When cold air mixes with warm air, many find themselves with a red nose, cough, and, particularly annoying, a sore throat. If this happens to you in the morning, it's not always due to a cold night. And while many think: Oh, it will pass, sometimes a sore throat hides more than just a common cold.

Today, with the help of modern research, we can nicely explain this folk advice. Let's take a look together at why it's not always wise to wait too long if your throat hurts more than usual – and which four signs you should pay special attention to.

1. When a rash appears alongside the throat – a sign that the body is fighting a serious battle

If a fine, reddish rash starts appearing on your skin – especially on the neck, chest, or upper back – alongside a sore throat, then you are probably dealing with something more serious than just a virus. This often happens with streptococcal infections – these are bacteria also known as Group A streptococcus.

According to the Centers for Disease Control and Prevention (CDC), millions of cases of these bacterial infections are reported annually, where these infections can also cause scarlet fever, bacteremia (when bacteria enter the blood), and even toxic shock syndrome, which can be a life-threatening condition.

In layman's terms, the body is overwhelmed with fire, so the skin reacts intensely. Scarlet fever, for example, causes a rash that looks like rough sand and often begins on the chest before spreading to other parts of the body. It is always accompanied by a very sore throat, sometimes vomiting, and high fever.

2. If the pain persists – even tea and honey don't help

A typical sore throat caused by a cold lasts three to five days and starts to improve. But if the pain becomes so severe that swallowing or eating is difficult, or if you even have ear pain, then it's probably no longer a harmless cold.

These are classic signs of tonsillitis, where your tonsils, which stand as guardians at the back of your throat, are severely inflamed – usually due to bacteria.

A study by the British National Health Service (NHS) shows that about 30% of sore throats in children and 10% in adults are caused by streptococcal bacteria. And these often do not go away without the help of a doctor – or as they used to say, without a good old course of antibiotics.

3. When a fever above 38 degrees Celsius strikes – the body is calling for help

A cold can cause a slight fever – around 37.5 degrees Celsius, maybe a bit higher. But if your thermometer reads 38.0 degrees or higher, and you are still dealing with a very sore throat, it is very likely to be a bacterial infection, most commonly the aforementioned tonsillitis.

The body often responds to such an infection with a high fever, as it wants to destroy the bacteria with heat – this is a completely natural defense mechanism. According to the British Medical Journal, high fever in bacterial infections typically lasts an average of 3 to 5 days, and if left untreated, it can lead to complications.

Always remember this rule: if after two days of high fever and feeling unwell there is no improvement, it's time to take action.

4. If the throat hurts for more than a week – it's no longer innocent

It happens that someone thinks they have a stubborn cold. But if a sore throat lasts for more than a week, worsens, or if swollen lymph nodes under the jaw, extreme fatigue, and loss of appetite occur alongside it, then something completely different may be lurking. One such condition is mononucleosis, also known as the "kissing disease" because it is often spread through saliva.

It is an infection with the Epstein-Barr virus, which can cause prolonged symptoms – including a sore throat, enlarged spleen, fatigue, and prolonged fever lasting for weeks. Data from the World Health Organization (WHO) show that up to 95% of adults come into contact with this virus by the age of 40, but only a portion of them become ill with visible symptoms.

In such cases, rest, fluids, herbal remedies, and, of course, medical supervision can help.

What does (folk) medicine say?

Our grandparents did not have laboratories, but they knew the power of nature. When dealing with a sore throat, they often used sage – a potent herb that acts as a natural antiseptic and helps disinfect the throat. Sage leaf gargle was prepared: a teaspoon of dried sage was steeped in a cup of boiling water and left to stand for 10 minutes. Gargle several times a day.

Apple cider vinegar mixed with honey and lukewarm water is also said to help. So does thyme, which acts as an antibacterial, and ginger, which is often incorrectly associated only with Asian cuisine today – it has long been used by our folk healers.

And when throat pain occurs with high fever, old books recommend cooling the forehead with vinegar compresses, drinking elderflower tea, which promotes sweating, and consuming garlic – a natural antibiotic that, due to its allicin content (main antibacterial substance), is one of the strongest natural enemies of bacteria.

Why is it important to differentiate between viral and bacterial infections?

Here lies the biggest trap. If you take antibiotics for a viral infection, you will not help yourself – you will only harm your good gut flora. Antibiotics kill bacteria, not viruses. According to the European Centre for Disease Prevention and Control (ECDC), 30–50% of antibiotic use in the EU is unnecessary. Therefore, not every cold is a reason to panic or rush to the pharmacy.

Listen to your body (and your grandma)

A sore throat is often innocent and quickly passes. But when it is accompanied by high fever, severe pain, rashes, or lasts too long, it is wise to listen to your body. Let this be your internal alarm bell - as our ancestors once perceived it, linking pain to what's happening inside the body and nature.

And one more practical tip: always keep track of how many days your throat has been hurting, measure your temperature, observe your skin, and do not hesitate to visit a doctor if the condition worsens. Sometimes, timely action is what prevents complications. So, there's nothing wrong with visiting the doctor sooner – especially when the signs are clear.

Ultimately – health is not something to be taken lightly. Even a sore throat can quickly show us how important it is to listen to ourselves.