Group A Strep Is Rising as School Starts: Symptoms, Testing, and When Kids Can Return

• The CDC reported on September 11, 2026, that group A strep infections and emergency-department visits involving strep throat and scarlet fever were beginning to increase in the United States as children returned to school.
• A sore throat alone does not confirm strep. Children with symptoms that do not clearly suggest a virus may need a rapid strep test, and children older than 3 generally need a backup throat culture after a negative rapid test.
• A child with confirmed strep should stay home until they are fever-free, well enough to participate, and have taken appropriate antibiotics for at least 12 hours, while following the school or childcare program’s policy.

What the CDC’s new group A strep update means

The Centers for Disease Control and Prevention reported on September 11, 2026, that group A strep activity was beginning to increase across the United States as children returned to school. Emergency-department data also showed an uptick in visits involving strep throat and scarlet fever, two illnesses caused by group A strep bacteria.

This is a seasonal increase, not a warning that every sore throat is strep or that a national outbreak has been declared. Group A strep infections can occur throughout the year, but reports are typically lowest during the summer and begin rising as children spend more time together in schools and childcare settings.

For parents and caregivers, the practical message is simple: pay attention to the pattern of symptoms, arrange testing when appropriate, and do not send a child back to school while they have a fever or before they have been on effective treatment long enough.

Updated September 21, 2026.

Common symptoms of strep throat in children

Strep throat is a bacterial infection of the throat and tonsils. It is most common among children ages 5 through 15, although people of any age can get it.

Symptoms often begin suddenly and may include:

• A sore throat that starts quickly
• Fever
• Pain when swallowing
• Red or swollen tonsils, sometimes with white patches or streaks
• Swollen lymph nodes at the front of the neck
• Small red spots on the roof of the mouth
• Headache, stomach pain, nausea, or vomiting, especially in children
• A rough, red rash known as scarlet fever

These symptoms can overlap with other infections, so they do not prove that a child has strep. In fact, viruses cause most sore throats. Cough, runny nose, hoarseness, mouth ulcers, and pink eye are symptoms that more strongly suggest a viral infection rather than classic strep throat.

When a child should be tested

Healthcare providers cannot reliably distinguish viral and group A strep throat by looking at the throat alone when clear viral symptoms are absent. Testing is therefore important before starting antibiotics.

A provider may use a rapid antigen detection test, commonly called a rapid strep test. A throat culture can find infections that a rapid test misses and remains the diagnostic gold standard.

For children and teens, the CDC recommends following up a negative rapid test with a throat culture. This backup step matters because untreated confirmed strep can cause complications, including acute rheumatic fever, although that complication is uncommon.

A positive rapid test or throat culture confirms group A strep throat. A negative culture generally means antibiotics are not needed for that sore throat because group A strep was not detected.

What parents should not do

• Do not assume that white patches automatically mean strep.
• Do not use leftover antibiotics or share medication with another family member.
• Do not give antibiotics for a presumed viral sore throat unless a healthcare provider confirms that they are appropriate.
• Do not rely on a home diagnosis to decide when a child can return to school.

When antibiotics are appropriate

Children with a positive rapid strep test or throat culture should receive antibiotics prescribed by a healthcare provider. Penicillin or amoxicillin is commonly recommended when there is no relevant allergy, but the medication and course depend on the child’s medical history and the provider’s assessment.

Antibiotics can shorten symptoms, reduce the chance of spreading the bacteria, and lower the risk of complications. They do not treat viral sore throats, and unnecessary antibiotic use can cause side effects and contribute to resistance.

If a child is not improving after 48 hours of prescribed treatment, contact the healthcare provider. Seek urgent medical attention sooner for trouble breathing, difficulty swallowing liquids, signs of dehydration, rapidly worsening illness, unusual sleepiness, or severe swelling in the throat or neck.

When can a child return to school after strep?

CDC clinical guidance says a child with group A strep infection should be well enough to participate, no longer have a fever, and have completed at least 12 hours of appropriate antibiotic treatment before returning to school or childcare. The CDC’s public testing guidance describes the general window as 12 to 24 hours, so families should also follow the child’s school, childcare, or local public-health policy if it is more specific.

The 12-hour treatment window is not a substitute for feeling well. A child who is still feverish, unusually tired, unable to drink, or too uncomfortable to participate should stay home and be reassessed as needed.

How families can reduce spread at home

Group A strep spreads through respiratory droplets and close contact. Handwashing, covering coughs and sneezes, and avoiding shared cups, utensils, and toothbrushes can reduce transmission. Children should also avoid close contact with others while they are sick and before they meet the return-to-school conditions.

Household members who were exposed generally do not need preventive antibiotics if they have no symptoms. They should watch for sore throat, fever, rash, or other concerning symptoms and contact a healthcare provider if those symptoms develop.

What happens next with the CDC report

The CDC reviews respiratory and other illness trends regularly. The September 11 update describes an early seasonal increase in U.S. group A strep activity; it does not provide a universal prediction for how high activity will rise or establish one return date for every school district.

School and childcare rules can differ between jurisdictions. The CDC guidance is a useful medical baseline, but families in Canada should follow the policy of their province, territory, school, or childcare provider because this particular activity report concerns the United States.

Helpful Links

• CDC Other Respiratory Illnesses Going Around – Review the CDC’s September 11, 2026 update on rising group A strep activity and emergency-department trends in the United States.
• CDC About Strep Throat – Check the CDC’s current list of strep throat symptoms, risk factors, complications, and common viral look-alikes.
• CDC Testing for Strep Throat or Scarlet Fever – Review how rapid tests and throat cultures are used and the CDC’s guidance on returning to school after treatment.
• CDC Clinical Guidance for Group A Streptococcal Pharyngitis – See the clinical guidance on testing, antibiotics, transmission, and return-to-school timing.
• CDC Preventing Group A Strep Infection – Learn how group A strep spreads and which everyday hygiene measures can help reduce transmission.

Frequently Asked Questions

Q. Can a child have strep throat without white spots on the tonsils?

A. Yes. White patches are only one possible finding. Strep can cause a sudden sore throat, fever, painful swallowing, swollen neck glands, or a rash without visible white patches. Testing is needed when the symptoms and examination do not clearly point to a virus.

Q. Does every child with a sore throat need a strep test?

A. No. Children with clear viral symptoms such as cough, runny nose, hoarseness, or pink eye may not need strep testing. When those symptoms are absent and strep is suspected, a healthcare provider can decide whether to use a rapid test and follow-up throat culture.

Q. Can a child return to school the morning after starting antibiotics?

A. Only if the child is well enough to participate, no longer has a fever, and has received appropriate antibiotics for at least 12 hours. The school or childcare program may require a longer interval, so families should follow its specific policy.

Q. Should siblings or other household contacts take antibiotics after exposure?

A. Usually not if they have no symptoms. Household contacts should watch for symptoms such as sore throat, fever, or rash and contact a healthcare provider if they become ill. Preventive antibiotics are not generally recommended for routine exposure.