Fall and kids colds go together like autumn leaves and schoolbooks, a sign of the season. When a cold comes with a sore throat, however, it can require extra care.
Sore Throat Remedy: Echinacea Throat Spray
Sore throat ranks right up there with earache as one of the most common reasons parents take their children to the doctor. Parents make the trip for two main reasons: to seek a way to ease their child’s pain and to find out if the cause is strep. If the sore throat arrived with other symptoms of a cold or the flu, that usually means it’s viral. The discomfort typically will last three or four days and go away without any medical treatment—and antibiotics won’t do a lick of good. But if strep (or one of the rarer bacteria) has caused the illness, your child probably needs antibiotics.
Sore throats of both kinds are quite contagious. The incubation period (the time between exposure and onset of symptoms) takes two to five days, so kids who seem healthy can spread infection.
Viral sore throats are often part of the package of a viral respiratory infection. With a cold, a child sniffles, sneezes, coughs, and may complain of a scratchy throat. Hoarseness or laryngitis develops when the voice box, or larynx, becomes inflamed. The sore throat your child may suffer when he has the flu goes along with other hallmarks of that syndrome: muscle aches, cough, headache, fever, and chills. Adenovirus causes flu-like symptoms with sore throat and pinkeye. Infectious mononucleosis—the “mono” that mainly afflicts teens and young adults—causes sore throats with fever, extreme malaise, fatigue, poor appetite, and enlarged lymph nodes.
So how do you tell—or at least hazard a guess—whether the cause of a sore throat is viral or bacterial? Runny nose and cough along with a sore throat usually indicate a viral respiratory tract infection. Strep throat, however, is rarely accompanied by these symptoms.
Strep throat, or infection with the Streptococcus pyogenes bacterium, accounts for about 15 percent of all sore throats. During some times of the year, however, up to half of kids’ sore throats may be due to strep. The prime symptoms are sore throat pain that worsens with chewing or swallowing and a fever above 101.3°F. Your child may also complain of headache and stomachache, sometimes with vomiting. An infected throat looks fiery red, and often—but not always—has a whitish crud resembling cottage cheese on the tonsils and back of the throat. The lymph nodes in the sides of the neck are enlarged and tender.
Some strep bacteria occasionally produce toxins that cause other diseases. For instance, scarlet fever or scarlatina can develop after a day or two of fever and sore throat. The tongue at first looks white and furry, then very red. Tiny red dots appear in the throat, usually on the soft part above the uvula (the waggly part that hangs down). Small bumps that feel like sandpaper appear on the base of the neck, face, and upper trunk, then spread. The rash is most noticeable in the skin folds, but may affect the palms of the hands and soles of the feet. Later, the skin peels. This illness usually afflicts children between four and eight years old; by the age of ten, most kids have developed lifelong antibodies against this strep toxin, but not future strep infections.
Distinguishing between viral sore throats and strep can be tricky. The main strep symptoms predict a positive throat culture only half of the time. Definitive diagnosis requires a positive result on one of two tests: a rapid strep test (based on recognition of strep antigens, substances that stimulate an immune response) or a throat culture. The rapid test gives results within fifteen to thirty minutes. Although you can trust a positive result to be correct, occasionally the result is falsely negative. This is why health practitioners usually follow the rapid test with cultures that give results within one to two days. While these tests may add a few dollars to your bill, they’re important for determining appropriate treatment.
If viral infection has caused your child’s sore throat, antibiotics will only wipe out the beneficial bacteria normally present in the body, thus eradicating one natural defense against infection. But if lab tests reveal strep, antibiotics can quickly improve your child’s symptoms—often within twenty-four to forty-eight hours. Doctors usually prescribe a ten-day course of penicillin, a relatively inexpensive antibiotic, for strep infections, but some newer drugs work just as effectively within five days. In addition to helping your child feel better sooner, the antibiotics can prevent complications such as scarlet or rheumatic fever. After twenty-four hours on antibiotics, your child is no longer contagious and can return to school if he feels up to it and if you feel it’s wise.
When antibiotic treatment for strep fails, it’s often because the patient didn’t take the antibiotic as prescribed. Because antibiotics—and antibacterial herbs—reduce symptoms within a day or two, it’s easy to forget about taking the rest of the medication or to think it’s no longer needed. Not completing the course of treatment, however, may contribute to developing antibiotic-resistant bacteria in the throat and perhaps a rebound infection with similar or worse symptoms. Be sure to give your child all of the antibiotic his doctor has prescribed. The same guideline holds for antimicrobial herbs such as echinacea, Oregon grape root, thyme, and others: Keep taking them for several days after symptoms disappear.
Kids with strep need antibiotics because the infection can spread from the throat to the tissues behind the throat, middle ears, sinuses, lymph nodes, and lungs. Two complications, rheumatic fever or glomerulonephritis, may occur one to three weeks after infection.
Rheumatic fever produces a variety of symptoms, including some combinations of fever, painful and swollen joints, a jerking movement known as chorea, heart inflammation, and skin rash. Sometimes it permanently damages the heart valves. Antibiotic treatment within a week of the onset of strep throat prevents it. Rheumatic fever is sneaky, though; sometimes it can appear after full treatment of strep, and in one-third of its cases, after very mild strep infections.
Glomerulonephritis is an inflammation of the kidneys that follows infection of the throat or skin by certain strains of strep bacteria. Signs include elevated blood pressure, blood and protein in the urine, and swollen eyelids, scrotum, feet, and legs. Antibiotic treatment of the initial strep infection has only a small preventive effect, but antibiotics play an important role in treating glomerulonephritis. Most children who develop this complication recover fully.
Most studies of the infection-fighting power of herbs are testtube studies, meaning that researchers drop some of the herb or some of its chemical constituents on the bugs in a test tube and see whether they die. Positive results tell nothing about whether the herb gets from the stomach to the site of infection in sufficient concentrations to kill microbes there, or in an effective form.
Such studies do suggest that applying particular herbal preparations to the infection site may do some good. With strep throat, you can do this by spraying the preparation onto the back of the throat or by gargling with herbal tea.
Echinacea (Echinacea spp.) is the best-researched herb for the colds and viruses that can cause sore throats. It enhances immunity by stimulating a type of cell called a macrophage to engulf and destroy invading microbes and to produce chemicals such as interferon that work against viruses. Echinacea helps activate our natural killer cells to combat viruses, bacteria, and other threats to our natural immunity.
Echinacea is best taken at the very first sign of a child’s cold, the early scratchy-throat and runny-nose stage. At that point, we give our children three to four cups of tea or the same number of doses of liquid echinacea per day, following label instructions for weight and age to calculate dose amounts. We continue to give that dose for several days, until all symptoms are gone.
The nice thing about echinacea is that it’s non-toxic and safe for children, though a rare child may be allergic to it. We find that echinacea glycerites have the best flavor, but capsules, tinctures, and tea can be used. Commercial sore-throat sprays with echinacea sometimes have a tingly, numbing effect that your child may find soothing.
Garlic (Allium sativum) and onions both show lots of antiviral and antibacterial activity, including action against strep bacteria. Raw garlic has the strongest medicinal effect, but let’s get real: all but the most hardy kids will want their garlic cooked. Both garlic and onions make a good addition to broths and soups.
Elecampane (Inula helenium) is antibacterial, relieves coughs, and soothes the inflammation of laryngitis; it also destroys herpes simplex II virus, and herbalists suspect that it may act against other viruses as well. It’s used as an expectorant for dry, irritable coughs and asthma. Elecampane is generally sold in root form, so you can decoct it by boiling and disguise its bitter taste with honey, unless your kids prefer capsules. Don’t take elecampane during pregnancy; those with diabetes should avoid it as well.
Shiitake mushrooms (Lentinula edodes) are a powerful and tasty medicinal food. Just a small amount is effective; one to three lightly sauteed mushrooms per person, per meal, is an adequate dose. Shiitakes have enjoyed a tremendous resurgence since research confirmed their antiviral and immune-stimulating effects. Unless your kids hate mushrooms, shiitakes are an excellent addition to vegetable soups and stir-fry meals during sore-throat season.
Oregon grape root (Mahonia aquifolium) contains a main constituent, berberine, that specifically destroys many types of bacteria, including strep. Its taste is bitter, so your children will probably prefer it in capsules or glycerite form.
Usnea (Usnea spp.) is the green-gray lichen that hangs from tree branches. Besides making great costumes, this strange-looking lichen works against strep throat and other upper respiratory infections. Usnea also serves as a broad-spectrum antibiotic, reduces inflammation, and stimulates the immune system. The strongest usnea products use alcohol to extract the herb’s constituents into a tincture, although traditionally it was decocted, or simmered, into a tea.
Lemon balm (Melissa officinalis) acts against a broad spectrum of disease-causing microbes. In test-tube studies, its volatile oils destroy bacteria, including strep, plus a variety of viruses, including some that cause flu symptoms. You can add this sweet-tasting herb to any healing tea, or purchase it in a glycerite.
Adapted with permission from Kids, Herbs, & Health by Linda B. White, M.D. and Sunny Mavor, A.H.G. (Interweave Press, 1999).