Epidemiology and seasonality of human parainfluenza serotypes 1-3 in Australian children.

backgroundParainfluenza viruses are significant contributors to childhood respiratory illness worldwide, although detailed epidemiological studies are lacking. Few recent Australian studies have investigated serotype-specific PIV epidemiology, and there is a paucity of southern hemisphere PIV reports. We report age-stratified PIV hospitalisation rates and a mathematical model of PIV seasonality and dynamics in Western Australia (WA).

methodsWe used linked perinatal, hospital admission and laboratory diagnostic data of 469 589 children born in WA between 1996 and 2012. Age-specific rates of viral testing and PIV detection in hospitalised children were determined using person time-at-risk analysis. PIV seasonality was modelled using a compartmental SEIRS model and complex demodulation methods.

resultsFrom 2000 to 2012, 9% (n = 43 627) of hospitalised children underwent PIV testing, of which 5% (n = 2218) were positive for PIV-1, 2 or 3. The highest incidence was in children aged 1-5 months (PIV-1:62.6 per 100 000 child-years, PIV-2:26.3/100 000, PIV-3:256/100 000), and hospitalisation rates were three times higher for Aboriginal children compared with non-Aboriginal children overall (IRR: 2.93). PIV-1 peaked in the autumn of even-numbered years, and PIV-3 annually in the spring, whereas PIV-2 had inconsistent peak timing. Fitting models to the higher incidence serotypes estimated reproduction numbers of 1.24 (PIV-1) and 1.72 (PIV-3).

conclusionPIV-1 and 3 are significant contributors towards infant respiratory hospitalisations. Interventions should prioritise children in the first 6 months of life, with respect to the observed autumn PIV-1 and spring PIV-3 activity peaks. Continued surveillance of all serotypes and investigation into PIV-1 and 3 interventions should be prioritised.