Is tonsillitis contagious (infectious)?
Blood oath it is!

It's dangerous too. Tonsillitis used to cause lots of heart damage from diphtheria and recurrent acute rheumatic fever.

Penicillin is cheap and effective. You don't need the modern semi-synthetic broad spectrum penicillins¹, just the original variety (modified only to allow it to be taken by mouth².)

How often and for how long you should take the penicillin, is debatable.
I was taught that 5 days of treatment left nearly half the children with the germ still in their throat, and 10 days left only 3-4% still with the germ.
One can be left with a 'carrier state" - germs still there, host not ill, but capable of passing it on to others.


How to prevent flu and tonsillitis spreading.

Sharing eating utensils, coughing and sneezing apart, we spit when we speak - all the time!
Tiny droplets of saliva take off as we pronounce consonants.
These dry quickly, leaving specks of dust called droplet nuclei.
Germs from our mouth on these droplet nuclei, can be breathed in by other people close to us.

I had an amusing experience once, watching a Shakespearian tragedy. Two players at the front of the stage, in the footlights. The standing player was holding forth and absolutely showering the man kneeling in front of him with saliva. Those droplets didn't have time to dry!

If you have a cold or sore throat, try not to talk directly at people at close range.



Tonsillectomy and adenoidectomy

Mid twentieth century, medical opinion was that all children would probably be better if their tonsils were removed!

This medical nonsense was curtailed when it was realized that poliomyelitis was made worse if tonsillectomy was performed when a child was about to suffer this.

At the Royal Childrens hospital in Melbourne, no tonsillectomies were performed for 9 months in the 1950's, during one polio outbreak.
When the children on the waiting list were reviewed after the polio epidemic, only 10% needed to have T and A's done.

When I graduated, about 20% of children in Australia were having this operation. This was twice the rate compared to USA and four times that in UK and Sweden.

It is much less commonly performed these days, but in its place is very valuable. I spent 10 years practicing in a small country town³ where I did the tonsillectomies. Most of the children and the occasional adult, did very well compared to their previous record.

If a child is getting frequent attacks of tonsillitis, 3 to 6 months on oral penicillin is usually effective and well tolerated.

After that, if still getting genuine tonsillitis attacks⁴ with very red throat, large tonsils with pus, fever and enlarged glands⁵, it's tonsillectomy.



Enlarged, swollen tonsils

These can be perfectly normal in small children.

Once attending play school etc, in contact with lots of other children, respiratory infections are frequent and actually beneficial to the child.

We are born with Th2  dominant, and need to meet germs to develop a healthy immune system with Th1 / Th2 balanced. At this stage of life, our immune system is really busy and so we have relatively large tonsils, adenoids and lymph nodes.

Very swollen tonsils, causing upper airways obstruction, are probably due to cows milk intolerance. Complete elimination of all cows milk derived dairy products, is worth trialling for 2 or 3 weeks.

If this is done, be careful when dairy is re-introduced, as reactions are sometimes more rapid and obvious than before.



Tonsil stone treatment

The surface of our tonsil is pitted. These "crypts" are deep, sometimes branched and always contain debris and germs. They are where our immune system samples germs, food etc - front line surveillance.

As well as these crypts, the top or bottom of the tonsil may be partly covered by a fold of skin (plica supra-tonsillaris and plica triangularis respectively.)

Tonsil stones are chalky or cheesy, off white lumps of compressed debris, in crypts or under the fold of skin above the tonsil (the supra tonsillar fossa.)
Once they are dislodged and probably accidentally swallowed, it is obvious that they taste quite nasty.

Removing tonsil stones may be achieved by pressing in front to them with a finger tip. Gargling with dilute hydrogen peroxide may do the job. I sometimes have to use a metal probe to winkle them out.



Sleep-disordered breathing

Has your child noisy breathing at night, with brief silences and then very noisy restart of breathing?

Are they growing too slowly, having trouble at school, bedwetting or behaving badly? All these can be connected, and due to food intolerance reactions.

If these things are associated with large tonsils and adenoids, surgical removal of same may be advised. I'd check for food sensitivity first. It will probably be cow's milk causing it.





More on tonsillitis under Strep throat on mouth page


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Tonsillitis notes and references

1. amoxicillin, dicloxacillin etc

2. phenoxymethyl penicillin V etc

3. Dimboola, Victoria, Australia

4. Clinical practice guidelines on tonsillectomy in Children published in 2010, recommended looking for 7 episodes in the previous 12 months, 5 episodes per year in the previous 2 years or 3 episodes per year in the past 3 years.

5. Streptococcal infection is more likely if there is tenderness under the jaw on both sides (with or without obvious swelling of the lymph glands.) This germ typically has the ability to spread rapidly (compared with say, the Staphylococcus.) It is likely therefore to infect both sides.

Viral sore throats are typically tender on one side only, and may have tender palpable lymph nodes in the posterior triangle of the neck behind sternomastoid muscle.

When I first went into practice in Dimboola, this subject interested me enough to research it. The report on that research study is on the Strep Throat Infection page on this site



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T&As were operations of tonsillectomy and adenoidectomy

Lymphocytes are one variety of white blood cell. They come as B (derived from bone marrow, but named after a different structure in birds) and T from the thymus gland in our chest.
T cells come as helper cells, regulatory cells and natural killer cells.
T helper cells come as Th1, Th2 etc

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