Tools to determine if you have a Strep infection
Sometime in the very near future you will be able to enter information into your cell phone and get a score that will assist you in deciding whether or not you should go to the doctor to evaluate your sore throat for Strep infection. The phrase “There is an app for that” may come into fruition for some other common health issues as well.
This is good news for the more than 12 million people who go to the doctor’s every year to get a sore throat evaluated. Most likely, it ends up being from a virus that cannot be treated with anything other than a tincture of time anyway. Reducing doctors visits could help alleviate strain on an already overburdened health care system. In addition to reducing unnecessary testing, there is also an opportunity to reduce the chance of prescribing an antibiotic that will not help treat a virus and only contribute to the ever growing problem of drug resistance.
Research from the Annals of Internal Medicine shows that a new risk measure called a “home score” may allow patients with symptoms to decipher at home whether or not a doctor’s visit is warranted. This research was conducted by Andrew Fine, MD, MPH, and Kenneth Mandl, MD, MPH, of Boston Children's Hospital. The “home score” combines patient symptoms along with local strep data in the community. This information together can estimate their strep risk, allowing them to decide whether to seek care or not. This at home risk score is thought to be the first health care tool that brings together individually contributed data along with community public health data. This allows or an individual risk assessment for a communicable disease. Other illnesses could be scored in the same way.
The tool measures risk on a scale from 0 to 100. Anyone with a score below 10 was considered at low risk. Dr Fine found that 90 percent of the people who scored below 10 on the “home score” would have tested negative for strep throat in the clinic anyhow.
The score is calculated using a patient's symptoms and age. It then takes into account statistical data by Mandl and Fine, of Boston Children's Division of Emergency Medicine and Informatics Program. That data indicates the recent strep incidence in the patient's location. If the “home score” is low, then the risk of having a strep infection is also low and therefore a doctor's visit is not needed. The future plans are for an online tool or smart phone application that would feed live surveillance data. By simply plugging in your symptoms and age you could conceivably get a risk score and decide if you should get a strep test.
"Using the home score could empower patients to make informed decisions about their medical care by contributing information about their symptoms," said Fine. "Integrating local epidemiologic context with the symptom information permits calculation of a personal, local risk of strep throat."
Based on their research, Mandl and Fine indicate that this could eliminate over 200,000 unnecessary doctor visits for strep throat screening in the U.S. every year.
Dr. Robert Centor, wrote an editorial accompanying the new study. "I just don't think it's practical," said Centor. He also questioned where the money would come from to conduct the necessary surveillance tests to calculate strep throat infection prevalence in the community.
Dr Cantor was not the only one to question the program. "It is totally unrealistic to think that real-time surveillance for group A streptococcus is going to be carried out in any community," Dr. Edward Kaplan, who also wrote an editorial accompanying the new study, said.
Dr, Mandl, responded that the programs could use the data already collected by hospitals and emergency rooms to measure community prevalence of infection. All that would be needed is an application to correlate the data.
What is Step throat?
So what exactly is strep throat? It is not the run of the mill throat irritation that you get from the common cold. It is an infection caused by Group A Streptococcus bacteria. It can cause your throat to feel sore and scratchy and if left untreated can cause kidney disease and rheumatic fever. Rheumatic fever can lead to serious complications such as damage to heart valves.
Symptoms may vary and can be very mild or severe. Fever may begin suddenly and can cause chills. Your throat may have a red color to it and have white patches. It can be difficult to swallow and your glands in your throat may become tender and swollen. Some individuals develop a headache and nausea as well.
A rapid strep test can be done in the emergency room, most health care provider offices and minute clinics. Results may take1 to 2 days to come back.
Treatment of Sore Throats
Most sore throats are caused by viruses and not bacteria. Only bacterial infections such as Strep should be treated with antibiotics. Penicillin is often used first and taken for a period of 7-10 days. However, in this story EmaxHealth's Dr. Wulffson writes that Antibiotics are worthless for most throat infections. In fact, in this study by Stamford researchers, it is warned us that antibiotics can be dangerous, even though they are prescribed to kill harmful bacteria.
Prevention of Strep Infection
We all know that prevention is the best medicine. Most individuals with strep are contagious until they have been on antibiotics 24-48 hours. Therefore they should stay home from work or school until then. Just like any virus or bacteria, get a new toothbrush before finishing your antibiotics. Otherwise you can re-infect yourself.
The following tips may help you feel better from any type of sore throat:
• Gargle with warm STRONG tea. The tannin in Black or Oolong tea will reduce inflammation and the warmth can sooth your throat.
• Drink cold liquids or suck on popsicles to numb the throat tissue.
• A vaporizer or humidifier can moisten and soothe a dry throat.
Take away message
If you are not feeling better within 48-72 hours seek medical attention. If your sore throat lasts longer than that you need to take it seriously.
Reference: National Institute of Health, Mayo Clinic.
Andrew M. Fine, Victor Nizet, Kenneth D. Mandl; Participatory Medicine: A Home Score for Streptococcal Pharyngitis Enabled by Real-Time BiosurveillanceA Cohort Study. Annals of Internal Medicine. 2013 Nov;159(9):577-583.