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Why it’s been such a nasty strep throat season in Minnesota

As if we haven’t dealt with enough RSV, various colds, flu, and COVID-19 of late, this has been a nasty season for strep throat. A University of Minnesota doctor explains why.

strep infection
Strep can go away on its own. But generally, if patients have symptoms of a strep infection and test positive, they are prescribed antibiotics to help their body fight it.
REUTERS/Santiago Arcos

Sore throat? Fever? Swollen lymph nodes? Might be strep throat.

As if we haven’t dealt with enough RSV, various colds, flu, and COVID-19 of late, this has been a nasty season for strep throat.

The Minnesota Department of Health doesn’t track strep on a case-by-case basis, but health professionals say strep is keeping urgent care clinics busy.

So, why the increase in strep this year? And is there anything Minnesotans can do to avoid it?

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Strep 101

When most people think of getting sick, they tend to think of respiratory viruses — the kinds of bugs that generally transmit via respiratory particles that travel through the air.

Strep, caused by the bacterium Streptococcus A, can transmit this way, too, but has a tendency to spread through touch, said Dr. Jill Foster, a pediatric infectious disease physician and division direction of pediatric infectious diseases at the University of Minnesota Medical School. You might find yourself with a case of strep if you wipe your eye or pick your nose after touching a doorknob an infected person has spread germs onto.

In addition to the telltale signs of a sore throat, fever and swollen lymph nodes on the neck, a person with a strep infection often develops whitish spots on their tonsils and the back of their throat. Unlike common respiratory viruses, strep isn’t generally associated with nasal congestion, Foster said.

Strep can go away on its own. But generally, if patients have symptoms of a strep infection and test positive, they are prescribed antibiotics to help their body fight it. That’s because, in some cases, strep can lead to rheumatic fever, which in rare cases can cause long-term heart problems, Foster said.

Worse strep this year

As for why this year seems to be a bad one for strep, Foster said it doesn’t seem to be that the strain of Strep A bacteria is more virulent than years past.

Instead, Foster said the theory is that this fall, when all the respiratory viruses seemed to go around at once, people may have also been colonized with strep — the term for when the bacteria takes up residence in the throat, whether or not it causes symptoms.

“So now, you’ve got a lot of people who got sick who all now have strep at the same time (and) now they’re just passing it around,” in schools, daycares, congregate care and other settings, Foster said.

Normally, kids are more susceptible to strep throat. Adults tend to develop immunity as they age, and often have strep bacteria living in their throats at low levels not causing problems. Because kids don’t have that immunity, they’re more likely to be symptomatic.

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This year, another concern is the number of strep cases that have become severe, getting into patients’ blood. The number of such infections declined during the height of the pandemic but have risen again.

With so many respiratory viruses going around this year, people are more susceptible to worse strep infections.

“Because the tissues are so inflamed (from a respiratory virus), the barrier between your mucous membranes and your blood is broken down, so then it spreads into the blood,” Foster said. Foster said hospitals are seeing cases of this in children, who are sick enough to land in intensive care.

Preventing strep

There are lessons to learn for preventing strep throat in the major COVID years, a time when there was little RSV and little flu and very little strep.

Masks certainly help in the prevention of all these pathogens, Foster said. But acknowledging people are not likely to wear them forever, she said the way we act when we’re sick matters, too.

“The biggest thing is really having this culture that if people are sick, they don’t go out and expose other people,” she said.

Given the tendency for strep to transmit via touch, hand sanitizer is another helpful tool.

“When you’re out and you’re touching a lot of doorknobs and you know, elevator buttons and things like that, use hand sanitizer, because it’s spread by your hands pretty efficiently,” she said.