Strep throat may be very mild, with only a few symptoms, or it may be severe. Often, persons with strep throat get sick 2 to 5 days after they are exposed to the bacteria that causes the illness.

Symptoms usually begin suddenly, and can include:

• Fever that begins suddenly and is often highest on the second day
• Red throat, sometimes with white patches
• Sore throat
• Headache
• Stomach ache
• Nausea
• Chills
• General discomfort, uneasiness or ill feeling
• Loss of appetite and abnormal taste
• Tender, swollen lymph nodes in the neck
• Difficulty swallowing

Some strains of strep throat can lead to a scarlet fever-like rash. This rash is thought to be an allergic reaction to toxins made by the strep bacteria.

A rapid test can be done in most health care provider offices, but misses a few of the cases. A throat swab can be tested (cultured) to see if strep grows from it. However, it will take one to two days for results to come back.

If the rapid test is negative, it may be followed by a culture, to find all the cases that might have been missed. This is more likely to be needed in children.