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. 2023 Apr 17;76(8):1349-1357.
doi: 10.1093/cid/ciac942.

Epidemiology of Human Parainfluenza Virus Type 3 and Respiratory Syncytial Virus Infections in the Time of Coronavirus Disease 2019: Findings From a Household Cohort in Maryland

Marissa K Hetrich  1 , Jennifer Oliva  1 , Kimberli Wanionek  1 , Maria Deloria Knoll  1 , Matthew Lamore  1 , Ignacio Esteban  1   2 , Vic Veguilla  3 , Fatimah S Dawood  3 , Ruth A Karron  1 ; SARS-CoV-2 Epidemiology And Response in Children Study Team
Collaborators, Affiliations

Epidemiology of Human Parainfluenza Virus Type 3 and Respiratory Syncytial Virus Infections in the Time of Coronavirus Disease 2019: Findings From a Household Cohort in Maryland

Marissa K Hetrich et al. Clin Infect Dis. .

Abstract

Background: During the coronavirus disease 2019 (COVID-19) pandemic, human parainfluenza type 3 (HPIV-3) and respiratory syncytial virus (RSV) circulation increased as nonpharmaceutical interventions were relaxed. Using data from 175 households (n = 690 members) followed between November 2020 and October 2021, we characterized HPIV-3 and RSV epidemiology in children aged 0-4 years and their households.

Methods: Households with ≥1 child aged 0-4 years were enrolled; members collected weekly nasal swabs (NS) and additional NS with respiratory illnesses (RI). We tested NS from RI episodes in children aged 0-4 years for HPIV-3, RSV, and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) using reverse-transcriptase polymerase chain reaction (RT-PCR). Among children with HPIV-3 or RSV infection, we tested contemporaneous NS from household members. We compared incidence rates (IRs) of RI with each virus during epidemic periods and identified household primary cases (the earliest detected household infection), and associated community exposures.

Results: 41 of 175 (23.4%) households had individuals with HPIV-3 (n = 45) or RSV (n = 46) infections. Among children aged 0-4 years, RI IRs /1000 person-weeks were 8.7 [6.0, 12.2] for HPIV-3, 7.6 [4.8, 11.4] for RSV, and 1.9 [1.0, 3.5] for SARS-CoV-2. Children aged 0-4 years accounted for 35 of 36 primary HPIV-3 or RSV cases. Children attending childcare or preschool had higher odds of primary infection (odds ratio, 10.81; 95% confidence interval, 3.14-37.23).

Conclusions: Among children aged 0-4 years, RI IRs for HPIV-3 and RSV infection were 4-fold higher than for SARS-CoV-2 during epidemic periods. HPIV-3 and RSV were almost exclusively introduced into households by young children.

Keywords: COVID-19; HPIV-3; RSV; child; household.

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Conflict of interest statement

Potential conflicts of interest. M. K. H. and M. D. K. report grant support from the CDC during this study and from Pfizer that is unrelated to this work. J. O. and K. W. report grant support from the CDC and the National Institutes of Health (NIH) during this study. M. L. is an employee of Merck & Co, Inc, with responsibilities related to device development. R. A. K. reports grant support from the CDC and support from the NIH, Sanofi Pasteur, and the Bill and Melinda Gates Foundation for research pertaining to respiratory syncytial virus vaccines. All remaining authors: No reported conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

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