What should you know about croup and parainfluenza?

Parainfluenza is a group of respiratory viruses. Infection may resemble a common cold, with a runny nose, cough, fever, and tiredness, or it may inflame the voice box and windpipe enough to cause croup. Croup presents with a barking cough, hoarseness, and a high-pitched sound when breathing in.

The virus name does not tell you how severe the illness is. Breathing effort, alertness, ability to drink, and skin colour are more useful signs to watch. A test is not always needed, because clinicians can often recognize croup from its pattern and examination.

Keep the child calm and upright, offer regular fluids, and keep air free of tobacco smoke. Wash hands and avoid close contact with vulnerable people while the child is unwell. Use fever medicine only as directed for the child's age, and do not share medicines between children.

A clinician may prescribe medicine that reduces airway swelling. Nebuliser treatment may be used when breathing symptoms require it. Antibiotics do not treat a viral cause unless another bacterial problem is diagnosed.

Seek emergency care for severe or tiring breathing, ribs pulling in, blue or grey lips, pauses in breathing, inability to swallow, or a child who is floppy or difficult to wake. Arrange urgent review if the noisy breath continues while resting, drinking becomes difficult, urine is much less frequent, or symptoms worsen after seeming mild.

Ask whether the presentation is consistent with croup, whether testing would change care, how to reduce spread at home, which treatment is suitable, and what breathing pattern should lead to emergency help.