Sore Throat In Detail

Key points to remember about sore throats

• most sore throats are caused by viruses and need no treatment other than pain relief
• sometimes children can get strep throat (Group A streptococcus bacteria)
• a rare complication of strep throat is rheumatic fever which can cause permanent heart damage 
• Māori and Pasifika children should see a doctor in the first 1 to 2 days of any sore throat

What causes a sore throat?

Sore throats are common in children. Causes can include:

• infection by viruses - the most common caupase
• infection by Group A streptococcus bacteria (strep throat) - a less common cause

Less frequently, glandular fever (Epstein Barr virus) can cause a sore throat, enlarged glands in the neck, fever and tiredness, particularly in teenagers and young adults. Glandular fever is diagnosed with a blood test.

Can COVID-19 also cause a sore throat?

Yes. If your child has a sore throat, call Healthline in New Zealand (for free) on 0800 358 5453. They will give you advice about what to do.  

If your Māori or Pasifika child or teen has a sore throat, please also talk to your family doctor. Your child may need 2 swabs - a COVID-19 swab and a throat swab for strep throat. That's because in New Zealand, Māori and Pasifika children are at greatest risk of developing complications from strep throat. Your child may need 10 days of antibiotics for a suspected strep throat to prevent rheumatic fever. 

What are the complications of strep throat?

In at-risk people, untreated strep throat can lead to rheumatic fever. See the rheumatic fever page. 

What puts my child at risk of getting a sore throat?

Sore throats caused by viruses are common in all children. Strep throat is more common in school-age children. Strep throats are rare in children under 3.

In New Zealand, Māori and Pasifika children are at greatest risk of developing complications from strep throat.

When should I seek help for my child with a sore throat?

It's very difficult to tell the difference between a viral sore throat and strep throat. 

Māori and Pasifika children and teenagers

If your Māori or Pasifika child or teen has any sore throat, please take them to your family doctor or school clinic for a throat swab. Your child may need 10 days of antibiotics for a suspected strep throat to prevent rheumatic fever. 

Keep your child away from school or early childhood centres for at least 24 hours after they start antibiotics, to reduce the risk of spreading the strep bacteria. 

All children

If your child with a sore throat is not Māori or Pasifika, they have a low risk of developing rheumatic fever. Sore throats are usually viral. Most children with a sore throat do not need any tests. 

You should see a doctor urgently if your child has:

• drooling (dribbling)
• difficulty breathing
• a new skin rash or bruising
• extreme tiredness or drowsiness
• possibly choked on a foreign object or swallowed a toxic substance

You should see your family doctor if your child:

• has symptoms that are not improving after 48 hours
• has not been drinking well for more than 24 hours, or you are worried about dehydration
• has great difficulty swallowing
• has increased snoring when asleep, or periods of stopping breathing when asleep
• has tender lumps in the neck that are getting bigger

What is the treatment for a sore throat?

Infections caused by viruses can not be treated with antibiotics. The body will clear out the virus on its own without treatment.

If your child needs take antibiotics for a strep throat, make sure they take all the doses for 10 days even if their symptoms have improved. Your child can return to school or daycare 24 hours after they start antibiotics.

Pain relief can help any sore throat. It will help your child eat and drink. You can relieve pain in the following ways:

• paracetamol (you must follow the dosage instructions on the bottle; it is dangerous to give more than the recommended dose)
• gargling with warm salt water (1 teaspoon of salt per glass of water)
• throat sprays can help but stop using them if your child doesn’t like them
• sucking on lozenges can help by increasing saliva production but don't give them to young children because of the risk of choking
• drinking warm liquids - honey or lemon is a common way of providing relief
• cool liquids and ice blocks 

If your child has glandular fever (Epstein Barr virus), they should not take antibiotics because antibiotics don't work against viral infections. In fact, some types of antibiotics, especially amoxycillin, can cause a rash in children with glandular fever.