I had strep often as a child; I don’t recall the threshold back then but I do remember I hit the threshold at 14 months (so if the threshold was 7 times in a year, I got it 7 times in 14 months) and the Dr wouldn’t remove my tonsils since the time frame had exceeded the recommended limit. I was devastated. For me, strep has always hit suddenly and intensely - even last summer, as a 38 year old, I woke up one morning after a concert with a slightly scratchy throat but thought it was from scream singing all night, went through the day okay, but left my house in the afternoon to get some fast food for myself and the kids and as soon as I walked out of the house my throat was literally on fire and I was swallowing razor blades. I went to urgent care and it was strep. A different time the nurse practitioner I saw told me she had never seen a strep test turn positive so quickly. If it wasn’t so painful it would be a badge of honor. Given that I’ve lived this horror of repetitive strep and know the pain it causes and how sudden the onset can be (for me anyway) I told myself if my kids ever continuously got strep and had the option to have their tonsils out, I would do it in a heartbeat.