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Parainfluenza viral infections in pediatric outpatients: seasonal patterns and clinical characteristics
A M Knott1, C E Long, C B Hall
1Department of Pediatrics, University of Rochester School of Medicine, NY 14642.
Abstract:
Parainfluenza types 1, 2 and 3 were studied in a pediatric outpatient population from 1976 to 1992 to compare seasonal patterns over time and to define better the spectrum of illness in all ages of children caused by these viruses. Parainfluenza type 1 occurred in the fall of odd numbered years; parainfluenza type 2 was less predictable; and parainfluenza type 3 appeared yearly with peak activity in spring or summer. The parainfluenza viruses were the major cause of croup and also accounted for one-half of the cases of laryngitis and over one-third of all lower respiratory tract illness in children from whom a virus was isolated. The major clinical manifestations of infection with parainfluenza types 1 and 2 were croup, upper respiratory infections and pharyngitis; for parainfluenza type 3 upper respiratory tract infection was predominant in all age groups. The parainfluenza viruses cause appreciable respiratory morbidity each year among infants and young children. They are the major cause of croup but also produce a spectrum of diseases ranging from mild upper respiratory tract infection to bronchiolitis and pneumonia. Most studies have focused on the morbidity of parainfluenza viruses in infants and young children who are hospitalized. Less appreciated is the impact of parainfluenza viral infections in outpatients and in older children. The parainfluenza viruses have a striking epidemiologic pattern which has evolved over the past 30 years. In the early 1960s parainfluenza types 1, 2 and 3 were all reported to be endemic.(ABSTRACT TRUNCATED AT 250 WORDS)
Insights
Parainfluenza viruses (types 1, 2, and 3) are significant causes of respiratory illness in children, particularly croup. This study analyzed their seasonal patterns and disease spectrum in pediatric outpatients from 1976-1992.
Area of Science:
- Pediatric Infectious Diseases
- Virology
- Epidemiology
Background:
- Parainfluenza viruses (types 1, 2, and 3) are common respiratory pathogens in children.
- Previous research often focused on hospitalized infants and young children, with less attention to outpatients and older children.
- Understanding the evolving epidemiology and clinical spectrum is crucial for public health.
Purpose of the Study:
- To compare the seasonal patterns of parainfluenza virus types 1, 2, and 3 over an extended period (1976-1992).
- To define the spectrum of illness caused by these viruses across all pediatric age groups in an outpatient setting.
- To assess the impact of parainfluenza viral infections beyond hospitalized populations.
Main Methods:
- Retrospective analysis of pediatric outpatient data from 1976 to 1992.
- Identification and categorization of parainfluenza virus types (1, 2, and 3) and associated clinical diagnoses.
- Comparison of seasonal occurrence and clinical manifestations across different age groups.
Main Results:
- Parainfluenza type 1 showed fall seasonality in odd years; type 2 was unpredictable; type 3 peaked annually in spring/summer.
- Parainfluenza viruses were the primary cause of croup and significant contributors to laryngitis and lower respiratory tract infections.
- Clinical presentations varied: croup, upper respiratory infections (URIs), and pharyngitis for types 1 & 2; predominantly URI for type 3.
Conclusions:
- Parainfluenza viruses cause substantial annual respiratory morbidity in children, with croup being a major manifestation.
- The viruses are responsible for a wide range of illnesses, from mild URIs to severe conditions like bronchiolitis and pneumonia.
- Recognizing the outpatient burden and diverse clinical spectrum in all pediatric age groups is essential for effective management and prevention strategies.