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The CDC issues an advisory about a surge in strep throat cases in kids


The CDC recently issued an advisory about a surge in strep throat in kids ages 5 to 15. Grown-ups can get this, too. Our colleague Leila Fadel had it over the holidays. It's been more complicated to detect lately because it is just one of several respiratory illnesses. So we called Dr. Afif El-Hasan, who's with the American Lung Association and a pediatrician with Kaiser Permanente in Orange County, Calif. Welcome to the program.

AFIF EL-HASAN: Thank you for having me on the program, Steve.

INSKEEP: I guess we should define it. What is strep throat?

EL-HASAN: Strep throat is actually a bacterial infection with the streptococcus bacteria that basically infects the throat, the tonsils, the back of the throat.

INSKEEP: OK. So what does it feel like? What are the symptoms that I would get if I had strep?

EL-HASAN: Well, strep throat actually makes up about 20 to 30% of sore throats in children, five to 15% of sore throats in adults. And what most patients feel is the classic sore throat with a fever. But you can also get nausea, vomiting, stomach aches and even a rash.

INSKEEP: That doesn't sound very pleasant. I would imagine that I've had this over the years at some point without getting a formal diagnosis.

EL-HASAN: That can certainly happen. And given the current environment, where we have a lot of viruses that are infecting children as well as adults, we are having an issue with trying to differentiate what is strep and what is a viral illness.

INSKEEP: How can you tell?

EL-HASAN: Sometimes it's very difficult to tell unless we actually do testing. I become more suspicious that it might be strep throat if someone comes in with a sore throat, a fever and does not have a runny nose or cough, doesn't have red eyes that you would see with a virus. And it's just the standalone symptoms of just sore throat, fever, maybe with some stomach pain and nausea. Then I become much more suspicious for strep throat. But the truth is, even with the other viral symptoms, it is also possible that there could be an accompanying strep throat with viruses.

INSKEEP: Oh, multiple things at once. Does strep spread the same way that COVID and other things do, through the air?

EL-HASAN: It is spread person to person. And it can sometimes be spread through droplets if someone coughs.

INSKEEP: Why do you think there's an increase now?

EL-HASAN: There's a number of reasons. The first one is the fact that we are seeing a prevalence of viruses together that everyone's heard over. Everyone's heard - you know, flu is here. We have COVID, of course. That's been lingering for quite a while, as well as other respiratory viruses. And those viruses actually do weaken the body's natural defenses and does make it easier for a bacteria like strep to cause an infection.

INSKEEP: Oh, wait a minute. If I've already had one of those other things, I may be more vulnerable to strep now?

EL-HASAN: That is correct. It may be that there's a higher likelihood of a secondary bacterial infection because those viruses do reduce the natural defenses of the body.

INSKEEP: I also had an experience over the course of a couple of years that I think a lot of people did at the beginning of the pandemic. I reduced my contact with other people. I wore masks a lot. And I didn't get sick at all for anything for a couple of years, which was great. But did that lower my immunity and other people's immunities?

EL-HASAN: Steve, I'm glad you brought that up. Yes, actually, that has been an issue. Everyone had the masks on. And we started to reduce our natural immunity that we would get when we were exposed to viruses. So when we took off the masks and we started going out and socializing more and being in crowds more, we became not only more susceptible, but also put ourselves in an easier situation to catch those viruses.

INSKEEP: What, if anything, should we do about this?

EL-HASAN: First of all, everyone should wash their hands. That's always been the most important preventative measure that any of us can take. We should always, if we are in large crowds, consider wearing a mask. Don't share food with other people. Eat healthy. Exercise. Those are the best preventative measures. And also, make sure that you get your flu shot.

INSKEEP: Dr. Afif El-Hasan with the American Lung Association. Thanks so much.

EL-HASAN: Thank you very much for having me on. Transcript provided by NPR, Copyright NPR.