Is It Strep Or Is It The Flu? Here’s How To Tell The Difference Between The Two Illnesses

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In early 2018, 12-year-old Alyssa Lino Alcaraz passed away after her strep throat, which would go on to cause fatal complications, was allegedly initially misdiagnosed as the flu. Alcaraz's case makes it clear that it's important to know from the beginning how to tell the difference between strep throat and the flu virus; even in less extreme cases, knowing how to tell the difference between the two will help sufferers clarify symptoms, get more accurate treatment, and get back to full health faster.

Strep throat, or a streptococcal infection, is a bacterial infection that requires treatment with antibiotics, according to Medicine Net, while the flu virus can't be targeted with antibiotic drugs and is usually treated with antivirals or by supporting the body until the immune system fights the virus off. Both strep throat and the flu are fairly contagious when somebody is experiencing symptoms (though less so when they're not), but unlike the flu, strep is not usually characterized by coughing and sneezing, according to the Mayo Clinic. With both illnesses, you may experience a fever, nausea, and the chills, but there is one major difference between the two that can help you and your GP figure out the best course of treatment for your illness.


While many people with the flu report a sore throat, the soreness that indicates that you have a bacterial streptococcal infection comes from a very specific source, and is usually very visible, even to the unprofessional eye. Flu-induced sore throats may look a little red and inflamed, but strep throats possess another attribute: red and white spots all along the soft palate at the back of the throat. They're caused by the bacterial infection of the skin, and can occur on the tonsils and elsewhere. Strep is part of the same group of bacteria as flesh-eating disease, according to Medicine Net, and these patches represent bacterial damage. White spots, red spots, or pus in the back of the throat are all considered signs of strep. They're your first stop if you're trying to figure out whether you've got strep or not; strep itself is diagnosed via a throat swab at the doctor's, where the doctor will examine the antigens present in your throat bacteria and note whether strep is present, and give you antibiotics to treat it.

Another, more subtle difference between the two illnesses is whether you're sneezing and coughing. Sneezes and coughs are considered integral to how the body manifests flu, while they're exceptionally rare in cases of strep. (Or you may be exceptionally unlucky and have both at once, which does occasionally happen.) This includes all kinds of coughs, from dry coughing to chesty coughs that involve dislodging a lot of phlegm. If you are coughing or sneezing, remember to cover your nose and mouth and disinfect your hands regularly, as this is how the flu virus usually spreads.

Additionally, there's a subtle difference between the sore throat you get from strep, and the sore throat you'd get from the flu, though both are unpleasant. The sore throat that indicates strep is usually exceptionally rapid; it seems to come out of nowhere and develop strongly within several hours, while the sore throat associated with flu may come on over a period of days, and is likely going to be accompanied by phlegm. However, both will likely prevent easy swallowing and may influence a patient's sense of taste — and both often mean swollen lymph nodes, so patients will literally be dealing with a pain in the neck — but people who are unsure about what they're suffering from are encouraged to think about the timeline of their sore throat, and whether it appeared very suddenly, as that often indicates strep.

It's crucial to get to the doctor if your sore throat or fever feels like it's more intense than usual. If left untreated, strep throat can develop into other bacterial infections such as scarlet fever, or even potentially septic shock, so it's really important to make sure whatever you have gets treated in a timely manner. If you're feeling rotten, it doesn't hurt to go to an urgent care — your doctor there can do a strep test, which can give you definitive results back in 10 or 15 minutes, or diagnose your flu, which can potentially be made a little easier with antiviral medication. Don't delay getting answers that can help you feel better faster.