A Wanaque, New Jersey rehabilitation facility experiencing an outbreak of adenovirus.
Photo: Julio Cortez (AP)

Officials have confirmed the ninth death of a child at a New Jersey nursing home in the last week alone, with at least eight of the fatalities being confirmed as the result of adenoviruses, CNN reported on Sunday.

According to CNN, at least 25 pediatric adenovirus infections have been confirmed at the Wanaque Center for Nursing and Rehabilitation in the city of Haskell as starting between Sept. 26 and Oct. 22. Adenoviruses are a family of common viruses that can cause respiratory symptoms as well as diarrhea, fever, internal inflammation, and neurological disease, among others. The outbreak at Wanaque is type 7 adenovirus, which the Centers for Disease Control writes is “most commonly associated with acute respiratory disease.” Usually adenovirus infections are mild, but they can quickly become life-threatening if a patient is immunocompromised or has respiratory difficulties, and those patients can remain infectious for quite some time.

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CNN wrote that while eight of the deaths have all been confirmed to be the result of adenovirus infections, health officials are still awaiting laboratory confirmation of a ninth:

The ninth victim, described as “medically fragile with respiratory illness” by the Wanaque Center for Nursing and Rehabilitation in Haskell, died late Saturday night at a hospital, the state health department said in a statement. It is awaiting laboratory confirmation of adenoviruses in a child who died Friday.

The viruses are known to persist on unclean surfaces and medical instruments, and may not be eliminated by common disinfectants, but they rarely cause severe illness in healthy people. Those with weakened immune systems, though, have a higher risk for severe disease and may remain infectious long after they recover, the US Centers for Disease Control and Prevention says. They are common in places with large groups of children, such as child-care settings, schools and summer camps.

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Dr. Shereef Elnahal, the state health commissioner, previously told USA Today that the sick children had compromised immune systems and were reliant on breathing machines, and that the facility could not quarantine them outside its ventilator unit.

“There was not a place (at the center) where they could have been safely placed,” Elnahal said.

As CNN noted, the facility says it promptly notified the New Jersey Department of Health (NJDOH) and other relevant agencies upon identifying the virus, and the NJDOH said the Wanaque facility is in “full compliance” with an order barring new admissions of patients. However, the union representing the facility’s nurses, Health Professionals and Allied Employees (HPAE), issued a statement saying that staff “reported a shortage of nursing staff which may lead to poor infection control practices that can put patient safety at risk.” Investigators found “minor hand-washing deficiencies,” CNN wrote, and the Centers for Medicare and Medicaid Services gave it an above-average quality rating but below-average hygiene rating based on an investigation in August.

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Vanderbilt University infectious disease specialist Dr. William Schaffner told CNN earlier this year that while adenoviruses are hard to diagnose and infections are believed to be under-reported, “They cause principally a whole bunch of minor troublesome infections spread by children, often from children to adults. But they’re not nearly as serious as influenza.”

“This is a tragic situation, and our thoughts are with the families who are grieving right now,” Elnahal said in a statement on the NJDOH website. “We are working every day to ensure all infection control protocols are continuously followed and closely monitoring the situation at the facility.”

[CNN]

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