What is a Sore Throat?

A sore throat is a feeling of discomfort, dryness or scratchiness/ itchiness of the throat that often makes swallowing difficult. Other symptoms that may be present include pain upon swallowing, a hoarse voice and swollen neck lymph nodes. It may be caused by a number of factors with infections being the most common cause. Upon examination, inflammation of the throat (pharyngitis) and surrounding structures  looks like there is redness with swelling, making the area more bright and shiny than the normal appearance.

If a sore throat is present with the inability to swallow or difficulty breathing, immediate medical attention is necessary. 

What causes a sore throat?

Sore throats are normally caused by either a viral or bacterial infection. This affects your tonsils which sits at the back of your throat - one on the right and one on the left. These two balls of tissue are part of your body's infection-fighting system to keep you from getting sick. But what happens if these infection fighters get infected? Then you have tonsillitis (say: tahn-sul-lye-tus). 

What Are Tonsils?

The tonsils' job is to help fight germs that come in through our mouth or nose before they cause infections in the rest of the body. Usually, tonsils do their job well. But sometimes bacteria or viruses get into the tonsils and infect them. When this happens, you have tonsillitis

The most important difference between a virus and bacteria is that bacteria respond well to antibiotic treatment and viruses do not. A sore throat is commonly spread by: sharing drinks, kissing, coughing, nose blowing, and sneezing.

Viral Infections Causing Sore Throat

  • Common cold.
  • Influenza (Flu).

A cold and the flu (seasonal influenza) are the most common causes of a sore throat. These are highly contagious viral infections, usually spread by coughing and sneezing, by inhaling the infected droplets in the air, by touching contaminated surfaces or even by shaking hands.

Other viral infections that can cause sore throat are :

  • Infectious mononucleosis (glandular fever) - caused by the Epstein-Barr virus, it may be spread through the saliva or by coughing and sneezing.
  • Measles.
  • Chickenpox.
  • Croup is a viral infection, usually affecting young children, and is most frequently caused by the parainfluenza virus. Along with sore throat and fever, the child usually has a characteristic harsh, barking cough.

Bacterial Infections Causing Sore Throat

  • Strep throat is the most common bacterial cause of a sore throat. Although it can occur in all age groups, children between the ages of 5 and 15 are most susceptible. The causative agent is the bacteria known as group A streptococcus or Streptococcus pyogenes. Timely diagnosis and treatment of strep throat is necessary to prevent complications, the most important of which are rheumatic fever and post-streptococcal glomerulonephritis.
  • Tonsillitis.
  • Diphtheria is rare these days because of routine childhood immunization (vaccine) against it, but may occur in non-immunized people. It is a serious bacterial infection, caused by Corynebacterium diptheriae, usually spread by coughing, sneezing or handling contaminated objects.

Other Causes of Sore Throat

Besides viral and bacterial infections, there may be some other reasons for a sore throat.

  • Mouth breathing can make the throat dry and sore.
  • Seasonal allergies such as allergic rhinitis.
  • Exposure to dry, cold winter air.
  • Sinus drainage / postnasal drip.
  • Air pollution.
  • Excessive cigarette smoking, including secondhand smoke.
  • Gastroesophageal reflux disease (GORD or GERD) which is the irritation of the throat that may be caused by regurgitation of stomach acids and fluids back into the oesophagus, usually due to a weakened oesophageal sphincter. This is also known as acid reflux and a common symptom is heartburn. A sore throat due to reflux often presents as a sore throat in the morning, upon waking.
  • Strained throat muscles, often as a result of prolonged shouting or cheering loudly.
  • Following prolonged antibiotic treatment or chemotherapy, there may be development of oral thrush due to candida infection (oral candidiasis). This is common in HIV/AIDS patients along with other mouth sores.


Symptoms of a sore throat caused by bacteria or a virus can include:

  • Painful red throat.
  • Swollen tonsils.
  • Difficulty in swallowing.
  • Fever.
  • Headache.
  • Swollen lymph glands and neck stiffness.


It is almost impossible to predict from the look of the throat, or the severity of the pain whether the cause is bacteria or a virus and a throat swab will usually need to be taken to confirm a diagnosis. We have included a picture, above, to indicate what type of sore throat you have, but this is only a guide - if you unsure go to your nearest health facility for a proper diagnoses.

Most viruses subside in a few days and treatment is not necessary, antibiotics are not given to relieve throat pain in general, and usually the best advice would be to let nature take its course.

People with a sore throat caused by bacteria can be treated very easily with a course of antibiotics prescribed by a doctor. Treatment is essential with bacteria infection to prevent more serious conditions developing.

What can I do to make my sore throat better?

Whether your sore throat is due to bacteria or a virus, the following will help to relieve your symptoms:

  • Drink plenty of non-alcoholic fluids.
  • Gargle with warm salty water.
  • If you have a high temperature take paracetamol (panado`s) to reduce it.
  • Adults may try gargling with soluble aspirin before swallowing it.
  • Suck throat lozenges (such as strepsils or medikeel).
  • Use throat sprays (available from chemists and some supermarkets).
  • Do not smoke or move away from areas where people are smoking.
  • Avoid alcohol.

When do I need to see a doctor?

  • You are finding it difficult and almost impossible to swallow.
  • Symptoms persist for more than 4 days.
  • The glands in your neck are swollen.
  • You have a persistent fever over 38.3 Degree Celsius.
  • You have pus on your tonsils.
  • You have any difficulty in breathing.
  • You have a stiff neck and severe headache.
  • You have an ear-ache.
  • If a rash develops.
  • There is blood in saliva or phlegm.
  • You have mouth ulcers lasting for over 2 weeks.
  • If the phlegm you have coughed up is either green or yellow.


Page created: 29 July 2010
Updated: 4 June 2014