An Outbreak of Human Parainfluenza Virus 3 (Phylogenetic Subcluster C5) Infection among Adults at a Residential Care Facility for the Disabled in Croatia, 2018

Abstract

Introduction: Although highly pertinent for children, outbreaks of human parainfluenza virus (HPIV) may cause up to 15% of all respiratory illnesses in adults and predispose them to serious adverse outcomes, with HPIV serotype 3 (HPIV3) being the most common. This study represents the first report of an HPIV3 outbreak among adults at a long-term health-care facility in Croatia. Methods: A retrospective study was conducted to investigate an outbreak of acute respiratory infection (ARI) at a single residential care facility for the disabled in Croatia. Demographic, epidemiological, and clinical data were collected for all residents, while hospitalized patients were appraised in detail by laboratory/radio-logical methods. Multiplex PCR for respiratory viruses and sequencing was performed. Partial HPIV3 HN 581 nt sequences were aligned with HPIV3 sequences from the Gen-Bank database to conduct a phylogenetic analysis, where different bioinformatic approaches were employed. Results: In late June 2018, 5 of the 10 units at the facility were affected by the outbreak. Among the 106 residents, 23 (21.7%) developed ARI, and 6 (26.1%) of them were hospitalized. HPIV3 was identified in 18 (73%) of the residents and 5 (83%) of the hospitalized individuals. Isolated HPIV3 strains were classified within the phylogenetic subcluster C5 but grouped on 2 separate branches of the phylogenetic tree. During the entire outbreak period, none of the institution's employees reported symptoms of ARI. Conclusions: Our study has shown that this health care-associated outbreak of HPIV3 infection could have been linked to multiple importation events. Preventive measures in curbing such incidents should be enforced vigorously.

Modeling Infection and Tropism of Human Parainfluenza Virus Type 3 in Ferrets

“…HPIV-3 is responsible for more hospitalizations than HPIV-1 and -2 combined ( 8 , 28 , 29 ). HPIV-3 transmission occurs via the respiratory route, and inpatient nosocomial outbreaks are common, causing considerable morbidity and mortality in high-risk groups ( 2 , 30 – 35 ). Academic hospitals have seen a shift in the profile of HPIV-3 patients, resulting in an increased number of immunocompromised patients with severe comorbidities.…”

Controlling a human parainfluenza virus-3 outbreak in a haematology ward in a tertiary hospital: the importance of screening strategy and molecular diagnostics in relation to clinical symptoms

“…Transmission occurs either through direct person-toperson contact, large droplets or from contaminated surfaces [5]. Household outbreaks have been well described in the literature, as have outbreaks in nursing homes [6,7], neonatal nurseries [8e10] and haemato-oncology wards in hospitals [5,11e16].…”

Identification of the Functional Domain of HPIV3 Matrix Protein Interacting with Nucleocapsid Protein

“…Human parainfluenza virus (HPIV) belongs to paramyxovirus, which is a single- and negative-stranded and enveloped RNA virus. HPIV is a common pathogen of acute viral respiratory infections, which mainly causes upper respiratory tract and lower respiratory tract infections in children [ 1 , 2 ]. In addition, it is also the main pathogen of respiratory tract infections in patients with immunodeficiency and chronic diseases, and the elderly [ 3 , 4 ].…”