Parainfluenza Virus Infection In Children Research Articles

Epidemiological and Clinical Characteristics of Human Parainfluenza Virus Infection in Children of Xianyang Children's Hospital in 2022

The incidence of HPIV infection in children is on the rise, particularly following the emergence of SARS-CoV-2, which presents a potential risk to the health of children.
 Objective: This study aims to investigate the epidemiological and clinical features of human parainfluenza virus (HPIV) in children admitted to Xianyang Children's Hospital (Xianyang Caihong Hospital) from January 2022 to December 2022.
 Methods: Out of the 5873 cases of hospitalised children, the ones which had HPIV as the only pathogen and were non-standard cases were excluded, and the rest were analysed for their clinical characteristics, based on the six nucleic acids kits used to detect HPIV in respiratory tract viruses. Results: Among 5873 cases of Nasopharyngeal swab specimens, there were 795 cases of HPIV antigen positive, of which 794 cases of HPIV3（13.52%, 3 cases of HPIV1（0.05%; There were 472 males (13.92%) and 325 females (13.09%) in them(χ2 =0.381, P=0.362).The infection rates in spring, summer, autumn and winter were 8.03%, 55.71%, 28.48% and 7.78%, respectively, and the difference of pairwise comparison were statistically significant (χ2=539.158, P=0).There were 318 cases (19.51%) in infant group and 164 cases (10.86%) in children group (χ2=45.118, P=0). With HPIV as the sole pathogen including 363 cases of bronchopneumonia, 237 cases of bronchitis, 8 cases of pertussis syndrome, 84 cases of bronchiolitis.
 Conclusion: ⑴. During the period of January to December 2022, Xianyang Children's Hospital has seen a high prevalence of HPIV, a virus causing lower respiratory tract infection, especially HPIV3. ⑵.No statistical evidence showed a difference between men and women in terms of high morbidity during spring and summer, which was more common among infants and young children. ⑶. Among children infected with HPIV, the four most common respiratory illnesses are bronchopneumonia, bronchitis, pertussis syndrome, and bronchiolitis. After undergoing symptomatic treatment, most children showed marked improvement. It is imperative to gain a thorough understanding of HPIV infections in children, enabling timely prevention and symptomatic treatment, identifying critical and serious illnesses, and reducing morbidity and mortality.

Virological Surveillance and Molecular Characterization of Human Parainfluenzavirus Infection in Children with Acute Respiratory Illness: Germany, 2015-2019.

Human parainfluenza viruses (HPIVs) are important causes of respiratory illness, especially in young children. However, surveillance for HPIV is rarely performed continuously, and national-level epidemiologic and genetic data are scarce. Within the German sentinel system, to monitor acute respiratory infections (ARI), 4463 respiratory specimens collected from outpatients < 5 years of age between October 2015 and September 2019 were retrospectively screened for HPIV 1–4 using real-time PCR. HPIV was identified in 459 (10%) samples. HPIV-3 was the most common HPIV-type, with 234 detections, followed by HPIV-1 (113), HPIV-4 (61), and HPIV-2 (49). HPIV-3 was more frequently associated with age < 2 years, and HPIV-4 was more frequently associated with pneumonia compared to other HPIV types. HPIV circulation displayed distinct seasonal patterns, which appeared to vary by type. Phylogenetic characterization clustered HPIV-1 in Clades 2 and 3. Reclassification was performed for HPIV-2, provisionally assigning two distinct HPIV-2 groups and six clades, with German HPIV-2s clustering in Clade 2.4. HPIV-3 clustered in C1, C3, C5, and, interestingly, in A. HPIV-4 clustered in Clades 2.1 and 2.2. The results of this study may serve to inform future approaches to diagnose and prevent HPIV infections, which contribute substantially to ARI in young children in Germany.

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

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

Parainfluenza Virus Infection Among Human Immunodeficiency Virus (HIV)-Infected and HIV-Uninfected Children and Adults Hospitalized for Severe Acute Respiratory Illness in South Africa, 2009-2014.

Background. Parainfluenza virus (PIV) is a common cause of acute respiratory tract infections, but little is known about PIV infection in children and adults in Africa, especially in settings where human immunodeficiency virus (HIV) prevalence is high. Methods. We conducted active, prospective sentinel surveillance for children and adults hospitalized with severe acute respiratory illness (SARI) from 2009 to 2014 in South Africa. We enrolled controls (outpatients without febrile or respiratory illness) to calculate the attributable fraction for PIV infection. Respiratory specimens were tested by multiplex real-time reverse-transcription polymerase chain reaction assay for parainfluenza types 1, 2, and 3. Results. Of 18 282 SARI cases enrolled, 1188 (6.5%) tested positive for any PIV type: 230 (19.4%) were type 1; 168 (14.1%) were type 2; 762 (64.1%) were type 3; and 28 (2.4%) had coinfection with 2 PIV types. After adjusting for age, HIV serostatus, and respiratory viral coinfection, the attributable fraction for PIV was 65.6% (95% CI [confidence interval], 47.1-77.7); PIV contributed to SARI among HIV-infected and -uninfected children <5 years of age and among individuals infected with PIV types 1 and 3. The observed overall incidence of PIV-associated SARI was 38 (95% CI, 36-39) cases per 100 000 population and was highest in children <1 year of age (925 [95% CI, 864-989] cases per 100 000 population). Compared with persons without HIV, persons with HIV had an increased relative risk of PIV hospitalization (9.4; 95% CI, 8.5-10.3). Conclusions. Parainfluenza virus causes substantial severe respiratory disease in South Africa among children <5 years of age, especially those that are infected with HIV.

Parainfluenza Virus Infections in Children With Hematologic Malignancies

Parainfluenza virus (PIV) infections are an important cause of morbidity in children with upper or lower respiratory tract infection (URTI and LRTI, respectively). However, the epidemiology of PIV infections in children with cancer has not been well studied. This retrospective study sought to determine the epidemiology of PIV infections and risk factors for progression to an LRTI in 1381 children diagnosed with leukemia or lymphoma, between 2000 and 2009. PIV infections were diagnosed in 83 (10%) of 820 children tested for respiratory infections. PIV type 3 accounted for 49 (61%) of the PIV infections. Of the 83 infections, 75 (90%) were community acquired. Children less than 2 years of age were more likely to have PIV infection (P = 0.002; odds ratio, 2.69; 95% confidence interval, 1.5-4.8). PIV infections were more common in children with acute lymphoblastic leukemia as compared with other malignancies (P < 0.0001; odds ratio, 4.13; 95% confidence interval, 2.37-7.21). The majority of patients, 66 (80%), had URTI. Children with LRTI were a median age of 27 months as compared with 56 months for children with URTI (P = 0.005). Fever with severe neutropenia was more common in patients with LRTI than with URTI (P = 0.02). LRTI was significantly associated with absolute neutrophil count <500 cells/μL (P = 0.002) and absolute lymphocyte count <100 cells/μL (P = 0.008) at onset of PIV infection. There was no mortality attributed to PIV infections, although 3 children required mechanical ventilation for respiratory failure due to PIV infection. PIV was the second most common respiratory viral infection in this population after influenza (A and B). Young children were more likely to have PIV infection and LRTI. Severe neutropenia and lymphopenia were associated with LRTI.

Parainfluenza Virus Infections In Children with Cancer

AbstractAbstract 3909 Background:Parainfluenza virus (PIV) infections are relatively common and cause significant mortality in adults undergoing hematopoietic stem cell transplantation (HSCT). Children are more prone than adults to develop PIV infections. However, data regarding the epidemiology of PIV infections in children with cancer is limited. This study sought to determine the epidemiology of PIV infections in children with leukemia/lymphoma (LL) and those undergoing HSCT, risk factors for progression to lower respiratory tract infection (LRTI) and impact of PIV infections on mortality after HSCT. Methods:A total of 1381 children with LL diagnosed between 2000–2009 and 1349 children who underwent HSCT between 1995–2009 were studied. Medical record review included patient demographics, disease characteristics, results of virologic analysis, characterization of the infection as nosocomial or acquired and with upper or lower respiratory tract involvement, duration of symptoms and viral shedding, presence of co-pathogens, absolute neutrophil count (ANC) and absolute lymphocyte count (ALC) at the time of infection, use of corticosteroids prior to infection, antiviral therapy and mortality. Statistical analysis was performed using Fischer's exact and Kruskal-Wallis test. Results:PIV infections occurred in 83 (6%) of patients with LL and in 46 (3.4%) HSCT patients. For patients with LL there were more infections in 2005–2009 compared to 2000–2004 (p<0.0001). Patients with acute lymphoblastic leukemia had more infections compared to those with acute myeloid leukemia or lymphoma (p<0.0001). Of the 83 LL patients, 76 (92%) had community-acquired (CA) infections and 17 (20%) patients had LRTI. For HSCT patients, allogeneic transplant recipients were more prone to develop PIV infections (p<0.0001). Of the 46 HSCT patients, 33 (72%) had CA infections and 18 (39%) patients had LRTI. A significantly greater number of HSCT patients had LRTI (p=0.04). Six (13%) HSCT patients died of PIV infection while all LL patients survived the infection (p=0.002). Of the 129 patients, culture and direct fluorescent antibody detection identified PIV infection in 126 (98%) patients. For patients with LL, LRTI was associated with age < 2 years (p=0.005), ANC <500 cells/μL (p=0.002) and ALC <100 cells/μL (p=0.008). For HSCT patients LRTI was associated with nosocomial infection (p=0.017), infection in the first 100 days after transplant (p=0.006), non-engraftment (p=0.014), use of steroids in the 2 weeks preceding the infection (p=0.035), fever (p=0.004), ANC <500 cells/μL (p<0.0001) and ALC <100 cells/μL (p<0.0001). Mortality in HSCT patients was associated with African-American race (p=0.013), LRTI (p=0.002), use of steroids (p<0.0001), mechanical ventilation (p<0.0001) and ALC <100 cells/μL (p=0.01). Prolonged duration of viral shedding was associated with ALC <500 cells/μL (p=0.045). Seventy-nine (61%) patients had PIV-3 infection. PIV-3 infection was not associated with increased LRTI or mortality. Pulmonary co-pathogens were isolated from 13 (10%) patients. Presence of co-pathogens was not associated with increased LRTI or mortality. Anti-viral therapy with aerosolized ribavirin with or without immunoglobulin therapy did not appear to alter mortality. Conclusions:An increasing incidence of PIV infections was observed in patients with leukemia and lymphoma at our institution. These infections were predominantly community-acquired. LRTI was associated with younger age, severe neutropenia and lymphopenia. HSCT patients had increased LRTI and mortality following PIV infection. LRTI was associated with nosocomial acquisition, infection before day + 100, use of steroids, severe neutropenia and lymphopenia. Mortality in the HSCT population was associated with African-American race, LRTI, use of steroids, mechanical ventilation and severe lymphopenia. Currently available therapy appears to be inadequate in reducing mortality from PIV pneumonia. This represents the largest cohort of children with cancer evaluated retrospectively to study the epidemiology of PIV infections. In comparison with studies on the adult population, the association of younger age, race, nosocomial infection and severe neutropenia with LRTI and mortality are novel observations. Disclosures:No relevant conflicts of interest to declare.

Epidemiological features of parainfluenza virus infections: laboratory surveillance in England and Wales, 1975-1997.

Hospital laboratory reports of parainfluenza virus (PIV) infections from England and Wales between 1975 and 1997 were analysed with regard to PIV type and seasonality, and in addition, those between 1985 1997 with regard to age, sex and clinical features. Laboratory-based surveillance data highlight striking differences in the seasonality of different PIV types. PIV-3 reports demonstrated a clear annual epidemic cycle, with a peak usually occurring in late spring or summer, whereas peaks of PIV-1 and PIV-2 occurred at one or two year intervals, in the late autumn or early winter. PIV-4 also occurred most frequently in the late autumn or early winter, but a clear epidemic cycle could not be identified. Laboratory surveillance data also provide insight into the age and disease distribution of PIV infection in children and indicate severity of PIV infection in immunosuppressed adults. Of 8221 PIV reports received between 1985-1997, PIV-3 accounted for 70.8%, PIV-1 for 17.2%, PIV-2 for 7.5%, and PIV-4 for 1.1%; 64.1% of reports came from infants under one year, 24.4% from children aged 1-4 years and 7.2% from individuals aged 5 years or older, with an excess of males in all age groups. Bronchiolitis, croup and pneumonia occurred in association with all PIV types. In children under 1 year, PIV-2 infections were more likely to be associated with bronchiolitis than infections with other PIV types. In children under 15 years, croup was more frequently associated with PIV-1 and PIV-2 than with PIV-3 or PIV-4. In 392 (7.2%) of the reported PIV infections between 1989 and 1997 an underlying condition was implicated, which included immunosuppression or chronic cardiac or pulmonary disease. Considerable morbidity is associated with PIV infections in infants and young children and would make the widescale use of a vaccine a valuable public health intervention. Surveillance information is essential to guide the development and use of preventive measures as well as to monitor their effectiveness.

Bacterial Involvement in Parainfluenza Virus Infection in Children

37 children with serologically confirmed parainfluenza virus (PV) infection were studied by new serological methods for evidence of concomitant bacterial infection. 24 of the children were hospitalized because of croup and 13 because of lower respiratory tract infection. Serological evidence of bacterial involvement was found in 4 (11%) of the 37 children, in none of the 24 children with croup but in 31% of the 13 children with PV infection of the lower airways (p less than 0.05). Streptococcus pneumoniae was implicated in 3 cases and Haemophilus influenzae in 1. Serological evidence of staphylococcal involvement was not seen in any case. The 3 patients with pneumococcal involvement had pneumococcal antigen in the acute serum. In all of them pneumonia was associated with PV type 1 or 3, and in 2 serum C-reactive protein was elevated. The data presented support the view, that secondary bacterial infection is rare in children with croup, but common in lower respiratory tract infection caused by PV.

Diagnosis of parainfluenza virus infection in children and older patients by detection of specific IgM antibody.

The significance of detecting specific antibody of the IgM class for the diagnosis of parainfluenza infections was examined. Paired sera from 763 children and adults admitted to the hospital for acute respiratory disease were tested for significant antibody titer rises in the hemagglutination inhibition (HI) test and for specific IgM antibody with the hemadsorption immunosorbent techniques (HIT). Sera were collected during two 6-month periods, January through June, 1982 and 1983. Evidence of parainfluenza infections was found in 122 patients (16%): 83 (25%) in 1982 and 39 (9.1%) in 1983. The HIT was superior to the HI test for detection of parainfluenza infection, in particular in infants and aged patients, 94 patients were positive only in the HIT test, 12 in the HI test, and 16 in both tests. In a control group of 120 persons (time- and age-matched to the patients of 1982) admitted for nonrespiratory illness, six (5%) showed parainfluenza IgM in their serum. Blocking experiments and retrospective clinical information indicated that the IgM antibody detected in these individuals is specific IgM acquired after a mild parainfluenza infection. Most (66%) patients showed IgM antibody titer rises or high titers (greater than 1,280) in both sera, and in 23%, a fall in IgM antibody titer was found. Detection of specific IgM antibody by HIT permitted early presumptive diagnosis in 71% of the patients with parainfluenza infection. IgM antibody persisted for 2-11 weeks. The HIT appears to be an important supplement for the diagnosis of parainfluenza infections.

Rapid diagnosis of parainfluenza virus infection in children.

The indirect immunofluorescent-antibody (IFA) assay for detection of parainfluenza virus antigen was performed on samples of nasopharyngeal secretions obtained from infants and children with various respiratory illnesses to determine the usefulness of the IFA assay for rapid diagnosis of parainfluenza virus infection. Ninety-four samples of nasopharyngeal secretions were obtained from 78 children during a community outbreak of parainfluenza virus infection. Application of the IFA assay revealed the presence of parainfluenza antigen in 67 of the 94 samples. When these same specimens were inoculated into tissue culture, the presence of parainfluenza virus was confirmed in 62 (93%) of the 67 IFA-positive specimens by hemadsorption on tissue culture monolayers (31 cases), presence of parainfluenza hemagglutinin in infected tissue culture fluids (23 cases), or by other methods (8 cases). Only four IFA-negative specimens were subsequently shown to be positive for parainfluenza virus by tissue culture infectivity. The IFA assay provided a more rapid and more accurate method for diagnosis of parainfluenza infection in children than did routine tissue culture methods employed currently.

Diagnosis and clinical significance of parainfluenza virus infections in children.

Cell type specific delivery of drugs by use of nanocapsules (NC) is a promising approach for induction of efficient anti-tumor immunotherapies. Here, we report the generation of IL-2 functionalized NC (HES-IL-2) to target CD25⁺ (IL-2 receptor α chain) T cells. In flow cytometry experiments HES-IL-2 exhibited an enhanced uptake by human CD25⁺ T cells compared to control capsules. The observed uptake was CD25 specific as CD25^high T cells displayed a significantly enhanced NC incorporation compared to CD25⁻ T cells with negligible internalization. In addition blocking of the IL-2 receptor dependent binding by an anti CD25 mAb significantly reduced the HES-IL-2 uptake by human CD25⁺ T cells. Furthermore, comparing and competitive studies of naïve CD25⁻, activated CD25⁺ and regulatory CD25^high human T cells revealed a low incorporation of HES-IL-2 in naïve and a moderate and high uptake, respectively in activated or regulatory T cells. Additionally, in order to preferentially address different T cell populations by means of various IL-2 receptor affinities, we generated HES-IL-2 with distinct reduced amounts of IL-2 on their surface. Intriguingly, in contrast to naïve CD25⁻ and activated CD25⁺ T cells, in which the NC uptake was clearly IL-2 dose-dependent we did not observe any differences when HES-IL-2 with a twofold and tenfold decreased amount of IL-2 were used for studies with regulatory CD25^high T cell, indicating a high IL-2 sensitivity of regulatory T cells for a specific targeting. In addition, <i>in vivo</i> studies in human T cell reconstituted RAG2^−/−γc^−/− mice exhibited a significantly enhanced uptake of HES-D-IL-2 by CD25⁺ T cells. In summary, we generated IL-2 functionalized NC for targeting of human CD4⁺CD25⁺ T cells <i>in vitro</i> and <i>in vivo</i>.

Clinical significance of parainfluenza virus infections in children

Clinical significance of parainfluenza virus infections in children