A sore throat is a condition of pain and scratchiness in the throat typically caused by other illnesses or conditions, such as viral or bacterial infections. Sore throats are more common in children between the ages of 4 and 7 years than in any other age group. The condition is uncommon in children less than 1 year of age.

Viral infections are the most common source of sore throats in young children. These include colds, influenza, measles, mumps, chickenpox, croup and mononucleosis.

Bacterial infections also can lead to sore throats. These include strep throat, tonsillitis (inflammation of the tonsils located at the back of each side of the mouth) and diphtheria (respiratory disease that causes breathing difficulties and painful swallowing).

A number of other factors can cause sore throats. They include allergies, breathing in polluted or dry air, overusing the voice and tumors.

The discomfort associated with a sore throat can be reduced by taking a non-aspirin pain reliever as recommended by a physician. Children also may find relief from gargling with salt water, sucking on a throat lozenge, eating popsicles, drinking plenty of liquids (such as water, soups and broths) and having a humidifier in the bedroom to keep the air moist.

The sore throat itself will not completely disappear until the underlying condition resolves. In the case of a viral infection, the illness will gradually fade without treatment over a number of days. Bacterial infections are treated with antibiotics. In some cases, the cause of sore throat must be treated with surgery. For example, severe cases of tonsillitis may require removal of the tonsils (tonsillectomy).

The chief method to prevent sore throats is to avoid getting sick by practicing good hygiene (e.g., regular handwashing) and avoiding contact with people who are sick.

Parents generally are urged to have a physician, preferably a pediatrician, examine the child if a sore throat is severe or persistent for a few days, or is accompanied by symptoms such as fever, blood in saliva or mucus, or significant fatigue. The condition may last less than 24 hours and does not usually persist for more than five days.

A sore throat is a condition of pain and scratchiness in the throat, which is located just behind the mouth. Also known as pharyngitis, sore throats are typically caused by another illness, such as a viral or bacterial infection.

Sore throats are more common in children between the ages of 4 and 7 years than in any other age group. Some estimates state that sore throat is a symptom in one-third of respiratory illnesses. Children may average about five sore throats each year.

The term “tonsillitis” is often used interchangeably with sore throat, but tonsillitis refers to a particular area of the throat that is inflamed (the tonsils, located at the back of the throat on either side of the mouth). Tonsillitis can cause the throat to be sore.

Sore throats typically occur with other symptoms related to the underlying illness that is causing the soreness. For example, infection with the Coxsackie virus can cause moderate fever, difficulty swallowing and blisters in the throat in addition to throat soreness.

Bacterial infections such as strep throat typically cause symptoms such as fever and thickened, bloody nasal discharge in children under age 3. Symptoms tend to be worse after age 3, and may include higher fever, painful soreness in the throat and difficulty swallowing, swollen glands, headache, vomiting, and pus or white spots on the tonsils.

Symptoms of tonsillitis closely mimic those of strep throat. Mononucleosis typically is characterized by a sore throat that lasts for one to four weeks and includes symptoms such as swollen glands in the neck, armpits and groin. Children with mononucleosis also may experience fatigue, fever and chills, and headache.

Many different factors can cause a sore throat. Viral infections are the most common source of sore throats in young children. These include colds, influenza, measles, mumps, chickenpox, croup and mononucleosis.

Children may become infected with viruses when breathing in particles from someone who is infected, or touching an object contaminated with germs, then transferring those germs into the body by touching the eyes, mouth or nose.

Bacterial infections also can lead to sore throats. For instance, bacterium called group A Streptococcus pyogenes causes strep throat.

If a bacterial infection is believed to be the cause, a physician may perform a throat culture. In this test, a long cotton swab is used to wipe the back of the throat. The swab is wiped onto a special culture dish, which is sent to a laboratory for analysis. An expert examines the sample to see if bacteria are growing there, and to determine the type of the infection. A rapid version of this test may be performed by some physicians, which can identify strep throat in minutes.

Other causes of sore throats include:

• Allergies or hay fever. Pollens, molds, pet dander and other allergens can trigger symptoms in some children that may include sore throat.
  
  
• Breathing in polluted or dry air. Outdoor air pollution and indoor air pollution (such as from tobacco smoke) often cause a child’s throat to feel sore or scratchy. Dry air (especially heated air during winter) can cause soreness in the throat, particularly upon waking.
  
  
• Smoking and other irritants. Older children who smoke or use alcohol may experience a sore throat. Spicy foods also can inflame the throat.
  
  
• Straining throat muscles. Children who yell for long periods of time (such as cheering at a sporting event) may experience soreness.
  
  
• Chronic sinus infections. Drainage from infected sinuses can trigger an infection of the throat, which in turn leads to soreness.
  
  
• Gastroesophageal reflux disease (GERD). This disease causes stomach acid to back up into the food pipe (esophagus) and may be accompanied by a sore throat. GERD is rare in children.
  
  
• Tumors. Growths that develop on the throat, tongue and voice box can sometimes lead to a sore throat.

The discomfort associated with a sore throat can be reduced by taking a non-aspirin pain reliever as recommended by a physician. Aspirin is not recommended for use in children because of the rare incidence of the serious Reye syndrome. Children also may find relief from gargling with salt water, sucking on a throat lozenge, eating popsicles, drinking plenty of liquids (such as water, soups and broths). Orange or other citrus juices should be avoided because they can irritate the throat. A humidifier can be used to keep the air moist in a bedroom.

A sore throat generally does not disappear until the underlying illness that causes the sore throat is eliminated. In most cases, viral infections gradually fade over a three-to-10-day period. Antibiotics cannot be used to treat viral infections.  

Children who have a bacterial throat infection usually are treated with an antibiotic regimen. The medication is usually taken in pill form over a 10-day period, and children generally are no longer contagious 24 hours after beginning therapy. It is crucial that children take the full medication dosage. Failure to do so can result in spread of the infection to other parts of the body, or the development of bacterial resistance to the medication. Illnesses that sometimes result from such infections include inflammation of the kidneys (post-streptoccocal glomerulonephritis), ear and sinus infections, scarlet fever and rheumatic fever (disease that affects the heart valves and joints).

Children who have severe tonsillitis sometimes require surgical removal of the tonsils (tonsillectomy). This is most likely when the tonsils are too big and obstruct a child’s ability to breathe properly. Unlike in the past, physicians do not routinely recommend removal of the tonsils if they become infected.

Children with mononucleosis typically are required to rest and avoid exercise until the sickness passes. A physician may suggest a pain reliever and fever reducer other than aspirin to treat symptoms.

The chief method of preventing sore throats is to keep hands free of germs that may cause viral or bacterial infection. Regular handwashing is important to achieving this goal. Children should always wash their hands before eating and after using the bathroom. They also should wash after spending time in public spaces or after touching animals. It is important to wash the front and backs of the hands and to get in-between the fingers.

Hand sanitizers also can be used to keep a child’s hands free of bacteria and viruses. These cleaners often contain a moisturizer that keeps the skin from drying out. It is important to use a sanitizer that contains alcohol in order to kill germs.

Adhering to the Centers for Disease Control and Prevention recommended vaccination schedule helps reduce the incidence of sore throats caused by serious diseases. Common or formerly common diseases such as measles, mumps, polio, and diphtheria caused many children to develop a sore throat, among other symptoms. Vaccinations for influenza are also available, and may help prevent sore throat in children caused by influenza.

Children also are urged to use the following precautions:

• Do not share certain items with others. These include eating utensils, food, glasses, napkins or towels.
  
  
• Wash hands after using public phones and do not touch drinking fountains with the mouth.
  
  
• Avoid contact with those who are sick.
  
  
• Stay indoors when air pollution is high.
  
  
• Avoid exposure to second-hand smoke.
  
  
• Cough or sneeze into tissues and throw them away.

Parents generally are urged to have a physician, preferably a pediatrician, examine their child if a sore throat is severe or persistent for more than a few days and is accompanied by any of the following:

• Blood in saliva or mucus
  
  
• Contact in recent period with someone infected with strep throat
  
  
• Dehydration characterized by sunken eyes, severe weakness and lower output of urine
  
  
• Fever higher than 101 degrees Fahrenheit (38 degrees Celsius) in children under 6 months or 103 degrees Fahrenheit (39 degrees Celsius) in children over 6 months of age
  
  
• Headache
  
  
• Hoarseness lasting longer than two weeks
  
  
• Drooling
  
  
• Major fatigue
  
  
• Pus at the back of the throat
  
  
• Recurring sore throats
  
  
• Stomach ache
  
  
• Tender or swollen lymph glands in the neck

Preparing questions in advance can help parents and children have more meaningful discussions with their physicians regarding their conditions. Parents and children may wish to ask their doctor the following questions related to sore throats:

1. How will I know whether my child’s sore throat requires treatment?
   
   
2. What symptoms should I look for that might indicate the cause of my child’s sore throat?
   
   
3. What is likely causing my child’s sore throat?
   
   
4. Will you swab my child’s throat?
   
   
5. How long will my child need to take antibiotics?
   
   
6. Is it possible that my child’s sore throat will recur?
   
   
7. What over-the-counter medications do your recommend to relieve symptoms?
   
   
8. Should my child stay home from school?
   
   
9. Will using a humidifier help my child’s symptoms?
   
   
10. When will my child no longer be contagious?
    
    
11. How can I prevent other family members from getting sick?