Sore Throat (Viral)

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There are two different germs that cause sore throats: viruses and bacteria. Most sore throats are caused by viruses. It is less common for infants and young toddlers to get strep throat (a sore throat caused by “strep” bacteria). If your child has any of the symptoms below, it is likely the sore throat is from a virus.

Your doctor will decide, based on your child’s symptoms and medical history, if any tests need to be done. A throat swab or “rapid strep test” will tell if the sore throat is caused by strep bacteria that can be treated with antibiotics. If the symptoms are that of a virus, this test is not needed and antibiotics will not be prescribed.

Strep bacteria can sometimes live on children’s throats without causing illness. As many as 1 in 5 children are “strep carriers.” This means that they have no symptoms, they are not contagious and their strep throat test stays positive even after taking antibiotics. If your child gets a sore throat and you know that he or she is a strep carrier, the doctor will treat the sore throat like a virus. Doing throat swabs on children who are carriers may cause them to take an antibiotic that they do not need.


If your child has any of the symptoms below, it is likely the sore throat is from a virus:

  • Fever
  • Decreased appetite
  • Hoarseness
  • Cough
  • Runny nose
  • Mild sore throat, usually 2 or 3 days after the above symptoms start. The throat may look red with "yellow patches."
  • Fussiness
  • Sleeping more than usual

How to Care for Your Child

Keep your child home from school or child care if he or she has a temperature under the arm over 100 degrees F. The child should be free of fever for 24 hours before returning to school.

  • Have your child rest and play quietly indoors.Giving child Acetaminophen
  • Give acetaminophen (such as Tylenol® ) or ibuprofen (such as Advil® or Motrin® ) as directed for fever and pain. Read the label to know the right dose for your child. Do not give aspirin or any product that contains aspirin (Picture 1).
  • Give your child lots of liquids to drink, like water, Pedialyte®, apple juice and popsicles (Picture 2).
  • Give soft foods often, but do not force your child to eat. He may not want to eat much if it hurts to swallow.
  • To soothe a sore throat, offer:
    • For children over age 1, warm fluids such as chicken broth or apple juice
    • For children over age 4, throat or cough lozenges or throat sprays. Read the label to know the right dose for your child. Do not use throat sprays that contain benzocaine, as this could cause a drug reaction.
    • For children over age 6 who are able to gargle without swallowing, a mixture of ½ teaspoon of table salt in 8 ounces of warm water. Swish and gargle the mixture 2 to 3 times a day for the next few days.
    • Do not let your child swallow the salt water; have him spit it out.
  • You can use a cool mist humidifier in your child’s room at night.

How to Protect Others

  • Make sure to wash your child's drinking glass and eating utensils in hot soapy water before others use them.Give child liquids
  • Give your child a paper bag and have him put his used tissues in this bag. Moisture from the child's nose and mouth is contagious.
  • Have your child wash his hands often.
  • Wash your hands after touching your child.
  • Throw away your child's toothbrush and buy a new one as soon as the illness is over. The germs that caused the sore throat may be on the child's toothbrush.

When to Call the Doctor

Call your doctor if your child:

  • Has trouble breathing
  • Still has a fever for 2 to 3 days after seeing the doctor
  • Stops drinking liquids
  • Starts pulling at his ears
  • Becomes a lot fussier.
  • Has any of these signs of dehydration:
    • Stops crying tears
    • Urinates less often 
    • Has dry, cracked lips

If you need a doctor for your child, call the Nationwide Children’s Hospital referral and Information Line at (614) 722-KIDS

Sore Throat (Viral) (PDF)

HH-I-121 11/89, Revised 8/17 Copyright 1989, Nationwide Children’s Hospital