What’s the difference? is a new editorial product that explains the similarities and differences between commonly confused health and medical terms, and why they matter.

It’s the time of the year for coughs, colds and sore throats. So you might have heard people talk about having a “strep throat”.

But what is that? Is it just a bad sore throat that goes away by itself in a day or two? Should you be worried?

Here’s what we know about the similarities and differences between strep throat and a sore throat, and why they matter.

How are they similar?

It’s difficult to tell the difference between a sore throat and strep throat as they look and feel similar.

People usually have a fever, a bright red throat and sometimes painful lumps in the neck (swollen lymph nodes). A throat swab can help diagnose strep throat, but the results can take a few days.

Thankfully, both types of sore throat usually get better by themselves.

How are they different?

Most sore throats are caused by viruses such as common cold viruses, the flu (influenza virus), or the virus that causes glandular fever (Epstein-Barr virus).

These viral sore throats can occur at any age. Antibiotics don’t work against viruses so if you have a viral sore throat, you won’t get better faster if you take antibiotics. You might even have some unwanted antibiotic side-effects.

But strep throat is caused by Streptococcus pyogenes bacteria, also known as strep A. Strep throat is most common in school-aged children, but can affect other age groups. In some cases, you may need antibiotics to avoid some rare but serious complications.

In fact, the potential for complications is one key difference between a viral sore throat and strep throat.

Generally, a viral sore throat is very unlikely to cause complications (one exception is those caused by Epstein-Barr virus which has been associated with illnesses such as chronic fatigue syndrome, multiple sclerosis and certain cancers).

But strep A can cause invasive disease, a rare but serious complication. This is when bacteria living somewhere on the body (usually the skin or throat) get into another part of the body where there shouldn’t be bacteria, such as the bloodstream. This can make people extremely sick.

Invasive strep A infections and deaths have been rising in recent years around the world, especially in young children and older adults. This may be due to a number of factors such as increased social mixing at this stage of the COVID pandemic and an increase in circulating common cold viruses. But overall the reasons behind the increase in invasive strep A infections are not clear.

Another rare but serious side effect of strep A is autoimmune disease. This is when the body’s immune system makes antibodies that react against its own cells.

The most common example is rheumatic heart disease. This is when the body’s immune system damages the heart valves a few weeks or months after a strep throat or skin infection.

Around the world more than 40 million people live with rheumatic heart disease and more than 300,000 die from its complications every year, mostly in developing countries.

However, parts of Australia have some of the highest rates of rheumatic heart disease in the world. More than 5,300 Indigenous Australians live with it.

Why do some people get sicker than others?

We know strep A infections and rheumatic heart disease are more common in low socioeconomic communities where poverty and overcrowding lead to increased strep A transmission and disease.

However, we don’t fully understand why some people only get a mild infection with strep throat while others get very sick with invasive disease.

We also don’t understand why some people get rheumatic heart disease after strep A infections when most others don’t. Our research team is trying to find out.

How about a vaccine for strep A?

There is no strep A vaccine but many groups in Australia, New Zealand and worldwide are working towards one.

For instance, Murdoch Children’s Research Institute and Telethon Kids Institute have formed the Australian Strep A Vaccine Initiative to develop strep A vaccines. There’s also a global consortium working towards the same goal.

Companies such as Vaxcyte and GlaxoSmithKline have also been developing strep A vaccines.

What if I have a sore throat?

Most sore throats will get better by themselves. But if yours doesn’t get better in a few days or you have ongoing fever, see your GP.

Your GP can examine you, consider running some tests and help you decide if you need antibiotics.

Kim Davis, General paediatrician and paediatric infectious diseases specialist, Murdoch Children’s Research Institute; Alma Fulurija, Immunologist and the Australian Strep A Vaccine Initiative project lead, Telethon Kids Institute, and Myra Hardy, Postdoctoral Researcher, Infection, Immunity and Global Health, Murdoch Children’s Research Institute

This article is republished from The Conversation under a Creative Commons license. Read the original article.

People often believe they are allergic to house dust. But of the 20% of Australians suffereing with allergies, a number are are actually allergic to microscopic house dust mites.

House dust mites belong to the same family as spiders and ticks. They measure just 0.2-0.3 mm, with 50 fitting on a single pinhead. They live for 65–100 days, and females lay 60–100 eggs in their life.

House dust mites love temperate climates and humidity. They feed off the skin cells we and animals shed, as well as mould, which they digest using special enzymes. These enzymes are excreted in their poo about 20 times a day. They also shed fragments of their exoskeletons.

All these fragments trigger allergies in people with this type of allergic rhinitis (which is also known as hay fever)

What are the symptoms?

When people with house dust mite allergy inhale the allergens, they penetrate the mucous membranes of the airways and eyes. Their body recognises the allergens as a threat, releasing chemicals including one called histamine.

This causes symptoms including a runny nose, an itchy nose, eyes and throat, sneezing, coughing and a feeling of mucus at the back of your throat (known as a post-nasal drip).

People with this type of allergy usually mouth breath, snore, rub their nose constantly (creating a nasal crease called the “dust mite salute”) and have dark shadows under their eyes.

House dust mite allergy can also cause poor sleep, constant tiredness, reduced concentration at work or school and lower quality of life.

For people with eczema, their damaged skin barrier can allow house dust mite proteins in. This prompts immune cells in the skin to release chemicals which make already flared skin become redder, sorer and itchier, especially in children.

Symptoms of house dust mite allergy occur year round, and are often worse after going to bed and when waking in the morning. But people with house dust mite allergy and pollen allergies find their year-round symptoms worsen in spring.

How is it diagnosed?

House dust mite allergy symptoms often build up over months, or even years before people seek help. But an accurate diagnosis means you can not only access the right treatment – it’s also vital for minimising exposure.

Doctor and nurse practitioners can order a blood test to check for house dust mite allergy.

Alternatively, health care providers with specialised allergy training can perform skin prick tests. This involves placing drops of the allergens on the arm, along with a positive and negative “control”. After 15 minutes, those who test positive will have developed a mosquito bite-like mark.

How is it treated?

Medication options include one or a combination of:

• daily non-sedating antihistamines
• a steroid nasal spray
• allergy eye drops.

Your health care professional will work with you to develop a rhinitis (hay fever) medical management plan to reduce your symptoms. If you’re using a nasal spray, your health provider will show you how to use it, as people often use it incorrectly.

If you also have asthma or eczema which is worsened by dust mites, your health provider will adapt your asthma action plan or eczema care plan accordingly.

If you experience severe symptoms, a longer-term option is immunotherapy. This aims to gradually turn off your immune system’s ability to recognise house dust mites as a harmful allergen.

Immunotherapy involves taking either a daily sublingual tablet, under the tongue, or a series of injections. Injections require monthly attendances over three years, after the initial weekly build-up phase.

These are effective, but are costly (as well as time-consuming). So it’s important to weigh up the potential benefits and downsides with your health-care provider.

How can you minimise house dust mites?

There are also important allergy minimisation measures you can take to reduce allergens in your home.

Each week, wash your bedding and pyjamas in hot water (over 60°C). This removes house dust mite eggs and debris.

Opt for doonas, covers or quilts that can be washed in hot water above 60°C. Alternatively, low-cost waterproof or leak proof covers can keep house dust mites out.

If you can, favour blinds and wood floors over curtains and carpet. Dust blinds and surfaces with a damp cloth each week and vacuum while wearing a mask, or have someone else do it, as house dust mites can become airborne during cleaning.

But beware of costly products with big marketing budgets and little evidence to support their use. A new mattress, for example, will always be house dust mite-free. But once slept on, the house dust mite life cycle can start.

Mattress protectors and toppers commonly claim to be “hypoallergenic”, “anti-allergy” or “allergy free”. But their pore sizes are not small enough to keep house dust mites and their poo out, or shed skin going through.

Sprays claiming to kill mites require so much spray to penetrate the product that it’s likely to become wet, may smell like the spray and, unless dried properly, may grow mould.

Finally, claims that expensive vacuum cleaners can extract all the house dust mites are unsubstantiated.

For more information, visit healthdirect.gov.au or the Australian Society of Clinical Immunology and Allergy.

Deryn Lee Thompson, Eczema and Allergy Nurse; Lecturer, University of South Australia

This article is republished from The Conversation under a Creative Commons license. Read the original article.