I have had strep throat at least once a year for the last 10 years. The last time I went to the doctor with a sore throat, she said that I had no other symptoms and took a throat culture just to see if I happened to be a strep carrier. It came back positive for strep as well as staph. What does this mean? I'm afraid to kiss my children -- I don't want to make them sick. Is there any cure for this?

Nicole

You are a chronic carrier of "strep" -- Streptococcus pyogenes, also called group A strep -- the bacterium responsible for strep throat. Strep throat causes sore throat, fever and lymph-node swelling in the neck. Usually, strep throat is a self-limited infection, but there can be complications. Abscesses (collections of pus) can form in the neck and must be drained. In the past, it was not uncommon for these abscesses to become life-threatening. Another complication of strep throat that is uncommon in the developed world is rheumatic fever. In this disorder, the strep infection sets up an immune reaction that can damage the heart and affect the joints.

While it is possible for an adult to get strep throat every year for 10 years, it is not common at all. Most cases of sore throat are viral infections, not strep infections. A physician can take a culture of the throat to distinguish the two. One problem with the throat culture is that as many as 10 to 15 percent of all people will have strep in their throats even with no illness. These people almost never have any problems whatsoever with the bacterium.

When I have a patient like you who has been diagnosed with strep throat over and over again, I take a throat culture during a period without illness. If the culture is positive, it confirms that my patient is a carrier -- which means the culture will always come out positive even when strep is not causing illness. This is probably what has happened to you. You probably just had viral illnesses once a year (which is about average).

It is NOT common for strep to be passed on to cause disease in other people. In fact, we usually do not treat strep "carriers" at all! The one problem you face is what to do the next time you have an illness that suggests strep throat. If you have such an illness, you may need to be treated for strep throat, just to be on the safe side. (Some features will suggest a viral illness rather than strep. For example, sneezing and nasal congestion point more to a viral infection, because strep does not usually cause nasal symptoms.)

As to your children, you don't need to do anything. Unless they have immune deficiencies or a history of rheumatic fever, you really don't have to worry too much about it. Don't forget that you have been harboring this bacterium for years. We all have bacteria in our mouths and on our skin. Yours just happen to be strep. Don't worry about the staph either. Unless you or your family is having recurrent staph infections, such as boils, you really don't have to be concerned about that, either.