Abstract
BackgroundWidespread availability of rapid diagnostic testing for respiratory viruses allows more in‐depth studies of human parainfluenza viruses (HPIV).ObjectivesThis study aimed to assess seasonality of HPIV types 1‐4, clinical outcomes by HPIV type, and risk factors for illness severity.Patients/MethodsThis retrospective study was performed from January 2013 to December 2015 in children and adults with HPIV, detected by multiplex reverse transcription polymerase chain reaction, participating in a community surveillance study of acute respiratory infections (ARIs) in New York City and patients admitted to a tertiary care center in the same neighborhood. Seasonality trends by HPIV type were compared between the community and hospital groups. The associations between HPIV type, demographics, clinical characteristics, and illness severity were assessed.ResultsHPIV was detected in 69 (4%) of 1753 community surveillance participants (median age 9.2 years) and 680 hospitalized patients (median age 6.8 years). Seasonality for HPIV types 1‐3 agreed with previously described patterns; HPIV‐4 occurred annually in late summer and fall. In the community cohort, 22 (32%) participants sought medical care, 9 (13%) reported antibiotic use, and 20 (29%) reported ≥1 day of missed work or school. Among hospitalized patients, 24% had ≥4 chronic conditions. Multivariable ordinal logistic regression demonstrated that increased severity of illness was significantly associated with HPIV‐4 and chronic cardiovascular and respiratory conditions in children and with age ≥65 years and chronic respiratory conditions in adults.ConclusionsHPIV‐4 presented late summer and early fall annually and was associated with increased severity of illness in hospitalized children.
Highlights
Human parainfluenza viruses (HPIV) types 1-4 are common respiratory pathogens that cause both upper and lower respiratory tract illnesses, especially in young children.[1]
The seasonality of human parainfluenza viruses (HPIV) types 1-3 was consistent with published trends,[1,3] but we found that HPIV-4 occurred annually in late summer and fall, suggestive of a local epidemiologic trend that has not been previously described
We found that HPIV-3 was most common among hospitalized patients (52%) while HPIV-4 was most common in the community cohort (36%)
Summary
Human parainfluenza viruses (HPIV) types 1-4 are common respiratory pathogens that cause both upper and lower respiratory tract illnesses, especially in young children.[1]. HPIV-4, while least well-characterized, has been described as associated with both mild illness in children and lower respiratory tract disease.[2] HPIV types have varying seasonality, prevalence, and clinical manifestations. Objectives: This study aimed to assess seasonality of HPIV types 1-4, clinical outcomes by HPIV type, and risk factors for illness severity. Patients/Methods: This retrospective study was performed from January 2013 to December 2015 in children and adults with HPIV, detected by multiplex reverse transcription polymerase chain reaction, participating in a community surveillance study of acute respiratory infections (ARIs) in New York City and patients admitted to a tertiary care center in the same neighborhood. The associations between HPIV type, demographics, clinical characteristics, and illness severity were assessed. Results: HPIV was detected in 69 (4%) of 1753 community surveillance participants (median age 9.2 years) and 680 hospitalized patients (median age 6.8 years).
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