Is It a Sore Throat or Strep Throat? How to Tell the Difference

Can older adults get strep?  

While strep is often associated with school-age children, adults are not immune to the painful and contagious illness. About 1 in 10 adults with a sore throat has strep throat, the CDC says.

“A lot of people think, ‘Oh, I'm an older adult; I don’t have it, I had it as a kid.’ But it's not one of those things that if you had it once you're not going to get it again,” Martinez-Bianchi says. So if you were around someone with strep throat and go on to develop symptoms, get tested for it.

Strep spreads very easily and in the same way that many illnesses do: through respiratory droplets — from coughs and sneezes, for example — and direct contact with an infected person.

Because strep is caused by a bacterial infection, it’s treated with antibiotics. If left untreated, the infection can lead to complications, including kidney inflammation, a bloodstream infection and rheumatic fever, a serious condition that can damage the heart.

Mafi says while older adults aren’t necessarily more susceptible to serious illness from strep throat, it’s important to remember that “the older you are, the more likely that any infection can lead to complications.”

When to see a doctor

If you think you have strep, you should see a doctor to get tested and treated. Results from a rapid test are available in minutes. However, even if you think your sore throat is not due to strep, there are instances that warrant a doctor’s visit.

For example, the viruses that cause COVID-19 and flu can cause a sore throat, so if you suspect you have one of these illnesses, call your health care provider. There are prescription antiviral treatments for both flu and COVID-19, and these medicines can reduce the risk of serious symptoms that can be especially dangerous for older adults and that can lead to other complications like pneumonia.  

The take-home message, Mafi says, is “if you're older, you have chronic comorbidities, you're vulnerable for different reasons, then you should be more vigilant.”

Another warning sign that you need medical attention is if you’re having so much pain and trouble swallowing that you’re drooling; this could be a sign of an abscess, Martinez-Bianchi says. Worsening symptoms, a high fever, difficulty breathing, chest pain and blood in the saliva or mucus are other signs that you should see a doctor. 

Relieving sore throat symptoms

If it’s a virus causing your sore throat, antibiotics won’t help and can, in fact, cause additional health issues, including diarrhea or rash, Mafi says. But several other remedies may bring relief, the CDC says, including:

• Ice chips, popsicles, or lozenges
• Gargling with salt water
• Drinking plenty of fluids
• Over-the-counter pain relievers, though you should always check with your doctor first to discuss any side effects or potential drug interactions.
• Rest. “You really need to take at least a day or two to really let your body rest and recover,” Mafi says.

And don’t forget about honey. A large review of studies published in the journal BMJ Evidence-Based Medicine found that honey is more effective than over-the-counter medications for cough and cold symptoms, including sore throat. “So I actually advise my patients to take honey,” Mafi says, though it’s not recommended for people who are immunosuppressed or for infants. “But, in general, it's very safe and it is effective.”