All my life, watching America

[venta]

Yesterday, I was reading a blog post by an American mum-of-five, and it was mentioned in passing that one of her daughters was really ill with strep.

Strep, you say?

I'm aware that American kids get strep throat. I'm even vaguely aware that that's short for streptococcus. What I'm not aware of is why us British kids don't get it. Is it one of those bizarre geographically-localised conditions? Is it something they make a fuss about that we don't?

So I took myself off to Wikipedia, and read up on Streptococcal pharyngitis. And it sounded dreadfully familiar. In fact, I had it when I was a kid. Repeatedly.

It's just that we call it by its more generic name of tonsilitis.

So there you go. Maybe you knew that anyway. I didn't, and I shall add a new word to my English/US dictionary (along with the recently-added fava beans, lima beans and garbanzo beans).

Edit for accuracy: it seems the most common cause of tonsilitis is viral, not bacterial. So strep throat is tonsilitis, but tonsilitis is not necessarily strep throat.

Comments

[sesquipedality.livejournal.com]

Cf mono(nucleosis)/glandular fever

[venta.livejournal.com]

Yup, I know that one. Not sure why, admittedly.

People make a lot of fuss over "like wow, they call taps faucets" but in general you can work stuff out in context - and knowing that there is an equivalent helps a lot. For years I've just been assuming that garbanzos and fava beans are types of beans that are common in the US but that we don't get. It's only recently I've had cause to look them up and gone oh... right. Just normal, then.

[zotz]

Not tonsilitis, no - just a sore throat. Throat infection. More commonly viral than streptococcal.

[leathellin.livejournal.com]

A general misunderstanding responsible for antibiotic demands for every sore throat under the sun and all those antibacterial throat sweets which won't make much difference for most sore throats.

[venta.livejournal.com]

I'm confused. Streptococcus is a bacterium, right? According to Wikipedia:

The typical symptoms of streptococcal pharyngitis are a sore throat, fever of greater than 38 °C (100 °F), tonsillar exudates (pus on the tonsils), and large cervical lymph nodes.

Other symptoms include: headache, nausea and vomiting, abdominal pain,[5] muscle pain,[6] or a scarlatiniform rash or palatal petechiae.


... which sounds a lot like tonsillitis to me.

Unless you're saying that USians use the phrase "strep throat" to mean any old sore throat?

[zotz]

I believe so, yes, unless the continuing moanings of medical pedants have actually worked in the last few years.

[venta.livejournal.com]

Ah, ok. See also "I was off work yesterday with 'flu".

Since the blog post I originally referred to involved quite a lot of projectile vomiting and ultimately a lab test, I'm willing to believe her that it really was strep ;)

[zotz]

Absolutely - it's not actually that rare for it to be streptococcal. It's just not the leading cause.

[beckyc.livejournal.com]

See also "I was off work yesterday with 'flu".

Or referring to any chest infection as pneumonia.

[venta.livejournal.com]

Oh, I don't think I've encountered people doing that. In my world that's still something that's pretty serious, and probably means you've been in hospital at the very least.

[undyingking.livejournal.com]

USians use the phrase "strep throat" to mean any old sore throat

I worked with one once who did. A colleague (also American but over here longer) warned her that it was crying wolf. They had a heated argument broken only by her vomiting at his feet.
Taught me not to critique other people's self-diagnoses, however implausible.
(And not to wear sandals to work.)

[leathellin.livejournal.com]

A general misunderstanding responsible for antibiotic demands for every sore throat under the sun and all those antibacterial throat sweets which won't make much difference for most sore throats.

[beckyc.livejournal.com]

What I'm not aware of is why us British kids don't get it.

Actually, I got rather ill* in one or other of my finals years with strep throat.

*Not hospital ill, just regular kind of ill only with oral steroids for my lungs and lasting for several months. Because GPs kept assuming it was viral, and me not getting better was "proof" of how it was viral, so they didn't need to swab to test for bacteria because it was clearly viral. Got to love the circular logic.

Now I come to think about it, I seem to do well for having doctors jump immediately from six-eight weeks worth of "It's viral, have paracetamol and take these oral steroids" to an emergency phone call going "Lab results are back. We need you to come to the surgery TODAY to get these very specific antibiotics, no it REALLY can't wait".

[venta.livejournal.com]

Interestingly (or not), in all the years of my childhood where I had tonsilitis about once every three weeks (actually, literally that often at some points) I don't believe anyone ever did an actual swab test. So I don't know if I've had strep throat (although I certainly had enough penicillin to sink a battleship...).

I find the term "strep throat" quite counter-intuitive, because my experience of tonsilitis is that frankly the sore throat part of it is pretty much the least of your worries. Then again, maybe that's why (as zotz suggests above) it gets overused to mean "a sore throat".

[exspelunca.livejournal.com]

Ah, yes, I remember it well. All those nights of high fever, throwing up, swollen neck - but "they" had decided that taking out tonsils was not a good thing any more so I took you to the doc and said, "Too many antibiotics, tell me at what point to panic and then we'll have some."

[venta.livejournal.com]

I'm interested that the current NHS page on the topic (http://www.nhs.uk/conditions/Tonsillitis/Pages/Introduction.aspx) agrees that it's most commonly viral (ie antibiotics won't help), and says only to go to the doctor if your child has been ill for more than 4 days, or is unable to eat/sleep.

I don't remember them ever testing to see if I had bacterial tonsilitis - did they? Or did they just dole out antibiotics and hope I'd go away?

[exspelunca.livejournal.com]

More or less, and you were never tested for anything,. It was always (until I said stop) antibiotics. When you were about 13 with a monumental bout we saw another doc in the practice who gave you a fortnight's blockbuster (remember going out of class to matron's fridge?) and threatened extraction if it happened again. It didn't.

[undyingking.livejournal.com]

My little neighbour B has suffered with frequent tonsillitis like that almost all her life. They finally decided to take her tonsils out, at the age of five. Seems to be working so far.

I, on the other hand, had it back in the day when they whipped tonsils out routinely at the slightest hint. I was too young to miss 'em.

[venta.livejournal.com]

When I was 15 or 16 they gave me a monster course of the most foul-tasting antibiotics I've ever had (and awkward, too - four times a day before food and they had to be kept in the fridge at all times, which made school days exciting). That was with the threat of "and if that doesn't work, we'll take your tonsils out".

Either the antibiotics, or the threat, fixed it.

[exspelunca.livejournal.com]

Sorry, didn't scroll far enough down and missed that!

[satyrica.livejournal.com]

Wow, Razorlight?

[venta.livejournal.com]

One kudo to you :)

(I'm aware that America is a really popular song to despise - I'm not a massive fan, but I don't think it's that bad ;)

[satyrica.livejournal.com]

Ha ha, I do shamelessly own and enjoy the album it's from but as you say, not very trendy!

[lanfykins.livejournal.com]

...it seems the most common cause of tonsillitis is viral, not bacterial

Unless you're me, in which case it's always sodding bacterial.

[drdoug.livejournal.com]

There's a similar thing going on where some people say they have had norovirus when they've had a bout of D&V. It's possible that norovirus was the cause (it is a pretty common one), but there are a bajillion things that can cause similar D&V and you really can't tell them apart from the symptoms alone. Some of them are transmissible in very similar ways too.

The first few times I met this it really bothered me. Now it just seems like a perfectly reasonable attempt to enlist sympathy by making it sound more serious, so I can just be sympathetic back. (Unless I think they'd be happier if I explain.)

[exspelunca.livejournal.com]

Do people really bother the doc with an upset tum, unless it goes on beyond a few days?

[drdoug.livejournal.com]

Most wouldn't for an upset tum that's mild and only lasts a few days, but gastroenteritis (any stomach/intestinal infection) can be really pretty nasty. Most will phone rather than visit - at least initially - which is a mercy for them and the other patients. If it's very severe or drawn out you totally should bother the doc.

I was more drawing a parallel between people (mostly American) saying "I have strep throat" when there's no evidence of streptococcal infection, and people (mostly British that I've encountered, but Americans might do it too) saying "I had norovirus" when there's no evidence of that particular virus. Sure, both of those are fairly common causes of those symptoms, but the symptoms in no way prove the specific infection.

(For clarity, I'm not the sort of doctor who makes you better, I'm the sort who makes you worse. In part by having a fair amount of medical knowledge but no clinical qualifications.)

[exspelunca.livejournal.com]

I see your point. I belong to the born-pre-NHS generation and we grew up regarding doctors only for things which looked as if they might become "really serious" i.e. nigh on terminal .

[venta.livejournal.com]

Well, D&V can be nigh on terminal :) Admittedly, not usually for otherwise-healthy persons, unless they've actually got cholera or something...