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J Infect Dis. 2014 Mar 1;209(5):695-702. doi: 10.1093/infdis/jit552. Epub 2013 Oct 16.

Epidemiology and clinical presentation of parainfluenza type 4 in children: a 3-year comparative study to parainfluenza types 1-3.

Author information

1
Department of Pediatrics, University of Colorado School of Medicine and Children's Hospital Colorado.

Abstract

BACKGROUND:

Human parainfluenza viruses (HPIVs) are among the most common causes of respiratory tract infections in children. Little is known about the epidemiology and clinical presentation of HPIV type 4.

METHODS:

A retrospective chart review and comparison of patients positive for HPIV types 1-4 by multiplex polymerase chain reaction between 2009 and 2012 at Children's Hospital Colorado was performed. Patients who had only direct fluorescent antibody testing performed or concurrent viral infections were excluded.

RESULTS:

Of 11,533 samples, 752 (6.5%) were positive for HPIV. After exclusion criteria, 316 samples were included in the study. HPIV-4 had year-round prevalence with biennial peaks in odd-numbered years. HPIV-4 and HPIV-3 had similar clinical presentations. 50.8% and 51.5% of patients with HPIV-3-4 had hypoxia compared to 20.3% and 33.3% of patients with HPIV-1-2 (P < .01). HPIV-1 (23.6%) and HPIV-2 (24.2%) were more associated with stridor than HPIV-3 (6.6%) and HPIV-4 (0%) (P < .01). No patients with HPIV-4 had croup. Patients with HPIV-4 had similar lengths of stay and mortality as those with HPIV-1-3.

CONCLUSIONS:

This is the first large-scale analysis of HPIV-4 clinical and epidemiologic features. HPIV-4 was most similar to HPIV-3 in clinical presentation. HPIV-4 had year-round prevalence with peaks in the autumn of odd-numbered years. HPIV-4 is a common respiratory pathogen capable of causing significant morbidity in children.

KEYWORDS:

children; epidemiology; infection; parainfluenza virus; parainfluenza virus type 4; paramyxovirus; respiratory virus

PMID:
24133181
PMCID:
PMC3923541
DOI:
10.1093/infdis/jit552
[Indexed for MEDLINE]
Free PMC Article

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