Croup caused by parainfluenza virus

Parainfluenza spreads through respiratory secretions and can start with a runny nose, congestion or a mild cough. As swelling develops near the upper airway, the cough may sound barking and breathing in may become noisy. This presentation is called croup; learn more on the [Croup](/conditions/croup/) page.

The virus name does not predict the severity of a particular child’s illness. Symptoms can change over hours, especially at night. Fever may accompany the infection, while the child’s breathing effort and ability to drink give more useful clues about urgency. See [Fever](/symptoms/fever/) for related guidance.

Keep your child calm and upright, offer small amounts of fluid often, and check them regularly. Comfort can reduce crying, which may intensify the sound of upper-airway breathing. Follow age-appropriate instructions for any fever medicine.

Do not use steam from a kettle or hot shower as a treatment. If the cough or breathing noise is concerning, arrange a [Child Health Consultation](/treatments/consultations-and-assessment/child-health-consultation/). A clinician may prescribe medicine to reduce airway swelling; selected cases may need [Nebuliser Treatment](/treatments/acute-and-urgent-care/nebuliser-treatment/).

Get emergency help when breathing is hard, the ribs or neck are visibly pulling in, the child cannot speak or cry normally because of breathlessness, or the lips appear blue or grey. Drooling with trouble swallowing, marked drowsiness or inability to drink also needs urgent care.

Noisy breathing only during crying may be less urgent than the same sound while resting, but it still deserves medical advice if it is new or worsening. Describe the cough and sound clearly; the [Cough](/symptoms/cough/) page may help.

Ask whether the pattern fits croup, whether treatment is needed now, how to position and observe your child overnight, and which symptoms mean you should call emergency services.