How To Tell the Difference Between Strep Throat and a Cold

Strep throat can cause nausea, vomiting, and stomach pain in children. Some children may develop a rash in places where their skin creases, like under their arms. Children under age 3 may have irritability, loss of appetite, and mild fever.

There are a few key differences between strep throat and the common cold:

How Common They Are

Strep throat: Strep throat is common, mostly in children aged 5-15. Although it can occur in adults, it becomes much less common after age 40.

Cold: Colds are among the most common illnesses in the world—even more common than strep throat. Anyone of any age can develop a cold. Adults get an average of 2-4 colds per year. Children get them much more frequently—up to 10 per year.

Which Germs Cause Them

Strep throat: Strep throat results from infection with bacteria, specifically group A streptococcus bacteria.

Cold: Colds result from infection with a virus. The most common cause is rhinoviruses, though more than 200 viruses can cause colds.

How They’re Diagnosed

Strep throat: A healthcare provider will swab your throat to collect a sample, which they will test for bacteria using a rapid strep test. If the test comes back negative but your provider still suspects you have strep throat, they may have a culture done in a laboratory.

A culture test of the sample can pick up on infections the rapid test might have missed. The results of this test may take up to two days

Cold: Healthcare providers usually diagnose colds based on symptoms alone.

How They’re Treated

Strep throat: Strep throat treatment requires antibiotics like penicillin or amoxicillin. These medications kill the bacteria that caused the infection. The medication can clear the infection within days and prevent you from spreading it to others.

Cold: Because a cold is a viral infection, antibiotics and other medications cannot cure it. Colds usually resolve on their own with plenty of rest, fluids, and over-the-counter (OTC) medications to ease symptoms.

Whether Treatment Can Prevent Complications

Strep throat: Treating strep throat with antibiotics greatly reduces the risk of developing serious complications, such as rheumatic fever, scarlet fever, ear infection, and abscesses (sacs of pus) near the tonsils.

Cold: Colds can also lead to complications, such as sinus infection, pneumonia, or bronchitis. These complications can be serious, particularly for people with weakened immune systems or respiratory problems like asthma. However, no treatment will prevent these complications.

By taking it easy and allowing yourself to heal, you will likely get better within a week.

Despite their differences, colds and strep throat are similar in ways that can sometimes make them hard to tell apart:

How They’re Spread

Both conditions are passed from person to person through respiratory droplets (snot or spit). If someone near you coughs or sneezes without covering their mouth, they send these droplets into the air. You might breathe in the droplets or touch an object the droplets fell on and then touch your face. Both situations can lead to infection.

Being in regular close contact with other people puts you at higher risk for strep throat and a cold. For example, people who live in military barracks are more likely to spread these infections to each other.

When They’re Spreading Most

You can get strep throat or a cold at any time of the year—the infections spread year-round. However, both infections happen most often in the winter and spring seasons. 

How They’re Prevented

Since both illnesses spread the same way, their prevention methods are also the same.

Protecting yourself from other people’s germs can help you avoid strep throat or a cold. Strategies include washing your hands, avoiding touching your face, disinfecting high-touch surfaces, and avoiding people who are sick.

Who They Affect

Because children are in daily close contact at school, they are more likely to spread germs to each other than adults. For this reason, both strep throat and colds are more common in children than in adults.

Adults who live or work with children are also at higher risk than those who do not.

It is possible to have strep throat and a cold at the same time. Since the infections are caused by different types of germs, you could be infected by both. People with weakened immune systems are at the highest risk of developing both infections. 

A pediatrician can diagnose colds and strep throat in children. A primary care physician can diagnose the conditions in children and adults.

If you or your child have mild cold symptoms, it’s unlikely that you need treatment from a healthcare provider. If symptoms become more severe or indicate strep throat, make an appointment with your provider.

Call a healthcare provider right away if you or your child has any of the following symptoms:

• Fever that is high or lasts longer than four days
• Trouble breathing
• Dehydration
• Symptoms that last longer than 10 days
• Symptoms that get better but then come back

Although strep throat and the common cold share some symptoms, they are distinct illnesses with different causes, severity, and treatments.

Strep throat can cause symptoms like severe sore throat, sudden fever, and body aches. The common cold may also cause a sore throat, but this symptom is usually mild and occurs with a runny nose and cough.

Understanding the differences between these two infections can help you get the right treatment and avoid spreading the illness to others.