eMedicine Specialties > Infectious Diseases > Viral Infections

Parainfluenza Virus: Follow-up

Author: Subhash Chandra Parija, MBBS, MD, PhD, FRCPath, Director-Professor of Microbiology, Head of Department of Microbiology, Jawaharlal Institute, Postgraduate Medical Education and Research, India
Coauthor(s): Thomas J Marrie, MD, Chair, Professor, Department of Medicine, Division of Infectious Diseases, University of Alberta College of Medicine
Contributor Information and Disclosures

Updated: Jul 24, 2008

Follow-up

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.
  • Reverse genetics has produced an attenuated chimeric HPIV-1 that contains type 3 internal proteins with type 1 surface glycoproteins F and HN.5

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.

Miscellaneous

Medicolegal Pitfalls

  • Clinically distinguishing pneumonia caused by HPIV from pneumonia caused by bacteria is difficult; hence, patients with pneumonia are sometimes inappropriately treated with antibacterial antibiotics.
 


More on Parainfluenza Virus

Overview: Parainfluenza Virus
Differential Diagnoses & Workup: Parainfluenza Virus
Treatment & Medication: Parainfluenza Virus
Follow-up: Parainfluenza Virus
References
[ CLOSE WINDOW ]

References

  1. Fry AM, Curns AT, Harbour K, et al. Seasonal trends of human parainfluenza viral infections: United States, 1990-2004. Clin Infect Dis. Oct 15 2006;43(8):1016-22. [Medline].

  2. Lau SK, To WK, Tse PW, et al. Human parainfluenza virus 4 outbreak and the role of diagnostic tests. J Clin Microbiol. Sep 2005;43(9):4515-21. [Medline].

  3. Juozapaitis M, Zvirbliene A, Kucinskaite I, Sezaite I, Slibinskas R, Coiras M, et al. Synthesis of recombinant human parainfluenza virus 1 and 3 nucleocapsid proteins in yeast Saccharomyces cerevisiae. Virus Res. May 2008;133(2):178-86. [Medline].

  4. Yoo SJ, Kuak EY, Shin BM. Detection of 12 respiratory viruses with two-set multiplex reverse transcriptase-PCR assay using a dual priming oligonucleotide system. Korean J Lab Med. Dec 2007;27(6):420-7. [Medline].

  5. Nolan SM, Surman SR, Amaro-Carambot E, et al. Live-attenuated intranasal parainfluenza virus type 2 vaccine candidates developed by reverse genetics containing L polymerase protein mutations imported from heterologous paramyxoviruses. Vaccine. Sep 15 2005;23(39):4765-74. [Medline].

  6. Arden KE, McErlean P, Nissen MD, et al. Frequent detection of human rhinoviruses, paramyxoviruses, coronaviruses, and bocavirus during acute respiratory tract infections. J Med Virol. Sep 2006;78(9):1232-40. [Medline].

  7. Connolly SA, Lamb RA. Paramyxovirus fusion: real-time measurement of parainfluenza virus 5 virus-cell fusion. Virology. Nov 25 2006;355(2):203-12. [Medline].

  8. Elizaga J, Olavarria E, Apperley J, et al. Parainfluenza virus 3 infection after stem cell transplant: relevance to outcome of rapid diagnosis and ribavirin treatment. Clin Infect Dis. Feb 1 2001;32(3):413-8. [Medline].

  9. Greer CE, Zhou F, Legg HS, et al. A chimeric alphavirus RNA replicon gene-based vaccine for human parainfluenza virus type 3 induces protective immunity against intranasal virus challenge. Vaccine. Jan 5 2007;25(3):481-9. [Medline].

  10. Hohenthal U, Nikoskelainen J, Vainionpaa R, et al. Parainfluenza virus type 3 infections in a hematology unit. Bone Marrow Transplant. Feb 2001;27(3):295-300. [Medline].

  11. Hu A, Colella M, Zhao P, et al. Development of a real-time RT-PCR assay for detection and quantitation of parainfluenza virus 3. J Virol Methods. Dec 2005;130(1-2):145-8. [Medline].

  12. Iwata S. [Diagnostic tests: Parainfluenza virus 1, 2, 3, 4]. Nippon Rinsho. Jul 2005;63 Suppl 7:349-51. [Medline].

  13. Laurichesse H, Dedman D, Watson JM, et al. Epidemiological features of parainfluenza virus infections: laboratory surveillance in England and Wales, 1975-1997. Eur J Epidemiol. May 1999;15(5):475-84. [Medline].

  14. Maeda Y, Hatta M, Takada A, et al. Live bivalent vaccine for parainfluenza and influenza virus infections. J Virol. Jun 2005;79(11):6674-9. [Medline].

  15. Matsuse H, Kondo Y, Saeki S, et al. Naturally occurring parainfluenza virus 3 infection in adults induces mild exacerbation of asthma associated with increased sputum concentrations of cysteinyl leukotrienes. Int Arch Allergy Immunol. Nov 2005;138(3):267-72. [Medline].

  16. Nishio M, Tsurudome M, Ito M, et al. Identification of RNA-binding regions on the P and V proteins of human parainfluenza virus type 2. Med Microbiol Immunol. Mar 2006;195(1):29-36. [Medline].

  17. Specter S, Hodinka R, Young S. Clinical Virology Manual. 3rd ed. 2001:239-40.

  18. Tanaka Y, Kato J, Kohara M, et al. Antiviral effects of glycosylation and glucose trimming inhibitors on human parainfluenza virus type 3. Antiviral Res. Oct 2006;72(1):1-9. [Medline].

  19. Templeton KE, Bredius RG, Claas EC, et al. Parainfluenza virus 4 detection in infants. Eur J Pediatr. Aug 2005;164(8):528-9. [Medline].

[ CLOSE WINDOW ]

Further Reading

[ CLOSE WINDOW ]

Keywords

parainfluenza virus, human parainfluenza virus, HPIV, HPIV-1, HPIV-2, HPIV-3, HPIV-4, croup, laryngotracheobronchitis, PIV, paramyxoviruses, croup-associated virus, CA virus, Sendai virus, croup, bronchitis, bronchopneumonia, pharyngitis, tracheobronchitis, bronchiolitis, acute respiratory tract infections, pneumonia, respiratory syncytial virus, RSV

[ CLOSE WINDOW ]

Contributor Information and Disclosures

Author

Subhash Chandra Parija, MBBS, MD, PhD, FRCPath, Director-Professor of Microbiology, Head of Department of Microbiology, Jawaharlal Institute, Postgraduate Medical Education and Research, India
Subhash Chandra Parija, MBBS, MD, PhD, FRCPath is a member of the following medical societies: Indian Academy of Tropical Parasitology, Indian Association of Biomedical Scientists, Indian Association of Medical Microbiologists, Indian Association of Pathologists and Microbiologists, Indian Medical Association, Indian Society for Parasitology, National Academy of Medical Sciences, India, and Royal College of Pathologists
Disclosure: Jawaharlal Institute of Postgraduate Medical education & Research , Pondicherry , India Salary Employment

Coauthor(s)

Thomas J Marrie, MD, Chair, Professor, Department of Medicine, Division of Infectious Diseases, University of Alberta College of Medicine
Thomas J Marrie, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American Society for Microbiology, Canadian Infectious Disease Society, and Royal College of Physicians and Surgeons of Canada
Disclosure: Nothing to disclose.

Medical Editor

Jeffrey D Band, MD, Clinical Professor of Medicine, Wayne State University School of Medicine; Director, Division of Infectious Diseases and International Medicine, William Beaumont Hospital Corporation
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Richard B Brown, MD, FACP, Chief, Division of Infectious Diseases, Baystate Medical Center; Professor, Department of Internal Medicine, Tufts University School of Medicine
Richard B Brown, MD, FACP is a member of the following medical societies: Alpha Omega Alpha, American College of Chest Physicians, American College of Physicians, American Medical Association, American Society for Microbiology, Infectious Diseases Society of America, and Massachusetts Medical Society
Disclosure: Nothing to disclose.

CME Editor

Eleftherios Mylonakis, MD, Clinical and Research Fellow, Department of Internal Medicine, Division of Infectious Diseases, Massachusetts General Hospital
Eleftherios Mylonakis, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American Society for Microbiology, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

Chief Editor

Burke A Cunha, MD, Professor of Medicine, State University of New York School of Medicine at Stony Brook; Chief, Infectious Disease Division, Winthrop-University Hospital
Burke A Cunha, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

 
 
HONcode

We subscribe to the
HONcode principles of the
Health On the Net Foundation

All material on this website is protected by copyright, Copyright© 1994- by Medscape.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.