Children's Health and Wellness

Human Parainfluenza Viruses (HPIVs) in Children

What are human parainfluenza viruses in children?

Human parainfluenza viruses (HPIVs) are a group of viruses that cause different types of respiratory infections. They are more common in children and babies. But they can occur in people of any age, especially those with a weak immune system.

Most HPIVs usually cause infections of the upper airway, such as a common cold, ear infections, or sore throat. Other infections caused by HPIVs affect the lower respiratory tract. These include pneumonia, bronchiolitis, and croup. Croup outbreaks usually occur during the fall.

What causes HPIVs in a child?

HPIVs can be spread by coming in contact with droplets from an infected person’s nose or mouth. A child may breathe in droplets or touch their eyes, nose, or mouth with a contaminated hand. Most children have an infection with HPIV before they are 5 years old. They may then have occasional reinfection when they are older, but these infections are usually less severe.

Which children are at risk for HPIVs?

Children between the ages of 3 months and 5 years are most likely to develop croup. Children under the age of 2 are more likely to get lower respiratory tract infections, such as pneumonia or bronchiolitis. Reinfections can occur after the first infection, but are usually less severe.

What are the symptoms of HPIVs in a child?

Symptoms can occur a bit differently in each child. They can include:

  • Runny nose
  • Redness or swelling of the eyes
  • Cough that sounds like a barking seal
  • Noisy, harsh breathing
  • Hoarse voice when speaking or crying 
  • Rattling felt on the chest or back when breathing
  • Wheezing
  • Fever
  • Irritability
  • Loss of appetite
  • Vomiting
  • Diarrhea

The symptoms of HPIVs can be like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.

How are HPIVs diagnosed in a child?

The healthcare provider will ask about your child’s symptoms and health history. He or she may also ask about your family’s health history. He or she will give your child a physical exam. Your child may also have tests, such as:

  • Blood test
  • Nasal swab of respiratory secretions
  • Chest X-ray

How are HPIVs treated in a child?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is. Antibiotics are not used to treat this illness. The goal of treatment is to help reduce symptoms until the infection goes away.

Croup symptoms can be scary for parents. Supportive treatment for croup may include:

  • Taking your child into cool, night air
  • Having your child sit in a steamy bathroom with the shower running to ease breathing
  • Having your child drink plenty of fluids
  • Treating a fever with acetaminophen or ibuprofen, if your child's healthcare provider says it's OK
  • Keeping your child as quiet and calm as possible to help lessen breathing effort

Talk with your child’s healthcare provider about the risks, benefits, and possible side effects of all medicines. Don't give ibuprofen to a child younger than 6 months old, unless your healthcare provider tells you to. Don't give aspirin to children. Aspirin can cause a serious health condition called Reye syndrome.

What are possible complications of HPIVs in a child?

A child with a weak immune system may get life-threatening pneumonia.

How can I help prevent HPIVs in my child?

Good handwashing is important to prevent the spread of HPIV to other babies and children. If your child is in the hospital, healthcare workers may wear masks, gowns, and gloves when they enter your child's room.

When should I call my child’s healthcare provider?

Call the healthcare provider if your child has:

  • Symptoms that don’t get better, or get worse
  • New symptoms

Key points about HPIVs in children

  • Human parainfluenza viruses (HPIVs) are a group of viruses that cause different types of respiratory infections.
  • Most HPIVs usually cause infections of the upper airway, such as a common cold, ear infections, or sore throat. Other infections caused by HPIVs affect the lower respiratory tract. These include pneumonia, bronchiolitis, and croup.
  • Children between the ages of 3 months and 5 years are most likely to develop croup. Children under the age of 2 are more likely to develop lower respiratory tract infections, such as pneumonia or bronchiolitis.
  • Antibiotics are not used to treat HPIVs. The goal of treatment is to help reduce symptoms until the infection goes away.
  • Good handwashing is important to prevent the spread of HPIV to other babies and children.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

  • Know the reason for the visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
  • Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
  • Ask if your child’s condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if your child does not take the medicine or have the test or procedure.
  • If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.
Print Source: Baker, Carol J., MD, FAAP. RED BOOK of Pediatric Infectious Diseases (2013) 2nd
Print Source: Sutton, AL., Respiratory Disorders Sourcebook, 3rd ed., 415-418
Online Source: Centers for Disease Control and Prevention (CDC)http://www.cdc.gov/parainfluenza/about/overview.html
Online Source: Centers for Disease Control and Prevention (CDC)http://www.cdc.gov/parainfluenza/hcp/clinical.html
Online Source: Centers for Disease Control and Prevention (CDC)http://www.cdc.gov/parainfluenza/seasons.html
Online Source: American Academy of Pediatricshttp://www.healthychildren.org/English/health-issues/conditions/chest-lungs/Pages/Croup-Treatment.aspx
Online Source: Parainfluenza Viral Infections, American Academy of Pediatricshttp://www.healthychildren.org/English/health-issues/conditions/chest-lungs/Pages/Parainfluenza-Viral-Infections.aspx
Author: Wheeler, Brooke
Online Editor: Metzger, Geri K
Online Editor: Sinovic, Dianna
Online Medical Reviewer: Freeborn, Donna, PhD, CNM, FNP
Online Medical Reviewer: Lentnek, Arnold, MD
Date Last Reviewed: 10/1/2016
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