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Dear Dr. Spector,

My daughter who is six years old was diagnosed as being a carrier of strep.  She was given a very strong antibiotic and that was supposed to eradicate it.  That was two months ago and she has it again.  She says her throat doesn’t hurt her whenever she has it which I guess it means she is asymptomatic.  The thing is her pediatrician said she can go to school but I read online carriers give it to others.  We, (my husband and I) have never caught it from her however so I am totally confused.  Do you think she is really a carrier or just gets it a lot.  I will be taking her to a Pediatric ENT.  My main concern am I exposing other people?  Thank you so much for your time and patience.

Fran

Brooklyn, New York

Dear Fran,

While there exists some controversy regarding the issue of asymptomatic oral carriers of strep, the weight of the evidence suggests that if the bacteria is not eradicated from the throat after appropriate antibiotic therapy, there is no need to pursue this any further in an otherwise healthy person, unless there is a family member or close contact that suffers recurrent infections.

Persistence of strep bacteria in the throat occurs in about one-fourth of patients treated appropriately with antibiotics. Most experts agree, however, that these "carriers" are not a significant source for spread of strep infections to others. When these bacteria are studied specifically, in fact, they seem to have a lesser ability to penetrate tissue and cause problems, due to the lack of certain surface proteins.

So, in summary, your daughter does appear to carry strep that does not seem to cause her, or your family, any problems. In addition, most doctors agree with your pediatrician that she should not pose any problem for other healthy children at school. Your ENT will confirm that there are no other factors specific to your daughter that would change this opinion, but it seems that you do not need to be concerned any further.

Thank you for your question!

Jared E. Spector, MD

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