Reemergencia del virus parainfluenza serotipo 1 (HPIV-1) como agente causal predominante de infecciones respiratorias agudas en niños durante un brote en Lambayeque, Perú
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Gac Med Bol
Abstract
El HPIV es un importante patógeno respiratorio pediátrico que puede causar hospitalizaciones por infecciones respiratorias agudas (IRA) y que recientemente se ha relacionado a neumonías graves, con tasas de mortalidad similares a la influenza. Sin embargo, reportes de brotes por este virus son poco frecuentes. Se realizó seguimiento a 4 casos pediátricos con IRA durante un brote en noviembre-diciembre 2023 en Lambayeque, Perú. Se analizaron hallazgos clínicos, de laboratorio e imágenes. Tres niños requirieron hospitalización, mientras que todos presentaron cuadros de vía respiratoria superior con tos, rinorrea y dificultad respiratoria, además de conjuntivitis. Exámenes mostraron infiltrados pulmonares compatibles con neumonía viral. Pruebas de inmunofluorescencia directa identificaron HPIV-1 en todos los casos. Este brote mostró la reemergencia de HPIV-1 como agente causal predominante de neumonías pediátricas, probablemente debido a disminución transitoria de la inmunidad de rebaño por la pandemia. El reconocimiento oportuno de HPIV-1 es clave para un adecuado manejo clínico y control de la morbilidad respiratoria infantil evitando uso innecesario de antibióticos.
HPIV is an important pediatric respiratory pathogen that can cause acute respiratory infection (ARI) hospitalizations and has recently been associated with severe pneumonias, with mortality rates similar to influenza. However, outbreak reports for this virus are infrequent. Follow-up was conducted on 4 pediatric ARI cases during an outbreak in November-December 2023 in Lambayeque, Peru. Clinical, laboratory and imaging findings were analyzed. Three children required hospitalization, while all presented with upper respiratory symptoms of cough, rhinorrhea and difficulty breathing, plus conjunctivitis. Exams showed pulmonary infiltrates compatible with viral pneumonia. Direct immunofluorescence testing identified HPIV-1 in all cases. This outbreak showed the reemergence of HPIV-1 as the predominant causal agent of pediatric pneumonias, likely due to a temporary decrease in herd immunity from the pandemic. Timely recognition of HPIV-1 is key for proper clinical management and control of childhood respiratory morbidity by avoiding unnecessary antibiotic use.
HPIV is an important pediatric respiratory pathogen that can cause acute respiratory infection (ARI) hospitalizations and has recently been associated with severe pneumonias, with mortality rates similar to influenza. However, outbreak reports for this virus are infrequent. Follow-up was conducted on 4 pediatric ARI cases during an outbreak in November-December 2023 in Lambayeque, Peru. Clinical, laboratory and imaging findings were analyzed. Three children required hospitalization, while all presented with upper respiratory symptoms of cough, rhinorrhea and difficulty breathing, plus conjunctivitis. Exams showed pulmonary infiltrates compatible with viral pneumonia. Direct immunofluorescence testing identified HPIV-1 in all cases. This outbreak showed the reemergence of HPIV-1 as the predominant causal agent of pediatric pneumonias, likely due to a temporary decrease in herd immunity from the pandemic. Timely recognition of HPIV-1 is key for proper clinical management and control of childhood respiratory morbidity by avoiding unnecessary antibiotic use.
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Vol. 47, No. 2