What is it?
Strep is a bacterial infection that is very common in children.  Strep can cause strep throat (pharyngitis, tonsillitis) and scarlet fever.  Symptoms include fever, headache, a red and sore throat, swollen lymph nodes (glands) in the neck, stomach ache, and a bright red skin rash.  The rash is common on the face, neck, chest, back, and skin folds (e.g., underarms, groin, elbows, knees).  both the cheeks and tongue may appear very red.  The rash often feels rough, like sandpaper.

Strep also causes other common infections including impetigo (skin infection), ear infection, and pneumonia.  Rarely, strep can cause more serious illnesses including meningitis, rheumatic fever (affecting the heart valves), bone and joint infections, and kidney disease.

How is it Spread?
Strep throat and scarlet fever are spread by contact with mucus from the nose or saliva.  They can be spread by coughing and sneezing, kissing on the lips and sharing food, eating utensils and mouthed toys.  They are also spread by touching your hands to your nose and mouth, reusing tissues, and forgetting to wash your hands after blowing noses.  They spread most easily in crowded, poorly ventilated rooms.

When is it Contagious?
Strep throat and scarlet fever are probably contagious the day before the start of symptoms and during the period of illness, until 24 hours after the start of effective antibiotic treatment.  After exposure to strep, it can take 2-5 days to develop symptoms.

How is it Diagnosed and Treated?
Strep throat is diagnosed by an exam and swab of the throat for rapid antigen tests and/or culture.  Scarlet fever is usually diagnosed by the typical symptoms.  Strep infections are treated by oral or injected antibiotic medication.  although the child usually feels better within several days after starting antibiotics, it is important to complete the whole course of antibiotics as prescribed.  If the child is uncomfortable with fever, headache and sore throat, acetaminophen may be helpful.  Cool drinks, popsicles, teas, and gargling with warm salt water can also help relieve the sore throat.

Should the Child Stay Home?
A child with strep infection should stay home until 24 hours after the atart of antibiotic treatment, the fever is gone, and the child feels well enough to participate in the program's activties.

How Can We Limit the Spread?

• Cough and sneeze into your elbow and away from people.  If you cough or sneeze into your hand or a tissue, wash your hands afterwards.
• Wipe runny noses with a clean tissue, throw the tissue away, then wash your hands.
• Don't share food, pacifiers or bottles.  Wash eating utensils and drinking cups well.
• Clean and disinfect mouthed toys and dining tables after each use.  Clean and disinfect water fountains, telephone receivers, and other frequently handled items daily.
• don't kiss children on the mouth - hug them and kiss them on the forehead instead.

Information provided on this page is not intended to provide medical advice or take the place of medical treatment.  The recommendations do not indicate a course of treatment or medical care.

These are guidelines to develop policies and procedures for preventing, recognizing and managing communicable disease in child care.  If the children in your care have been exposed to this disease, you may copy this exposure notice and hand out to your day care parents.

This Exposure Notice has been copied from "Keeping Kids Healthy, Preventing and Managing Communicable Disease in Child Care", a project of the The Center for Health Training funded by the California Department of Education, Child Development Division.