PARAINFLUENZA VIRUS

Dr.Inawati, M.Kes
Bagian Mikrobiologi FK UWKS
 outline
Virology
Symptoms & Illnesses
Reinfection
Transmission
Prevention & Treatment
 VIROLOGY
Human parainfluenza viruses (HPIVs) belong
to theParamyxoviridae family. They are
negative-sense, single-stranded, enveloped
RNA viruses that have fusion and
hemagglutinin-neuraminidase glycoprotein
"spikes" on their surface. There are four types
(1 through 4) and two subtypes (4a and 4b) of
HPIVs. Each type has different clinical and
epidemiological features. HPIVs commonly
infect infants and young children. However,
anyone can get HPIV infection.

 Symptoms and Illnesses

The incubation period, the time from exposure to
HPIV to onset of symptoms, is generally 2 to 7
days.
HPIV-1 and HPIV-2 are most often associated
with croup (laryngotracheobronchitis). HPIV-1
often causes croup in children, whereas HPIV-2 is
less frequently detected. Both types can cause
upper and lower respiratory tract illnesses.
People with upper respiratory tract illness may
have cold-like symptoms.
HPIV-3 is more often associated with
bronchiolitis, bronchitis, and pneumonia.
HPIV-4 is not recognized as often, but may cause
mild to severe respiratory tract illnesses.
 Reinfection
People can get multiple HPIV infections in their
lifetime. These reinfections usually cause mild
upper respiratory tract illness with cold-like
symptoms. However, reinfections can cause
serious lower respiratory tract illness, such as
pneumonia, bronchitis, and bronchiolitis in some
people. Older adults and people with
compromised immune systems, in particular,
have a higher risk for severe infections.
Most children 5 years of age and older have
antibodies against HPIV-3 and approximately 75%
have antibodies against HPIV-1 and HPIV-2.
 Transmission
HPIVs usually spread from person to person through
the air by coughing and sneezing, and
close personal contact, such as touching or shaking
hands, and
touching objects or surfaces that have the viruses on
them then touching the mouth, nose, or eyes.
HPIVs can remain infectious in airborne droplets for
over an hour and on surfaces for a few hours.
People are most contagious during the early stage of
illness.
People usually get HPIV infection in the spring,
summer, and fall. However, it is possible to get infected
at any time of the year. For more information, see HPIV
Seasons.
 Prevention and Treatment
Currently, there is no vaccine to prevent HPIV
infection. However, researchers are trying to
develop vaccines. Also, there is no
specific antiviral treatment for HPIV illness.
Most HPIV illnesses are mild and typically
require only treatment of symptoms.
In hospital settings, healthcare
providers should follow contact precautions,
such as handwashing and wearing protective
gowns and gloves.
To help protect patients from HPIV infection,
also see
 Laboratory Diagnosis
Infection with human parainfluenza viruses (HPIVs) can be
confirmed by
direct detection of viral genome by polymerase
chain reaction assay;
direct detection of viral antigens in respiratory secretions
(collected within 1 week of symptom onset) using
immunofluorescence orenzyme immunoassay;
isolation and identification of the virus in cell culture; or
demonstration of a significant rise in HPIV-specific IgG
antibodiesbetween appropriately collected paired serum
specimens or specific IgM antibodies in a single serum
specimen.
Healthcare providers usually do not order laboratory
testing for HPIVs for routine clinical care of patients with
respiratory illness because there are no specific treatments
for HPIV illness.
 HPIV Seasons
In the United States, human parainfluenza viruses
(HPIVs) commonly cause respiratory tract illnesses.
There are four types of HPIVs and two subtypes that
circulate at different times of the year.
HPIV-1 infections often cause croup in children. There
are usually more cases in the fall of odd-numbered
years.
HPIV-2 infections can also cause croup. HPIV-2
infections occur more commonly in the fall. It is less
frequently detected than HPIV-1 and HPIV-3.
HPIV-3 infections usually occur in spring and
early summer months each year. However, HPIV-3
infections can occur throughout the year, particularly
when HPIV-1 and HPIV-2 are not in season.
HPIV-4 (subtypes 4a and 4b) seasonal patterns are not
as well characterized.