From the Guidelines
Discharge instructions for a patient with parainfluenza virus should focus on supportive care and preventing transmission, with a review 24 hours prior to discharge to assess for unstable clinical factors, such as temperature >37.8ºC, heart rate >100/min, respiratory rate >24/min, systolic blood pressure <90 mmHg, oxygen saturation <90%, inability to maintain oral intake, or abnormal mental status, as recommended by 1 and 1. The patient should rest at home until fever-free for 24 hours without medication and symptoms improve.
- Stay hydrated by drinking plenty of fluids like water, clear broths, and electrolyte solutions.
- Take acetaminophen or ibuprofen as directed for fever and discomfort.
- Use a cool-mist humidifier to ease congestion and soothe irritated airways.
- Practice good hand hygiene by washing hands frequently with soap and water for at least 20 seconds.
- Avoid sharing personal items like utensils or towels with household members.
- Cover coughs and sneezes with tissues or your elbow.
- Clean frequently touched surfaces regularly. Return to medical care if you experience difficulty breathing, persistent high fever, inability to keep fluids down, or worsening symptoms. Parainfluenza is a viral infection, so antibiotics are not effective; treatment focuses on managing symptoms while your immune system fights the virus, which typically takes 7-10 days for recovery, and follow-up clinical review should be considered for all patients who suffered significant complications or who had significant worsening of their underlying disease, either with their general practitioner or in a hospital clinic, as stated in 1 and 1. It is the responsibility of the hospital team to arrange the follow-up plan with the patient and the general practitioner, and patients should be offered access to information about their illness, take home medication, and any follow-up arrangements, as recommended by 1 and 1.
From the Research
Discharge Instructions for Parainfluenza Virus
- There are no specific licensed antiviral agents for the treatment of parainfluenza virus (PIV) infection 2, 3.
- Aerosolized or systemic ribavirin in combination with intravenous gamma globulin has been reported in small, uncontrolled series and case reports of immunocompromised patients, but its effectiveness is not well established 2.
- DAS181, an inhaled sialidase, is undergoing clinical development for the treatment of PIV in adults and children 3.
- Patients with PIV infection may be discharged with instructions to:
- Manage symptoms such as cough, productive sputum, fever, and dyspnea 4.
- Monitor for signs of bacterial or fungal coinfection, which can increase mortality rates 4.
- Maintain good hygiene practices to prevent transmission to others.
- Follow up with their healthcare provider to monitor their condition and adjust treatment as needed.
Considerations for Immunocompromised Patients
- Immunocompromised patients, such as those with severe combined immunodeficiency disease or hematopathic stem cell transplant recipients, may be at higher risk for severe disease and complications from PIV infection 2, 3.
- These patients may require closer monitoring and more aggressive treatment, including antiviral therapy and supportive care.