical professional must perform a strep test in order to diagnose strep throat.
There are two kinds of tests: a rapid antigen test and a throat culture.
A rapid antigen test involves a quick swab of the back of the throat.
This test is often performed first, and the results are available in about 10 minutes.
While a positive result almost always means that you have a strep infection, a negative result may be incorrect.
If a rapid test comes back negative, but the person has concerning symptoms, the doctor may still be concerned about strep and order a throat culture, which takes one to two days for the results to come back.
As with the rapid test, the throat culture involves swabbing the back of the throat for a sample that is then grown in a lab to determine whether it’s strep.
Either test can be a little uncomfortable for a few seconds, but overall, it’s an easy test for most people—even children.
When to get a strep test
If your child has any of the symptoms of group A streptococcus—especially if they are running a fever over 101 degrees Fahrenheit, have swollen lymph nodes, or are complaining of extreme pain in their throat—it’s time to get a strep test.
While bacterial throat infections, including strep, can often get better on their own, antibiotics are still necessary to prevent rare but serious side effects, such as rheumatic fever.
The Cost of a Strep Test
How much you pay for a strep test and diagnosis depends on where you live, whether you have insurance, and where you get tested.
Because of these factors, there is no data on national average costs for strep tests.
However, you can expect to pay more at an urgent care clinic or an emergency room than a doctor’s office, and you will pay more at any location if you don’t have health insurance.
Urgent care clinic
Urgent care clinics are often the quickest and most convenient way to get a strep test.
Unlike a primary care physician, who may require an appointment, many urgent care clinics accept walk-in visits, and some are open longer than a typical doctor’s office.
The average cost to visit an urgent care clinic depends on the location, what type of insurance you have, and the cost for an office visit.
For example, the walk-in MinuteClinic charges $73-$45 for a strep test in addition to any laboratory fees, but you may pay $111 or more to be seen at an urgent care clinic in the Midwest.
In addition, if a second culture is needed because the doctor has questions about the results of the first rapid test, that can add to the cost.
Doctor’s office
Your health insurance should cover a visit to your primary care physician or pediatrician for the cost of a copay and potentially additional lab fees. Without insurance, the cost varies.
For example, a doctor’s office in New Hampshire and surrounding states charges $115 for a strep test and diagnosis, but the cost at a California-based doctor’s office is as high as $380 in some locations.
Hospital or emergency room
A strep test is considered a level one problem at most hospitals. Like a visit to your doctor’s office or local urgent care clinic, the cost varies.
Once again, a level one emergency visit in New Hampshire costs as little as $134, whereas a hospital visit in San Francisco charges close to $300 for a strep test.
At-home strep tests
At-home strep tests are suitable for verifying that a child has strep throat, but they may be problematic if they return a negative result, because up to 10% of rapid strep tests are false negatives.
In the case of a false negative, a throat culture is needed to confirm the infection.
Most at-home strep tests cost less than $50 for a box of 25 tests.
For example, you can purchase a box of 25 strep tests for $73.99 at Walmart.
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When to See a Doctor
If your child is sick and their symptoms are not improving with standard home care like ibuprofen, Tylenol, and hydration, you should take them to your pediatrician for further evaluation.
While many upper respiratory infections, including throat infections, are caused by viruses, bacteria such as strep can also cause infections and may require antibiotics for treatment and to prevent complications.
If your child’s doctor suspects strep throat, they will do a rapid strep test or throat culture and may prescribe antibiotics if they are needed.
If an older adult in your family runs a fever and seems confused and disoriented, that could mean they have a urinary tract infection caused by a bacterial strep virus or other serious infection, and they should see a doctor right away.
Older adults are susceptible to more severe illnesses due to strep infections and should be started on a course of antibiotics as soon as strep is diagnosed.
Oftentimes, going to the emergency room is the fastest way to get them evaluated and treated.
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