Strep Throat Vs. Common Cold

One of the primary symptoms associated with strep is a sore throat. However, a sore throat is also a common symptom of colds, which, unlike strep throat, are caused by viruses and not bacteria. Viruses are responsible for 85 to 95%¹ of throat infections in adults as well as children under five, with the remainder being caused by bacteria (such as group A streptococcus, which is responsible for strep throat). 

In children between the ages of five and 15, bacterial infections are more common than in other age groups, but they still only account for 30% of throat infections (most of which are caused by strep). The other 70% are caused by viruses. 

So, how do you know if you have strep throat or the common cold? Of course, you’ll need to see a doctor to find out for certain, but this detailed comparison can help you determine which is most likely.

What is strep throat?

Strep throat is a bacterial infection affecting the throat and tonsils. The bacteria that cause strep can spread through coughing, sneezing, or contact with contaminated surfaces.

If strep throat isn’t appropriately treated, it can lead to serious complications, such as rheumatic fever.²

Symptoms of strep throat

According to the Centers for Disease Control and Prevention³ (CDC), strep throat is generally a mild infection. However, the symptoms can be severe enough to interfere with daily functioning. The most common signs of strep throat are:

• Sore throat

• Fever 

• Pain when swallowing

• Headache

• Nausea or vomiting

• Stomach pains

• Tiny red spots on the roof of the mouth

• Red swollen tonsils, which may also have white patches or streaks of pus

• Swollen lymph nodes in the front of the neck

Infants and young children with strep throat might:

• Appear fussy or irritable

• Refuse to eat

• Sleep more than usual

• Develop a textured, red rash (scarlet fever)

Diagnosis

To confirm you have strep throat, your doctor will do a rapid strep test or throat culture.

A rapid strep test usually takes about ten minutes. During the test, your doctor will take a swab from your throat and test it for strep bacteria. If the test is positive, you have strep throat, and your doctor can prescribe antibiotics.

If your rapid test is negative, but your doctor still suspects you have strep, they may take a throat culture and send it to a lab for analysis. A culture is more accurate than a rapid strep test, but it takes longer to get results. You'll usually get your results in one to two days.

Treatment

Antibiotics, most often penicillin or amoxicillin, are commonly prescribed to treat strep throat. Early treatment can help prevent severe complications, such as rheumatic fever, and reduce the likelihood that you’ll spread the infection to others.

You should start feeling better within one or two days of starting antibiotics. However, it's important to keep taking the antibiotics until they’re gone, even if you feel well. Finishing your course of antibiotics reduces your risk of developing severe complications and prevents an infection relapse.

Quitting the antibiotics early can help bacteria build resistance to antibiotic treatments, meaning that the antibiotics may not be effective against future infections. 

Over-the-counter medications such as ibuprofen (sold under brand names such as Advil and Motrin) and acetaminophen (Tylenol) can provide symptom relief. Gargling with warm salt water can also help soothe a sore throat.

You can make a soothing salt water rinse at home by combining one-quarter teaspoon of salt with a cup of warm water. Gargle for 10 to 15 seconds, then spit it out. You can repeat this therapy as needed throughout the day. Note that gargling salt water should be reserved for adults and children old enough to gargle without swallowing. 

Prevention

Strep throat spreads easily between people in close contact, especially in schools and daycares. It’s typically spread through respiratory droplets and direct physical contact. You can reduce the spread by:

• Washing your hands with soap and water often and for at least 20 seconds

• Washing your hands before and after preparing and eating food

• Coughing into your elbow, upper sleeve, or a tissue instead of your hand

• Using alcohol-based hand sanitizer when washing your hands isn’t an option

• Thoroughly cleaning utensils and dishes used by someone who has strep and frequently cleaning shared surfaces 

What is a cold?

A cold is a viral infection that affects the nose, throat, and sometimes the sinuses and lungs. While rhinoviruses are the most common type of virus responsible for colds, more than 200 unique viruses can trigger a cold.

Colds are highly contagious, and, like strep throat, a cold can spread through coughing, sneezing, or contact with contaminated surfaces. An estimated one billion people in the United States will catch colds each year.

While the common cold is typically harmless, it can have severe consequences for certain groups of people, including infants, older adults, and people with underlying health conditions.

Symptoms of a cold

After contracting a cold virus, it can take one to three days before you start feeling sick. The most common signs of a cold are:

• Runny nose

• Coughing 

• Sneezing 

• Sore throat

• Low or no fever (101 degrees Fahrenheit or lower — higher may indicate the flu)

• Headache 

• Body aches

• Feeling generally unwell

Most people will recover from a cold within about seven to ten days. However, if symptoms persist, a different condition, such as a sinus infection, may be responsible. 

Diagnosis

A cold is diagnosed based on symptoms. By recognizing common cold symptoms, you can seek treatment early and help prevent the spread of infection.

There is no single medical test to diagnose a cold. However, your doctor may order a strep test or other diagnostic tests if your cold signs and symptoms are severe or last longer than ten days. These tests can rule out other conditions with similar symptoms.

Treatment

The common cold is a viral infection and, as such, does not respond to antibiotics. Treatments for a cold focus on symptom relief.

There is no cure for the common cold, but there are treatments that can help relieve your symptoms and make you feel more comfortable. Common cold treatments include:

• Over-the-counter medications: These can help relieve pain and reduce fever. Some over-the-counter cold medications also contain decongestants that help clear a stuffy nose. Some common over-the-counter cold medications include ibuprofen (Advil, Motrin), acetaminophen (Tylenol), and decongestants. Be sure to read the labels carefully and follow the directions.

• Nasal sprays: These can help to relieve a stuffy nose. There are a few different kinds of nasal sprays. Some contain a decongestant medication. However, you shouldn’t use nasal sprays containing a decongestant for more than three days because they can worsen nasal congestion. There are also nasal sprays with saline (salt water). These can be used as often and for as long as you wish. Steroid-based nasal sprays are effective for allergies but generally aren’t effective for a stuffy nose caused by a cold. Speak to your doctor regarding the use of over-the-counter or prescription nasal sprays and for guidance on the duration of use.

• Home remedies: Several home remedies can help to relieve cold symptoms, including:

  • Gargling with warm salt water

  • Drinking fluids to stay hydrated

  • Drinking warm liquids such as soup

  • Resting

Prevention

You can't completely prevent colds, but there are steps you can take to reduce the spread, such as:

• Washing your hands often and thoroughly with soap and water, especially before preparing food and eating

• Using an alcohol-based hand sanitizer when washing your hands isn’t practical 

• Avoiding close contact with people who are sick

• Avoiding touching your eyes, nose, and mouth unless you have just washed your hands

• Cleaning shared surfaces 

The lowdown

The common cold and strep throat are both contagious infections that can cause similar symptoms, including headaches and sore throat. However, strep throat is caused by bacteria and is more likely to cause symptoms like red, swollen tonsils and swollen lymph nodes. In contrast, colds are caused by viruses and are more likely to cause symptoms like a runny nose and cough.

While no treatment can get rid of a cold virus, home remedies and over-the-counter medications can help with symptom relief. You should visit your doctor for testing if you think you may have strep throat. Antibiotics are effective for strep throat and can help to prevent severe complications.

If you suspect you have a cold, but your symptoms last longer than ten days or are severe, you should see your doctor to rule out other conditions, such as strep throat or a sinus infection.