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Cold, Flu, & Cough Health Center

Get to the Bottom of Your Sore Throat

A scratchy throat can be more than just an annoyance. Experts offer tips for assessing your sore throat “threat level.”
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WebMD Feature
Reviewed by Louise Chang, MD

As a symptom of illness, sore throat rivals fatigue for being both commonplace and a potential sign of catastrophe. Usually, having a sore throat is nothing to worry about -- most are caused by cold and flu germs. In rare cases, however, a sore throat can signal something much more serious. One of the first symptoms of infection caused by the dreaded ebola virus, for example, is a sore throat.

And strep bacteria, a common cause of sore throat, especially in children, can spread like wildfire if it gets into the blood, damaging the liver, brain, kidneys, and other organs.

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Jim Henson, creator of the Muppets, came down with a sore throat caused by a strep infection late Sunday, May 13, 1990. He was admitted to the hospital with pneumonia on Tuesday and died 20 hours later of septic shock, a life-threatening response to a severe infection.

"In the preantibiotic era, people died from sore throats all the time," says Robert T. Sataloff, MD, associate dean for clinical academic specialties at Drexel University College of Medicine in Philadelphia. "They'd end up with general toxicity and seed infections in the brain or lungs, and they'd die."

So how do you know the difference between a scratchy throat that will disappear on its own and the start of a potentially deadly infection?

Sore Throat Threat Level: Always "Guarded"

When it comes to sore throat, forget the "low" threat level. The symptom always merits "guarded" or even "elevated" alertness. Pay attention, but don't panic.

If you were talking loudly at a noisy, smoky bar, you may have strained your vocal cords, resulting in throat soreness. If you have hay fever, or if your allergies are acting up, that can make your throat feel scratchy. Even sleeping with your mouth open in the winter, when the air can get as dry as the Sahara, can cause a sore throat.

Even if your sore throat is caused by a viral infection, such as a cold or the flu, you probably can wait it out while drinking hot tea with honey and sucking on throat lozenges to ease the discomfort. Because most sore throats are caused by viruses that don't respond to antibiotics, there's not much you can do about them outside of resting so your immune system is strong and ready to fight the invaders.

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