Expert Advice -- Are Ear Infections and Soar Throats Contagious?

My two-year-old daughter just had a mild ear infection and sore throat and our pediatrician put her on the antibiotic, Augmentin. How long is she contagious? And how long should I keep her at home, out of contact with other children?

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Robert Steele

Robert W. Steele, MD, is a board certified pediatrician at St. John's Regional Health Center in Springfield, MO. He graduated from medical... Read more

Your question brings up some important points about upper respiratory infections in children.

Sore throats

Sore throats may be caused by either bacteria or viruses.

• Viruses often give you other symptoms like runny nose, watery eyes, and cough, but not always.
• Bacteria, like the one that causes strep throat, usually are not associated with these "cold" symptoms.

However, it is impossible to tell just by looking at the throat whether it is a virus or strep throat. You have to test it. Currently, there are no antibiotics that work well against viruses that typically cause a sore throat. That's okay because the body gets rid of this on its own, so all you have to do is treat the symptoms like the pain.

Strep throat needs antibiotics to cure it. A person with strep throat is considered non-infectious after the first 24 hours of antibiotics. Thus, persons with strep throat should stay home from school until that 24 hours is up.

Viruses, on the other hand, are most infectious usually before you have symptoms, such as a sore throat. Thus, it is usually not necessary to keep your child home from school if she only has a viral sore throat. For many reasons I believe it is important not to treat a "strep throat" based upon observation alone. The throat should be swabbed for culture.

Ear Infections

There is no easy way to test the infected fluid behind the ear drum to see if the ear infection is from a virus or bacteria.

Clearly up to one third of ear infections may be caused by viruses. This means up to one third of ear infections require no antibiotics at all. However, because we can't easily test this, physicians assume the ear infection is from a bacteria and prescribe an antibiotic. Ear infections are not contagious because the fluid that is infected is well isolated behind the ear drum.

I realize this is quite a long answer to your short question. In a nutshell, your daughter's ear infection is not contagious. The throat infection, if bacterial is no longer contagious, and if viral is most likely not contagious.

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