Influenza and Parainfluenza Viral Infections in Children


Influenza and Parainfluenza Viral Infections in ChildrenInfluenza is a virus that is one of the most common respiratory infections that affect infants and children during the winter months, usually peaking in January or February. It is transmitted through large particle droplets in the air, and also through contaminated surfaces. The incubation period is 1 to 4 days, and the virus can shed 24 hours before fever and symptoms occur, peaking by day 3 and resolving by day 7. Classic influenza infection symptoms include sudden onset of fever, chills, body aches followed by runny, cough, and sore throat. Infants may only present with fever and irritability.

Laboratory testing can be done in the office or hospital setting for the diagnosis of influenza through rapid testing when influenza-like symptoms are present.

Treatment for influenza is benign and self-limiting including time, rest, and plenty of fluids. Antiviral therapy can be used in the first 48 hours of onset of symptoms. This decision is based on the duration of symptoms, individual’s risk and underlying medical conditions.

Bacterial infections of the respiratory tract are the most common complication of an influenza illness. These can include ear infections, sinusitis, and pneumonia which require treatment. Complications and increased hospitalization can occur among children and infants who have the influenza virus with underlying medication disorders such as blood disorders, diabetes, neuromuscular disorders, congenital heart disease, pulmonary disease, asthma, and cystic fibrosis.

Prevention of influenza includes frequent washing of hands, avoiding touching face or mouth, and not sharing food or drinks with others.

Receiving the influenza vaccine yearly is the best prevention against influenza. All persons of 6 months of age and older should be vaccinated yearly, especially those with underlying medical conditions such as asthma, heart disease, diabetes, neuromuscular disorders, cancer, and immunodeficiency. Pregnant women who received the influenza vaccine can protect their baby up to 6 months of age. Also the vaccination of daycare children has been found to reduce influenza-like illness among other household members.

Questions or contraindications for the influenza vaccine should be discussed with your doctor.

Parainfluenza Virus

Parainfluenza Virus (PIV) infections mostly involve the large airways of the lower respiratory tract of children. They are a frequent cause of childhood illness, such as croup, bronchiolitis, and pneumonia. Most occur in children younger than 5 years of age and responsible for 6-11% of hospitalizations due to respiratory infections. These include the respiratory syncytial virus, mumps, measles, and human metapneumovirus.

PIV is transmitted through exposure to airborne droplets or contact with contaminated surfaces with incubation period lasting 2-4 days. An infected person may shed the virus up to 1 week before the onset of symptoms.

Croup is a distinctive sudden onset of a hoarse, barking-like cough, sometimes associated with increased work of breathing and inspiratory stridor. Symptoms can last 3-5 days. Some children have drooling, difficulty swallowing and decreased appetite. Treatment includes the use of corticosteroids and inhaled medication. Croup caused by the PIV virus can be more severe causing fever, thick secretions, and more sever laryngeal obstructions requiring immediate treatment.

Respiratory syncytial virus and human metapneumovirus are the most common types of bronchiolitis cases from PIV. Symptoms include fever, increased work of breathing, expiratory wheezing, and air trapping. Young infants and children with compromised immune systems usually require hospitalization.

There are no vaccines available for parainfluenza virus and no licensed antiviral therapy for the treatment of PIV infection. The most effective way of prevention is through good handwashing and not sharing food or drinks. Supportive care and proper hydration can help children mobilize secretions.

Thomas G. Fox and John C. Christenson
Pediatrics in Review 2014;35;217
DOI: 10.1542/pir.35-6-217

About author MacKoul Pediatrics

MacKoul Pediatrics is an amazing local pediatrics office in Cape Coral, FL where caring, compassionate doctors and nurses work with you to keep your children as healthy as possible. MacKoul cares for children from birth to college age, from Cape Coral, Fort Myers, Naples, and beyond.

October 28, 2014