Ten children died as a result of a serious viral outbreak in the ventilation unit of a long-term care facility in Wanaque, New Jersey.(Photo: Kevin Wexler / northjersey.com)

WOODLAND PARK, N.J. – A The 10th child died Wednesday night of an adenovirus after an outbreak in a long-term care facility in New Jersey that infected 27 medically fragile children, the state health department said.

The death occurred as the epidemic entered its sixth week at the Wanaque Nursing and Rehabilitation Center. A second outbreak, which would be a different type of adenovirus, was confirmed Wednesday at the Voorhees Pediatric Center of Camden County.

Shereef Elnahal, Commissioner for Health, told Voorhees that four children were suffering from a mild form of the disease. Preliminary tests showed that the virus was not of the same type as the one that swept the center of Wanaque.

"The loss of these young lives is heartbreaking and our thoughts are with the affected families," Elnahal said of the death. "We are working closely with the facility to monitor respiratory disease and ensure that all infection control protocols are followed on an ongoing basis."

All children infected in both epidemics have a severely compromised immune system, said the Department of Health. The ministry did not identify children by name, age or gender, citing confidentiality issues. They range from toddlers to young adults, the vast majority of whom are under 18 years old. Most of them depend on fans or tracheostomies to breathe.

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The Department of Health posted a full-time staff member from the Wanaque Long-Term Care Center to monitor its implementation of infection control procedures.

The center stopped admitting new patients until the end of the epidemic. The most recent case diagnosis means that the earliest end point for the outbreak would be four weeks from November 24th.

The ministry is also discussing the potential tightening of infection control and infection control measures in institutions with such fragile children.

On October 21, a surprise inspection of the Wanaque center revealed deficiencies in handwashing and basic hygiene, but these were considered minor deficiencies. Elnahal plans to meet with federal officials to discuss the need for stronger standards

Epidemics in Wanaque and Voorheesdo not seem to be related, said Elnahal. "I really do not think that's the case," he said. "They are very far and the presentation of the disease is different".

Additional diagnoses of adenoviruses may be likely, due to the two-week incubation period, Elnahal said. Although adenoviruses usually cause cold and flu-like symptoms in healthy people, they can be devastating for people with compromised immune systems.

Health officials in Camden County worked with members of the state's health department to control the Voorhees outbreak and went to the facility on Tuesday and Wednesday to make sure the protocols for are respected, said Ron Tomasello, the county's information officer. "The facility is fully cooperative since [the state was] first contact on Friday, "he said.

A surprise inspection of the facility by the Ministry of Health on Tuesday revealed no abnormalities in infection control and no citations were issued, Elnahal said.

"Even if your facility has a perfect score on our infection control survey, it can still happen," he said. "All epidemics can not be avoided."

The center was able to "safely and quickly separate sick, exposed, and well-separated individuals," a recommended measure to curb the spread of the disease, the state health department said. He voluntarily reduced the new admissions.

The facility informed families with children of the Voorhees Center about the Wanaque outbreak last week. Another letter was issued Wednesday to inform Voorhees families of the outbreak and preventive measures taken. The institution announced that it would inform parents of any changes in the status of their children.

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The Voorhees facility is owned by a for-profit company, Forkid Care. The facility received an overall rating of two out of five stars on the federal government's "Comparison of Retirement Homes" Web site, with an above-average staff score and significantly below average for health inspections. The phone number provided to homeowners on the website of the state health department is the same as that of the establishment.

His patients may have degenerative diseases, complex convulsive disorders, traumatic brain injury and various other conditions requiring nutrition and breathing assistance.

Teams from the state health department will be visiting New Jersey's four pediatric long-term care facilities this month to discuss infection control practices and the spread of the disease. The other two facilities are antennas at Toms River Children's Hospital and Mountainside.

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