Why Do My Kids Keep Getting Strep?

My son is 8.5 years old and attends a public school in Austin, Texas. He and several of his friends, not all in the same class, seem to be continually getting strep throat. My son has had it at least three times, and he has missed an unusually large amount of school this year with fevers. Other friends’ kids have had strep six times! This seems crazy. What is going on, and what should we do to stop this strep cycle?
—Strep, please stop!

Group A strep is a bacteria that causes a variety of illnesses of varying severity, the most common of which is strep throat. Strep throat is the cause of a large share of sore throats in children, and there is a quick swab test that can be done by your doctor to detect it.

The past year has been a bad one for strep. We cannot observe trends in strep throat directly, because it’s not a disease that the CDC tracks (there are some illnesses that are “notifiable diseases,” so the CDC must be told about a positive test; this isn’t one of them). However, the CDC does track serious strep infections that result in streptococcal toxic shock syndrome (STSS). To be clear, this is very rare, but since it’s caused by the same bacteria as strep, we can use it to get a sense of trends over time.

Cherry-red cough syrup is poured from a bottle onto a dripping spoon. — Getty Images

There was a large spike in strep in 2023 relative to the pandemic years, when cases were lower. In 2023, there had been 700 cases of STSS, versus only 186 in 2022 and 112 in 2020. Pre-pandemic, cases were higher —307 in 2018. In 2024, things are tracking lower than 2023 but still higher than pre-pandemic; 530 cases this year.

The repeat infections you describe — while they do happen — are unusual. People definitely can get repeat strep infections over short periods (it is not like a virus in the sense that once you fight it off, you typically have some medium- to long-term immunity). This can happen for those who are immunocompromised, but it can also happen if there is a continual strep source.

In this case, it seems possible that the kids are just constantly passing the bacteria back and forth. It’s also possible that someone in the vicinity is an asymptomatic strep carrier. Either way, it’s not clear there is much to do about it other than to encourage hand washing, discourage nose picking, treat them when they are sick, and wait for the summer.