Overview 

Parainfluenza is a highly contagious infection that contributes to many respiratory diseases across the globe. This infection is caused by viruses that are collectively known as human parainfluenza viruses that manifest and spread to the lungs and create severe symptoms in both adults and children. With such a contagious and deadly virus out there, what can we do to combat this? Well, this article will go over many of the treatment options available, both holistic and medical, that can help treat and alleviate cases of parainfluenza.

Understanding parainfluenza

Parainfluenza are a group or family of viruses known as human parainfluenza viruses (HPIVs), comprising 4 different strains of viruses:¹

• HPIV-1: Associated with croup and cold-like symptoms 
• HPIV-2: Associated with croup and cold-like symptoms
• HPIV-3: Linked  to bronchitis and pneumonia
• HPIV-4: More rare than the other types of HPIVs

These spread from person to person through methods such as respiratory droplets that are formed from coughing, sneezing or being in close contact with another individual. These viruses can cause upper and lower respiratory problems, with individuals primarily observing symptoms in areas such as their nose, through or lungs, which can progress and damage the body. 

Symptoms of parainfluenza’s viral infection can affect a range of people, however, are typically known to greatly damage the respiratory systems of babies and young children. Below are some common symptoms of parainfluenza to look out for: 

• Fever
• Runny nose
• Coughs
• Sore throat 
• Shortness of breath
• Wheezing

In some cases of parainfluenza, specifically those with a weakened immune system in  the elderly, symptoms can drastically worsen and manifest as respiratory infections. This can severely affect breathing and lung function, highlighting the need for effective and quick diagnosis from your GP or local hospital.

Diagnosis of parainfluenza

So how is parainfluenza diagnosed? Well, parainfluenza can be diagnosed through symptom observation when you first contact your GP. Possible candidates for your symptoms can then be shortlisted with various laboratory tests. This includes swabs of your nose and throat that can help determine if any of the genetic material from the viruses is present. Importantly, your GP or healthcare provider may request further imaging such as a CT scan or chest X-ray, both of which can determine the severity and urgency of your symptoms.

Treatment options

Home care and self-management

Despite the various healthcare-based options available when treating parainfluenza, you might find self-management options such as holistic methods of care to be more successful in easing symptoms. These can include:

• Rest and hydration: Getting plenty of rest and staying hydrated can improve and alleviate symptoms of parainfluenza, as well as ease the tension caused by symptoms, such as coughing
• Over-the-counter medications: Medications such as Ibuprofen and paracetamol  can help reduce fevers, body aches and any pains that are associated with parainfluenza infection
• Humidifiers and steam therapy: Using humidifiers and steam, perhaps from a hot shower, can help ease breathing difficulties and loosen the trapped mucus from a stuffy nose 

Medical interventions

Alternatively, you might find that these methods of self-management are showing no signs of improvement in symptoms of parainfluenza. In this case,  medical intervention may be  necessary. Though there is no current treatment available for cases of parainfluenza, severe cases may be handled with medical interventions or novel approaches described below.  

Antiviral medications

Despite not yet being in commercial use, studies have shown that a specific antiviral medication, known as Ribavirin, has improved parainfluenza patient outcomes, particularly in those with compromised immune systems or at higher risk of complications. However,  side effects of Ribavirin exist, like nausea.²

Antibiotics (for secondary bacterial infections)

It is very important to know that antibiotics do not work effectively against viral infections such as parainfluenza, as antibiotics primarily target bacterial infections However, with parainfluenza causing damage to the respiratory tract, you can become more susceptible to conditions such as bacterial pneumonia, which is a bacterial infection that can be alleviated with the use of antibiotics. However, this should be taken with caution and under the supervision of your GP.

Corticosteroids 

Severe cases of parainfluenza can damage the respiratory tract and lungs, causing widespread inflammation in these areas that contributes to its various respiratory symptoms. Corticosteroids can help in cases of parainfluenza that develop croup, where children administered with corticosteroids have shown a reduced need for life-saving medical interventions compared to children with croup, without corticosteroids as an HPIV treatment.³ Common corticosteroids under research include dexamethasone or prednisolone, which can be taken up orally, injected into the muscle or through inhalers.

Hospitalisation and supportive care

With worsening symptom progression of parainfluenza, as well as the exhaustion of treatment options, severe cases of parainfluenza require immediate surveillance and care through hospitalisation, where hospital staff can monitor your health and assess the best steps moving forward in terms of supportive care.

Oxygen therapy 

Individuals with significant respiratory distress or low oxygen levels caused by parainfluenza may require supplementary oxygen therapy to support and improve the oxygenation of their vital organs. This can be provided in a hospital setting, with medical equipment such as nasal cannulae and oxygen masks to ensure that their organs are receiving enough oxygen to carry out vital processes such as respiration, metabolism and energy production. 

Intravenous fluids 

In HPIV cases where patients struggle to maintain proper fluid intake and stay hydrated, intravenous (IV) fluids exist to support patients. Importantly, dehydration can further exacerbate their current state, so using IV fluids can help replenish lost fluids and electrolytes. They also act quickly as they are injected directly into the bloodstream, where they work to ensure that the body receives enough hydration and nutrients promptly, without requiring much effort from the hospitalised patient. This will also help the patient’s body in successfully fighting off the viral infection, helping them recover efficiently. 

Mechanical ventilators (In severe cases) 

In severe cases, such as parainfluenza found in infants or individuals with underlying medical conditions, respiratory function may start to be constricted. If this individual is unable to maintain sufficient oxygen levels independently, a mechanical ventilator may be used. This is a machine that efficiently controls the exchange of oxygen and carbon dioxide in the lungs by controlling breaths through a ventilation tube inserted into the patient’s airway, helping the lungs inflate and perform gas exchange. This ensures that the patient is receiving enough oxygen to function well, whilst removing excess carbon dioxide that may have accumulated. Mechanical ventilation ultimately supports patients in recovering from severe parainfluenza, providing essential respiratory support whilst the body is actively fighting the infection.

Prevention strategies 

While treating parainfluenza is crucial, preventing this infection in the first place is equally as important. By taking protective measures and adopting preventative strategies, you can reduce your risk of contracting parainfluenza as well as reduce the potential for the virus to spread to others around you. 

Vaccination 

Although there are currently no vaccines available that target and protect against parainfluenza, researchers are making an effort to identify and produce HPIV vaccinations.⁴

Hygiene practices 

Practising good hygiene, including frequent hand washing, covering coughs/sneezes and cleaning surfaces/objects can help reduce the spread of HPIV as well as reduce your own risk of getting HPIV. The Centers for Disease Control and Prevention (CDC) recommends that you wash your hands with soap for at least 20 seconds, and where there is no soap and water available, an alcohol-based hand rub should be used.⁵

Avoiding exposure to infected individuals 

Where possible, you should avoid close contact with individuals who are sick or show symptoms of respiratory illnesses discussed before. Similarly, if you find that you have some of these symptoms, you should try to stay at home or perhaps wear a face mask to avoid spreading any infection, especially to high-risk groups such as infants, the elderly, and those with a weakened immune system.

Summary 

Parainfluenza infections vary from mild to severe, with life-changing health implications, affecting people from infancy to the elderly. While many cases can be managed well at home or through over-the-counter medication, severe cases require medical intervention such as antivirals, corticosteroids, or even hospitalisation and supportive care like oxygen therapy or mechanical ventilation. With such a variety of treatments, early intervention and prevention are crucial in managing parainfluenza infections. Should you experience any of the listed symptoms, particularly for those in a high-risk group, you should seek professional medical advice from your GP, who can direct you through your symptoms and diagnose you early on, helping prevent complications and promote faster recovery.