Epidemiological and clinical characteristics of respiratory human parainfluenza virus infection in children

Abstract

Objective To study the epidemiological and clinical features of human parainfluenza virus (HPIV) infection in children in Suzhou, and to provide the evidence-based foundation for early warning, diagnosis and treatment of respiratory infection in children. Methods The sputum specimens and medical history were obtained from children with acute respiratory tract infection hospitalized at the Childen′s Hospital Affiliated to Soochow University from January 2006 to December 2015.Seven kinds of common respiratory viruses including respiratory syncytial virus, influenza virus A, influenza virus B, HPIV Ⅰ, HPIV Ⅱ, HPIV Ⅲ and adenovirus were detected by using the direct immunofluorescence.Mycoplasma pneumoniae(MP), chlamydia pneumoniae, human bocavirus(hBoV) were detected by using fluorescence quantitative PCR.Rhinovirus and human metapneumovirus were detected by using reverse transcription-PCR.Sputum was cultured for bacteria. Results In 21 769 cases, the detection rate of HPIV positive was 3.21%(829 cases), among which, HPIV Ⅰ, HPIVⅡ, HPIVⅢ were respectively detected in 113 cases(0.52%), 16 cases(0.07%) and 700 cases(3.21%), respectively.There were 378 cases of simple infection and 428 cases of mixed infection, and the mixed infection was very common in Streptococcus pneumoniae, Haemophilus influenza, MP and hBoV.There was a difference in HPIV infection among genders, and the detection rate of the boys was higher than that of girls[4.14%(563/13 591 cases) vs. 3.25%(266/8 178 cases), χ2=11.036, P=0.001]. In the 28 d-1 year old and >1-3 year old group, the detection rate of HPIV was higher[4.71%(494/10 476 cases) and 4.21%(244/5 793 cases), respectively]. In spring and summer, there was a higher detection rate of HPIV infection.The clinical manifestations with simple infection of HPIV Ⅰ and HPIV Ⅲ were cough, fever and wheezing.The rate of fever and shortness of breath in those of HPIV Ⅰ was 71.74%(33/46 cases), 10.87%(5/46 cases), and that in HPIV Ⅲ was 40.12%(134/334 cases), 2.10%(7/334 cases), HPIV Ⅰ infection was more likely to cause fever and shortness of breath than those of HPIV Ⅲ, there were significant differences(χ2=16.410, P<0.001; χ2=10.177, P=0.001). Pneumonia had the highest detection rate of viral infection. Conclusions HPIVⅢ is the leading pathogen among the types of HPIV in the hospitalized children in Suzhou area.Among the subtypes of HPIV, the peak of HPIV infection occurs in spring and summer.The children less than 3 years old are the most susceptible to parainfluenza virus, and the HPIV detection rate is gradually declines with age. Key words: Human parainfluenza virus; Respiratory infection; Child