Parainfluenza Virus Follow-up
- Author: Subhash Chandra Parija, MBBS, MD, PhD, FRCPath; Chief Editor: Burke A Cunha, MD more...
Further Inpatient Care
- Indications for hospitalization
- Respiratory distress
- Dehydration
- Stridor at rest, even after receiving therapy
Further Outpatient Care
- Bed rest
- Use of vaporizers producing moist air
Deterrence/Prevention
- Field trials of formalin-killed whole HPIV-1, HPIV-2, and HPIV-3 vaccines failed to protect children against natural infections in the late 1960s. Current approaches to HPIV vaccines include intranasal administration of live attenuated strains, subunit strategies using HN and F proteins, recombinant bovine human viruses, and strains engineered using reverse genetics.
- At present, antigenically and genetically stable attenuated stains of HPIV-3 have been developed with cold adaptation (CA), whose stability is enhanced because of multiple markers of attenuation in tissue culture. Cold adaptation strains of HPIV-1 and HPIV-2 have been developed, and attenuation in tissue culture and animal models has been demonstrated.
- BCX 2798 and BCX 2855 are effective inhibitors of HPIV-3 HN in a mouse model and may be promising candidates for prophylaxis and treatment of HPIV-3 infection in humans.[10]
- A live attenuated respiratory syncytial virus and HPIV-3 vaccine has been found safe and immunogenic in a phase 1 study.[11]
- Reverse genetics has produced an attenuated chimeric HPIV-1 that contains type 3 internal proteins with type 1 surface glycoproteins F and HN.[12]
Complications
- Adult respiratory distress syndrome and exacerbation of nephritic syndrome
- Serious morbidity in immunocompromised hosts (eg, transplant recipients)
- Rare complications, including Guillain-Barré syndrome and meningitis
Prognosis
- HPIV infections in older children and adults are generally mild. Occasionally, bronchiolitis or viral pneumonia in children and tracheobronchitis in adults has been reported.
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