Multicluster nosocomial outbreak of parainfluenza virus type 3 infection in a pediatric oncohematology unit: A phylogenetic study

Antonio Piralla, Elena Percivalle, Alessandra Di Cesare-Merlone, Franco Locatelli, Giuseppe Gerna

Research output: Contribution to journalArticlepeer-review


Background: Human parainfluenza virus type 3 (hPIV-3) has been reported to cause nosocomial outbreaks of respiratory infection, in particular among hematopoietic stem cell transplantation recipients. Design and Methods: From September 2007 through January 2008 several episodes of hPIV-3 infection were observed among young patients followed at the Oncohematology Unit (OHU) or other units of the Pediatrics Department. In 32 young patients (median age 3.5 years, range 21 days-27 years), hPIV-3 infection was diagnosed by direct fluorescent antibody staining of cells from respiratory secretions, and virus quantified by real-time RT-PCR in nasopharyngeal aspirates or bronchoalveolar lavage samples. In addition, the epidemiologic relatedness of hPIV-3 strains was investigated by sequencing two variable regions of the hemagglutinin-neuraminidase gene (nt 1-569 and nt 762-1239). Results: Of the 32 hPIV-3-positive patients, 19 were hematopoietic stem cell transplantation recipients, 8 had hematologic malignancies, and 5 were immunocompetent children. Sixteen patients had upper, and 16 lower respiratory tract infection. All patients but one had high viral load in nasopharyngeal aspirates (>1.0×106 RNA copies/mL). One patient died from respiratory failure with a high viral load in bronchoalveolar lavage. Phylogenetic analysis showed that 16/32 strains were identical. Besides this major cluster, three other clusters were identified, each one defining a smaller outbreak. Conclusions: Phylogenetic analysis allows identification of the role of a single or multiple hPIV-3 strains in the person-to-person transmission within an outbreak occurring in clinical units.

Original languageEnglish
Pages (from-to)833-839
Number of pages7
Issue number6
Publication statusPublished - Jun 2009


  • Hematopoietic stem cell transplant recipients
  • Human parainfluenza virus type 3
  • Nosocomial outbreak
  • Phylogenetic analysis

ASJC Scopus subject areas

  • Hematology


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