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At least 27 children have been linked to the outbreak at the Wanaque Center for Nursing and Rehabilitation in Haskell, said the New Jersey Department of Health.
"To date, individuals associated with the epidemic have become ill between September 26 and October 29," he said. "Affected children had a severely compromised immune system – including respiratory problems – before the start of the epidemic."
Viruses are found on impure surfaces and medical instruments. They can not be eliminated by common disinfectants, but they rarely cause serious illness in healthy people.
People with weakened immune systems have a higher risk of contracting serious illness and may remain infectious for a long time after recovery, says the US Center for Disease Control and Prevention. The disease is common in places where large groups of children live, such as daycares, schools and summer camps.
Mother who lost her daughter speaks
"She's gone," said Kristine Poulos about her 16-year-old daughter Elizabeth. "I can not bring her back, she will not come back."
Poulos' daughter, who needed to breathe and eat probes as part of her usual care, was transferred to another hospital with a fever but was later transferred to the Wanaque facility where she is died last week.
While the schedule for other deaths is not yet clearly defined, the Wanaque plant said it "promptly informed all relevant government agencies of the first identification of the virus." According to health department spokeswoman Nicole Kirgan, on October 9, state health officials were informed of a respiratory illness in the facility, which informed the parents 10 days later October 19th.
Poulos told WABC that the adenovirus had been diagnosed in his daughter at least five days before state health officials were informed. "Why do not you bring it back sooner?" she asked.
Last week, another statement from the facility indicated that the health department "continued to work closely with the facility to ensure that all infection control measures were followed." .
The property has not responded to several calls and emails for comments. He was "instructed to no longer admit new patients until the end of the epidemic and that they are in full compliance," according to the state health department. Public health officials said that the outbreak could only be declared once every four weeks without any other case.
Health experts say that the time needed to respond to a potential outbreak and inform families is variable and may depend on the time they need to investigate an outbreak, grow a virus and confirm their identity.
Victims go from toddlers to adults
Dr. Shereef Elnahal, commissioner of the New Jersey Department of Health, told reporters that the people who died in this facility were young children to young adults.
"The vast majority is under the age of 18. Some have been hospitalized and others are being treated at this facility," Elnahal said.
The epidemic seems to be limited to the respiratory unit of the institution, he added.
"It can be difficult, if not impossible, to know how the virus has arrived in the institution, what is the source or what is its specific mechanism of spreading from one person to the other", said Elnahal. "But we are working with the CDC on this ongoing investigation into an outbreak."
The outbreak in New Jersey was caused by a type 7 adenovirus, the health department said. This type is "most often associated with an acute respiratory illness," says the CDC. Other types of adenovirus infections can cause flu-like symptoms, a pink eye and diarrhea.
"The strain of adenovirus observed during this outbreak is associated with living conditions in the community and is known to cause serious illness," said the state health department.
Faith Karimi, CNN's Nadia Kounang, Laura Ly, Susan Scutti and Liv Kiely contributed to this story.
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