What is the protocol for Parainfluenza virus isolation?

From the Guidelines

Parainfluenza virus isolation requires standard and droplet precautions for hospitalized patients, and patients should be placed in a private room or cohorted with others who have the same infection, as recommended by the CDC and the Healthcare Infection Control Practices Advisory Committee 1. To prevent the spread of parainfluenza virus, healthcare workers should wear surgical masks when within 3 feet of infected patients and practice good hand hygiene.

• Key considerations for parainfluenza virus isolation include:
  • Placing patients in a single room or cohorting them with others who have the same infection 1
  • Wearing gloves when entering the room of patients with confirmed or suspected parainfluenza infection, or before handling the patients or their respiratory secretions or fomites potentially contaminated with the patients' secretions 1
  • Wearing a gown if soiling of clothes with patient's respiratory secretions is expected 1
  • Limiting to essential purposes only the movement or transport of patients from their rooms when they are diagnosed or suspected to be infected with parainfluenza virus 1 These precautions should be maintained for the duration of illness, typically 5-7 days in adults but potentially longer in children and immunocompromised patients. No specific antiviral medications are routinely recommended for parainfluenza infections; treatment is primarily supportive care including hydration, fever control, and respiratory support as needed. Isolation is particularly important in healthcare settings to prevent transmission to vulnerable populations such as immunocompromised patients, the elderly, and young children, as parainfluenza spreads through respiratory droplets and direct contact with infected secretions. The virus can survive on surfaces for several hours, making environmental cleaning and proper hand hygiene essential components of infection control.

From the Research

Parainfluenza Isolation

• Parainfluenza viruses are single-stranded, enveloped RNA viruses of the Paramyoviridaie family, causing respiratory illnesses in children and adults 2
• There are four serotypes of parainfluenza viruses, which can lead to a wide spectrum of illnesses, including otitis media, pharyngitis, conjunctivitis, croup, tracheobronchitis, and pneumonia 2
• Seasonal parainfluenza virus epidemics result in a significant burden of disease in children, accounting for 40% of pediatric hospitalizations for lower respiratory tract illnesses and 75% of croup cases 2
• In adults, especially the elderly and immunocompromised, parainfluenza viruses can cause severe disease and fatal pneumonia 2
• Currently, treatment for parainfluenza virus infection is supportive, with the exception of croup, where corticosteroids have been found to be beneficial 2
• Novel drugs, such as DAS181, appear promising in efforts to treat severe disease in immunocompromised patients, and vaccines to decrease the burden of disease in young children are in development 2

Comparison with Respiratory Syncytial Virus (RSV)

• RSV is a common cause of respiratory tract infections, and in severely immunosuppressed patients, it can cause significant morbidity and mortality 3
• Palivizumab, an RSV-specific monoclonal antibody, has been shown to reduce hospitalization rates among children at high risk of RSV infection 3, 4
• A multi-drug regimen, including inhaled ribavirin, corticosteroids, and intravenous immunoglobulin (IVIG), with or without palivizumab, has been found to be safe and effective in treating RSV and parainfluenza virus infections in adult lung and heart-lung transplant recipients 5

Treatment and Prevention

• There is no consensus concerning the most effective therapy for severe parainfluenza virus infection in high-risk patients 4
• Effective antiviral therapies for parainfluenza virus infection are not available, and treatment is mainly supportive 2
• Palivizumab has been recommended for prevention of RSV infection in high-risk populations, including preterm infants, children with chronic lung disease or congenital heart disease, and immunocompromised patients 6