From the Guidelines
Treatment for parainfluenza virus primarily involves supportive care, as antiviral therapies like ribavirin and IVIG have limited data to support their use 1. The management of parainfluenza virus infection focuses on alleviating symptoms and preventing complications.
- Rest and adequate hydration are essential for recovery.
- Over-the-counter medications such as acetaminophen or ibuprofen can help manage fever and discomfort, with dosages similar to those for other viral infections (e.g., 10-15 mg/kg every 4-6 hours for children, not exceeding 5 doses in 24 hours; 650-1000 mg every 6 hours for adults for acetaminophen).
- A cool-mist humidifier may ease congestion and sore throat.
- For severe cough, dextromethorphan might provide relief, with dosages based on age for children and 10-30 mg every 4-8 hours for adults.
- Saline nasal drops or sprays can help with nasal congestion. Most cases don't require antibiotics as they're ineffective against viruses. However, if bacterial complications like pneumonia or sinusitis develop, antibiotics may be prescribed. Severe cases, particularly in immunocompromised patients, young children, or the elderly, may require hospitalization for oxygen therapy or IV fluids, as indicated by the need for close monitoring and supportive care 1. The virus spreads through respiratory droplets, so frequent handwashing and avoiding close contact with infected individuals can prevent transmission. Rapid PCR panels should be considered for detection of respiratory viruses, including parainfluenza, in patients with cough and/or shortness of breath that might indicate a viral infection 1.
From the Research
Treatment Options for Parainfluenza
- There are currently no licensed antiviral agents for the treatment of Parainfluenza virus (PIV) infection 2.
- Treatment for PIV infection is generally supportive, with the exception of croup where the use of corticosteroids has been found to be beneficial 3.
- Aerosolized or systemic ribavirin in combination with intravenous gamma globulin has been reported in small, uncontrolled series and case reports of immunocompromised patients 2.
- DAS181, a novel sialidase fusion protein inhibitor, has shown promise in treating severe PIV disease in immunocompromised patients 4, 3, 5.
DAS181 Treatment
- DAS181 has been shown to inhibit infection with PIV strains in vitro and in an animal model 4.
- Clinical improvement in respiratory and systemic symptoms has been observed in immunocompromised patients with PIV-3 infection after a 5-day DAS181 treatment course 4.
- Inhaled DAS181 was administered for 5-10 days to four pediatric hematopoietic cell transplantation patients with PIV, resulting in clinical improvement in oxygen requirement and respiratory rate, as well as a decrease in viral load 5.