Parainfluenza

Answer 1

Definition

Parainfluenza refers to a group of viruses that lead to upper and lower respiratory infections.

Causes, incidence, and risk factors

There are four types of parainfluenza virus, all of which can cause upper respiratory infections or lower respiratory infections (pneumonia) in adults and children. The virus is responsible for approximately 40-50% of croupcases and 10-15% of bronchiolitis and bronchitis cases and some pneumonias.

The exact number of cases of parainfluenza is unknown but suspected to be very high. Sometimes the viruses cause only a runny nose and other symptoms that may be diagnosed as a simple cold rather than parainfluenza.

Infections are most common in fall and winter. Parainfluenza infections are most severe in infants and become less severe with age. By school age, most children have been exposed to parainfluenza virus. Most adults have antibodies against parainfluenza although they can get repeat infections.

Symptoms

Symptoms vary depending on the type of infection. Cold-like symptoms consisting of a runny nose and mild cough are common. Life-threatening respiratory symptoms can be seen in young infants with bronchiolitis.

In general, symptoms may include:

• Chest pain
• Congestion
• Cough
• Croup
• Runny nose
• Shortness of breath
• Sore throat
• Wheezing

Signs and tests

A physical exam may show sinus tenderness, swollen glands, and a red throat. The doctor will listen to the lungs and chest with a stethoscope. Abnormal sounds, such as crackling or wheezing, may be heard.

Tests that may be done include:

• Arterial blood gases
• CBC
• Swab of nose for rapid viral test

Treatment

There is no specific treatment for the viral infection. Specific treatments are available for the symptoms of croup and bronchiolitis.

Expectations (prognosis)

Most infections in adults and older children are mild and recovery takes place without treatment, unless the person is very old or has an abnormal immune system. Medical intervention may be necessary if breathing difficulties develop.

Complications

Secondary bacterial infections are the most common complication. Airway obstructionin croup and bronchiolitis can be severe, even life-threatening.

Calling your health care provider

Call your health care provider if your child develops croup, wheezing or any other type of breathing difficulty. You may wish to call your health care provider for children under 18 months of age with any type of upper respiratory symptoms.

Prevention

There are no vaccines available for parainfluenza. Avoiding crowds to limit exposure during peak outbreaks may decrease the likelihood of infection.

Limiting exposure to daycare centers and nurseries may delay infection until the child is older.

Answer 2

Definition

Parainfluenza refers to a group of viruses that lead to upper and lower respiratory infections.

Causes, incidence, and risk factors

There are four types of parainfluenza virus, all of which can cause upper respiratory infections or lower respiratory infections (pneumonia) in adults and children. The virus can cause croup,bronchiolitis,bronchitis and certain types of pneumonia.

The exact number of cases of parainfluenza is unknown but suspected to be very high. Sometimes the viruses cause only a runny nose and other symptoms that may be diagnosed as a simple cold rather than parainfluenza.

Infections are most common in fall and winter. Parainfluenza infections are most severe in infants and become less severe with age. By school age, most children have been exposed to parainfluenza virus. Most adults have antibodies against parainfluenza although they can get repeat infections.

Symptoms

Symptoms vary depending on the type of infection. Cold-like symptoms consisting of a runny nose and mild cough are common. Life-threatening respiratory symptoms can be seen in young infants with bronchiolitis and those with weakened immune systems.

In general, symptoms may include:

• Chest pain
• Cough
• Croup
• Fever
• Runny nose
• Shortness of breath
• Sore throat
• Stuffy nose
• Wheezing

Signs and tests

A physical exam may show sinus tenderness, swollen glands, and a red throat. The doctor will listen to the lungs and chest with a stethoscope. Abnormal sounds, such as crackling or wheezing, may be heard.

Tests that may be done include:

• Arterial blood gases
• Chest x-ray
• CT scan of the chest
• Complete blood count (CBC)
• Swab of nose for rapid viral test

Treatment

There is no specific treatment for the viral infection. Specific treatments are available for the symptoms of croup and bronchiolitis.

Expectations (prognosis)

Most infections in adults and older children are mild and recovery takes place without treatment, unless the person is very old or has an abnormal immune system. Medical intervention may be necessary if breathing difficulties develop.

Complications

Secondary bacterial infections are the most common complication. Airway obstructionin croup and bronchiolitis can be severe, even life-threatening.

Calling your health care provider

Call your health care provider if you or your child develops croup, wheezing or any other type of breathing difficulty. Contact your health care provider if a child under 18 months develops any type of upper respiratory symptoms.

Prevention

There are no vaccines available for parainfluenza. Avoiding crowds to limit exposure during peak outbreaks may decrease the likelihood of infection.

Limiting exposure to daycare centers and nurseries may delay infection until the child is older.

References

Lee FUH, Treanor J. In: Mason RJ, Broaddus CV, Martin TR, et al. Murray & Nadel's Textbook of Respiratory Medicine. 5th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 31.

Reviewed By

Review Date: 09/17/2010

David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Denis Hadjiliadis, MD, Assistant Professor of Medicine, Division of Pulmonary, Allergy and Critical Care, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.