Influenza and Parainfluenza Viral Infections in Children

1. Thomas G. Fox, MD* 2. John C. Christenson, MD* 1. *Department of Pediatrics, Ryan White Center for Pediatric Infectious Disease, Indiana University School of Medicine, Riley Hospital for Children, Indianapolis, IN. * Abbreviations: IIV: : inactivated influenza vaccine LAIV: : live attenuated influenza vaccine LRI: : lower respiratory tract infection PCR: : polymerase chain reaction PIV: : parainfluenza virus URI: : upper respiratory tract infection 1. Because influenza and parainfluenza viruses are responsible for significant morbidity and mortality in young infants and children, especially those with chronic conditions, clinicians must learn to recognize, treat, and prevent infections caused by these viruses. 2. Disease caused by influenza virus can be prevented through the vaccination of all persons 6 months or older. Special attention should be given to pregnant women and persons with chronic medical conditions, such as asthma, congenital heart disease, and neuromuscular disorders. After completing this article, readers should be able to: 1. Describe the epidemiology of influenza and parainfluenza virus infections. 2. Recognize the clinical features of influenza infections. 3. Select the most appropriate vaccines for the prevention of influenza. 4. Differentiate clinically between influenza and parainfluenza virus infections. 5. Order the most appropriate test for the diagnosis of respiratory viral infections. Influenza and parainfluenza viruses (PIVs) are among the most common respiratory pathogens that affect infants and children worldwide. Infections and their complications are responsible for a significant number of hospitalizations and fatalities on a yearly basis. In most temperate climate countries, seasonal patterns of disease are observed. In warmer climates, disease can be observed year round. The fear of an influenza pandemic looms when new strains are discovered. Recognition and prevention become pressing priorities. In recent years, a greater emphasis in preventing influenza through vaccination has emerged within the United States. Many health care systems have mandatory vaccinations programs for health care professionals. In addition, vaccination is now recommended for all persons 6 months or older. Available antiviral agents are effective not only as therapy but also as preventive agents. PIVs are the most common cause of laryngotracheitis or …