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-> Children's Health
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amother
Lavender
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 Mon, Dec 26 2016, 5:47 am
One of the things I have learnt on imamother is that in America people get tested and treated for strep quite easily.
I have rarely heard of anyone having strep in England. It is not something we are tested for.
I am trying to understand this - any insights?
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amother
Slategray
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Mon, Dec 26 2016, 6:01 am
No insights but it's the same in Australia, we never had strep growing up and my kids have never got strep now.
we do have tonsillitis which I'm not sure is the same thing? Because doc doesn't need swab to check for it he just checks your throat.
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amother
Ivory
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Mon, Dec 26 2016, 6:52 am
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Strep isn't that common but for whatever reason ($$ is my guess) any time you come in with a sore throats you get s strep test.
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SixOfWands
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Mon, Dec 26 2016, 9:45 am
| amother wrote: | No insights but it's the same in Australia, we never had strep growing up and my kids have never got strep now.
we do have tonsillitis which I'm not sure is the same thing? Because doc doesn't need swab to check for it he just checks your throat. |
Some people use the terms interchangeably, but in fact tonsillitis is a broader term that includes strep.
The reason for the swab is to ensure that the cause of the infection is strep (bacterial) and that antibiotics would be effective. You can't tell that by a visual exam.
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martina
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Mon, Dec 26 2016, 10:09 am
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In some european countries the doc will determine if bacterial infection with a fingwr prick blood test, results within minutes
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Laiya
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Mon, Dec 26 2016, 10:16 am
[deleted]
Last edited by Laiya on Mon, Dec 26 2016, 10:18 am; edited 1 time in total
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yo'ma
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Mon, Dec 26 2016, 10:17 am
| martina wrote: | | In some european countries the doc will determine if bacterial infection with a fingwr prick blood test, results within minutes |
There are two types of tests, a right away test and a 24 hour one. The 24 hour one is more accurate. Some doctors do both.
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gp2.0
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Mon, Dec 26 2016, 11:24 am
The answer is actually very interesting.
A strep throat will heal on its own, with or without antibiotics. The antibiotics are prescribed to prevent complications, particularly rheumatic fever.
Rheumatic fever is very rare. Most people who get strep won't develop rheumatic fever, whether or not they take antibiotics.
So a few decades ago, the UK stopped routinely prescribing antibiotics for strep throat. They'll still prescribe antibiotics for an aggressive or invasive strep throat but not for a routine one.
Meanwhile, the US continued prescribing antibiotics for every diagnosed strep throat, irregardless of severity, age and other health conditions.
But the rates of rheumatic fever stayed the same - very rare. Rheumatic fever didn't increase in the UK as a result of less people getting antibiotics.
So the US is overcompensating - giving everyone antibiotics to protect the one person among millions who will develop rheumatic fever.
Meanwhile the UK doesn't seem to think its necessary to medicate millions of people with mild infections in order to prevent one person from getting a major infection. Instead they recommend antibiotics only for people who already have major infections - for an aggressive/invasive strep throat, one which hasn't healed in a timely manner - which would likely still prevent rheumatic fever from occurring.
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seeker
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Mon, Dec 26 2016, 11:47 am
| martina wrote: | | In some european countries the doc will determine if bacterial infection with a fingwr prick blood test, results within minutes |
Would you rather have your (or your child's) finger pricked or mouth swabbed?!
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seeker
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Mon, Dec 26 2016, 11:52 am
| gp2.0 wrote: | The answer is actually very interesting.
A strep throat will heal on its own, with or without antibiotics. The antibiotics are prescribed to prevent complications, particularly rheumatic fever.
Rheumatic fever is very rare. Most people who get strep won't develop rheumatic fever, whether or not they take antibiotics.
So a few decades ago, the UK stopped routinely prescribing antibiotics for strep throat. They'll still prescribe antibiotics for an aggressive or invasive strep throat but not for a routine one.
Meanwhile, the US continued prescribing antibiotics for every diagnosed strep throat, irregardless of severity, age and other health conditions.
But the rates of rheumatic fever stayed the same - very rare. Rheumatic fever didn't increase in the UK as a result of less people getting antibiotics.
So the US is overcompensating - giving everyone antibiotics to protect the one person among millions who will develop rheumatic fever.
Meanwhile the UK doesn't seem to think its necessary to medicate millions of people with mild infections in order to prevent one person from getting a major infection. Instead they recommend antibiotics only for people who already have major infections - for an aggressive/invasive strep throat, one which hasn't healed in a timely manner - which would likely still prevent rheumatic fever from occurring. |
Interesting. I'm going to look into this more myself because I was under the impression that complications (including but not limited to rheumatic fever) are more common than that, and potentially severe enough that antibiotics are worth it.
Also it bears mention that the antibiotics used against strep throat are usually fairly specific, not broad-spectrum medicines that will knock out every single beneficial microbe in your body. Still not something you want to take for no reason, but not as bad as other possibly unnecessary treatments.
What does "invasive and aggressive" mean? My (American, and pretty typical in viewpoints) pediatrician will only test and treat a strep throat if the throat looks pretty nasty in the first place. As for me, strep is so painful that I'm desperate to take the medication and get rid of it within a day because in my experience if you don't treat it, it gets worse until you do. I've never had it go away on its own, maybe because within a few days the pain would be so bad I'd be running to the doctor anyway. Similar for my DD who I mentioned on another thread - she'll have mild, atypical symptoms for a while but it never just goes away until she comes down with a flaming throat and gets treated.
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gp2.0
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Mon, Dec 26 2016, 12:13 pm
| seeker wrote: | Interesting. I'm going to look into this more myself because I was under the impression that complications (including but not limited to rheumatic fever) are more common than that, and potentially severe enough that antibiotics are worth it.
Also it bears mention that the antibiotics used against strep throat are usually fairly specific, not broad-spectrum medicines that will knock out every single beneficial microbe in your body. Still not something you want to take for no reason, but not as bad as other possibly unnecessary treatments.
What does "invasive and aggressive" mean? My (American, and pretty typical in viewpoints) pediatrician will only test and treat a strep throat if the throat looks pretty nasty in the first place. As for me, strep is so painful that I'm desperate to take the medication and get rid of it within a day because in my experience if you don't treat it, it gets worse until you do. I've never had it go away on its own, maybe because within a few days the pain would be so bad I'd be running to the doctor anyway. Similar for my DD who I mentioned on another thread - she'll have mild, atypical symptoms for a while but it never just goes away until she comes down with a flaming throat and gets treated. |
This is new information for me too. What I'd been told in the past was that if the strep is treated with antibiotics there's no risk of secondary complications, and if the strep isn't treated with antibiotics it will "never fully heal" and could at any future time develop secondary complications. That appears to be an urban myth. Apparently once it heals, it heals, whether or not you take medication.
Not sure but I think by aggressive/invasive they mean if the symptoms last a week or longer, or are accompanied by more unusual symptoms.
There's also some interesting info about people who are strep carriers - they'll always test positive for strep but they won't have symptoms or get sick with strep themselves. So if a carrier develops a viral sore throat they'll be diagnosed with strep throat because of their carrier status. Probably uncommon, but interesting.
I had strep throat a few times as a child and teenager. I've never had it diagnosed as an older teenager or adult. So either I abruptly stopped having strep and haven't had strep in about 15 years, or I still intermittently get strep but I just got better at managing the symptoms until they resolved on their own. I don't know which one is true.
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amother
Cobalt
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Mon, Dec 26 2016, 12:28 pm
| gp2.0 wrote: | The answer is actually very interesting.
A strep throat will heal on its own, with or without antibiotics. The antibiotics are prescribed to prevent complications, particularly rheumatic fever.
Rheumatic fever is very rare. Most people who get strep won't develop rheumatic fever, whether or not they take antibiotics.
So a few decades ago, the UK stopped routinely prescribing antibiotics for strep throat. They'll still prescribe antibiotics for an aggressive or invasive strep throat but not for a routine one.
Meanwhile, the US continued prescribing antibiotics for every diagnosed strep throat, irregardless of severity, age and other health conditions.
But the rates of rheumatic fever stayed the same - very rare. Rheumatic fever didn't increase in the UK as a result of less people getting antibiotics.
So the US is overcompensating - giving everyone antibiotics to protect the one person among millions who will develop rheumatic fever.
Meanwhile the UK doesn't seem to think its necessary to medicate millions of people with mild infections in order to prevent one person from getting a major infection. Instead they recommend antibiotics only for people who already have major infections - for an aggressive/invasive strep throat, one which hasn't healed in a timely manner - which would likely still prevent rheumatic fever from occurring. |
That is interesting.
I think there are other considerations as well. Strep is considered contagious and parents are told to keep their children who have strep home until they've had three doses of antibiotics. Most working parents don't have enough sick days accumulated to keep a child home for more than a couple of days here and there, especially if they have more than one child.
My daughter got a positive strep test last week. I kept her home the next day and called the school. They sent home a note to all the parents that there was a case of strep in the class and that they should be aware of the symptoms and keep their kids home if they get sick. And then DH and I both got sick and ended up at urgent care on x-mas. It turns out that neither of us have strep, although I have an ear infection whose only symptom was a sore throat.
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zohar
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Mon, Dec 26 2016, 12:44 pm
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I wonder if certain infectious diseases are more prevalent in version areas. I know that for some reason, American women test positive for group b strep (nothing to do with an inflamed throat) at a much much higher rate than Israeli and European women.
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amother
Lavender
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Mon, Dec 26 2016, 1:47 pm
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I am from England. I am almost 40. I have never ever heard of anyone having strep or being tested for strep. I didn't even know there was such a thing as strep in your throat until I came on this website!
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amother
Coral
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Mon, Dec 26 2016, 1:49 pm
Not sure they prescribe antibiotics less often, they just test less often, preferring instead to make a judgment call by looking at the throat with their eyes.
I assume to save money on the rapid tests, due to their system of socialized medicine.
The thinking being, if they prescribe antibiotics when it's actually viral, oh well, and if they don't prescribe when someone actually has strep, nu, it won't kill them either (hopefully).
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amother
Coral
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Mon, Dec 26 2016, 1:51 pm
| amother wrote: | | I am from England. I am almost 40. I have never ever heard of anyone having strep or being tested for strep. I didn't even know there was such a thing as strep in your throat until I came on this website! |
Right, because they don't call it that, because they don't do the actual test that would definitively diagnose it.
I hear the same goes for diagnosing people with UTI's, pneumonia and other common bacterial infections.
Eta. An American friend of mine has an English dh. When they visited England, her son was sick and she brought him to the doctor. Twice in different visits. Once, the doctor looked in his throat and said he had the German Measles(!), again, no test, and prescribed Amoxicillin, which is the first line antibiotic used against strep throat.
Another time, the doctor looked in his throat, said, It looks viral so I'll give you some antibiotics. Again, makes no sense because antibiotics aren't used against viral infections.
If this is typical, then yes it makes sense that English people never heard of anyone having strep, because it's not diagnosed.
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amother
Lilac
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Mon, Dec 26 2016, 2:05 pm
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Tonsilitis or pharyngitis are both inflammation of tonsils or throat. They can be caused by a million different viruses or bacteria. The only one we care about is strep because it can cause heart and kidney problems (if not treated within 9 days). You don't absolutely need a culture to diagnose. There are criteria (centor criteria) doctors use. I don't know if that's why cultures aren't used in England but that doesn't mean it's not treated when necessary.
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LiLIsraeli
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Mon, Dec 26 2016, 2:17 pm
| seeker wrote: | | Would you rather have your (or your child's) finger pricked or mouth swabbed?! |
I may be weird but I would much rather the finger prick over the throat swab!
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gp2.0
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Mon, Dec 26 2016, 2:51 pm
| amother wrote: | Not sure they prescribe antibiotics less often, they just test less often, preferring instead to make a judgment call by looking at the throat with their eyes.
I assume to save money on the rapid tests, due to their system of socialized medicine.
The thinking being, if they prescribe antibiotics when it's actually viral, oh well, and if they don't prescribe when someone actually has strep, nu, it won't kill them either (hopefully). |
Um. But this doesn't actually make sense. Antibiotics also cost money.
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gold21
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Mon, Dec 26 2016, 3:06 pm
| amother wrote: | | I am from England. I am almost 40. I have never ever heard of anyone having strep or being tested for strep. I didn't even know there was such a thing as strep in your throat until I came on this website! |
It's tonsillitis where you live.
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