“Mama, I just threw up,” my 8-year-old son recently told me. He had just gotten over a stomach virus a few months prior, so I was gearing up for another 24-hour session of trash bags and Pedialyte. Instead, he seemed … fine?
I chalked it up to all the oranges he had eaten the night before, thinking maybe he had a bit of acid reflux. He kept down his food and didn’t throw up again — until the next night. And the next. What gives?
This was a very odd illness. I was even more surprised when I took him to urgent care on the third day, and he was diagnosed with strep throat. Apparently, the type of strep going around right now is causing a lot of gastrointestinal symptoms (ugh!), instead of the traditional sore throat and fever.
You may think you know everything about strep, but this common winter illness seems to be acting differently this year. We talked to doctors to learn more — and discover the symptoms to look for.
What is strep?
According to the Centers for Disease Control and Prevention, strep throat is caused by a bacteria called Group A Streptococcus (GAS). Common symptoms include fever, pain while swallowing, red and swollen tonsils, and a sore throat that develops rapidly.
Apart from those common symptoms, less typical symptoms that may appear, especially in kids, include headache, nausea or vomiting, rash, and/or stomach pain. This winter, those uncomfortable tummy troubles seem to be at the forefront of strep infections.
Dr. Zachary Hoy, a board-certified pediatric infectious disease specialist, told HuffPost, “The strain of strep that has been seen this winter season seems to have more associated GI symptoms with it than the typical strain. There are also still several cases of ‘classic’ or ‘typical’ strep that cause significant sore throat and fever.”
It may seem like everyone is getting strep right now, as this type of infection tends to spread more during the cold months.
“Infections can occur year-round but tend to peak in the late winter to early spring,” Dr. Monica Abdelnour, a pediatric infectious disease specialist at Phoenix Children’s, told HuffPost.
“Strep throat spreads through close contact with respiratory droplets from someone who is infected,” Abdelnour continued. “This helps explain why cases increase in winter when people spend more time indoors and children are in close contact at school. It typically takes two to five days from exposure for symptoms to appear.”
Why are GI symptoms occurring with strep?
“Sometimes ‘typical’ strep can cause abdominal pain with enlarged mesenteric lymph nodes called mesenteric adenitis,” Hoy explained.
These lymph nodes are located in the abdomen, which could be to blame for the stomach upset.
“There has been speculation that this could account for the GI symptoms of vomiting and diarrhea with the strain of strep seen this winter,” Hoy continued. “The strep strain this winter could also have some toxins produced by the strep bacteria that could trigger more GI symptoms.”
(Keep in mind, these speculations are based on past strep strains, and Hoy said these theories haven’t been documented or proved.)
Strep throat can look different in kids, but the main signs and treatment are similar to those for adults.
Illnesses like strep throat can present differently in different people, and in kids, strep may often look much different than in adults. (This could also explain the GI symptoms my son experienced.)
“Strep throat can affect people of all ages but is most common among school-aged children and adolescents, particularly between the ages of 5 and 15,” Abdelnour said. “Children sometimes present with less common symptoms such as stomach pain, vomiting and nausea in addition to sore throat and fever. Certain skin-related strep infections are also more common in children than adults.”
Additionally, scarlet fever could develop from strep, which looks like “a red, sandpaper-like rash usually on the upper chest and trunk,” according to Abdelnour. Another complication is impetigo, which “is a skin infection that usually appears as small blisters around the mouth and chin, which can thicken into honey-colored crust over days to weeks.”
Another potential complication of strep is acute rheumatic fever, “an inflammatory condition that can affect the heart,” says Abdelnour. She recommends being sure to complete the full course of antibiotics if prescribed.
If you or your child have any of the following symptoms, consider getting tested for strep:
- Sore throat or pain with swallowing
- Fever
- Red and swollen tonsils
- White patches or streaks of pus on the tonsils
- Small red spots on the roof of the mouth
- Swollen lymph nodes in the neck
- Little to no cough
Once strep is confirmed by a doctor, the typical treatment is a 10-day course of antibiotics, such as amoxicillin or penicillin. Abdelnour said, “Treatment helps shorten symptoms, reduce spread to others and prevent rare but serious complications.”
Keep in mind that there are also other illnesses going around with similar symptoms.
Not every sore throat is strep — just like every case of vomiting isn’t the stomach bug. Other common viruses are circulating right now, including cold, flu, COVID-19 and norovirus.
“When there are uncommon presentations of common diseases such as strep with increased GI symptoms, it highlights the importance of being evaluated by your child’s pediatrician and rapid testing,” Hoy said. He added that “there is significant overlap between strep, flu, RSV and other respiratory viruses during the winter.” That means your child could have a stomach bug and strep at the same time.
“There are rapid tests in office (rapid strep, rapid flu, rapid RSV, rapid COVID) that can be done in the pediatrician’s office that can help guide treatment,” Hoy explained. “Also, the pediatrician’s exam can be helpful in differentiating the different respiratory winter illnesses. If strep testing is negative, you would not need antibiotics and antibiotics could cause worsening rashes or allergic reactions, so antibiotics should only be given when necessary.”
Antibiotics stopped my son’s vomiting episodes because they were caused by strep. I never would have thought that this would be a strep symptom, which makes me even more thankful that I took him to the doctor for treatment.
“Seeing a health care provider is important to make sure you receive the correct diagnosis and treatment,” Abdelnour said.
And don’t forget to do your part to minimize the spread of illness, no matter what it is.
“To reduce the risk of infection and spread, practice good hand hygiene and consider utilizing masks,” Abdelour said. “Children diagnosed with strep throat or strep-related skin infections should stay home from school or child care until at least 12-48 hours after starting antibiotics.”
