An eighth child dies after an adenovirus epidemic in a New Jersey facility

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"A medically fragile child with respiratory diseases" died Friday afternoon at the Wanaque Center for Nursing and Rehabilitation in Haskell, the health department said in a statement. He was awaiting laboratory confirmation of the presence of adenoviruses, known for their persistence on surfaces and medical instruments soiled and unable to be removed by common disinfectants.

Viruses rarely cause serious illness in healthy people. But people with weakened immune systems are at higher risk for serious illness and may remain infectious long after recovery, says the US Center for Disease Control and Prevention. They are common in places where large groups of children live, such as daycares, schools and summer camps.

There have been 23 confirmed cases of adenovirus in Wanaque, including seven deaths of children. Confirmed cases became ill between September 26th and October 22nd.

The health department said this week that the facility had been "charged with not admitting new patients until the end of the outbreak and that they were in full compliance" .

The moment of death is not clear. The Ministry of Health was informed of respiratory diseases at the center on 9 October. Wanaque sent letters to the parents of the center's children on October 19, according to the health department.

On Tuesday, the New Jersey Department of Health announced the death of six pediatric residents at the center and the infection of 12 other residents. On Wednesday, the ministry announced an additional child death.

The ministry said it was an active epidemiological investigation and that laboratory tests could confirm other cases.

An on-site team on Sunday discovered minor flaws in hand washing.

"The ministry continues to work closely with the center to ensure that all infection control measures are well followed," Wanaque said in a statement released on Wednesday.

Children's ages are not revealed to protect the privacy of patients, said Nicole Kirgan, a spokeswoman for the Department of Health. They were aged from "young children to young adults, but most are under 18".

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The epidemic, caused by type 7 adenovirus, "affects medically fragile children whose immune system is severely compromised.The strain has been particularly associated with the disease in community living conditions and may be more serious, "according to the Department of Health.

In a statement, the institution said "promptly informed all relevant government agencies when the virus was identified."

"The Wanaque Center continues to cooperate fully with these agencies and has sought their medical advice regarding the virus," the center said. "As a result, facility staff diligently applied all available infection prevention and control measures to protect the health and safety of Wanaque Center residents."

The nurses at the facility had previously reported a shortage of nurses and supplies, according to a statement from the union representing the nursing staff. Health professionals and related employees (HPAE) said that shortages may have resulted in "poor infection control practices".

The union said it represented the 70 nurses working in Wanaque.

In a study by the Government Centers for Medicare and Medicaid Services, Wanaque was rated above average in terms of overall quality, but a lower than average health inspection rating . According to an inspection conducted in August, CMS reported that "it was determined that the facility had failed to provide a clean and welcoming physical environment to its residents".

"Sustainable for the environment"

"Most of the time, adenoviruses produce a flu-like illness with cough and runny nose and mold, but it's better," Dr. William Schaffner, an infectious disease specialist at Vanderbilt University told CNN. . "But they can also cause conjunctivitis and, especially in children, diarrhea."

In rare cases among people whose immune systems are weakened, viruses can cause pneumonia or inflammation of the brain and surrounding tissues. In extremely unusual cases, an adenovirus infection can lead to death.

Most adenovirus infections are benign, with symptoms that typically last about 10 days, according to the CDC. And for most patients, only home remedies and over-the-counter medications to relieve symptoms are needed.

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Unlike the flu, viruses are not seasonal and can cause illness throughout the year. And even if there is a vaccine, it is only available for army recruits.

The viruses themselves are also "resistant to many common disinfectants and can remain infectious for long periods of time on environmental surfaces and medical devices," says the CDC. They tend to be transmitted by coughing and sneezing, direct contact with an infected person or contact with objects and surfaces, such as doorknobs and switches, where viruses can live and remain infectious for long periods of time. days, even weeks.

Viruses can "stay stable at room temperature for weeks" on impure surfaces, according to Dr. Alex Valsamakis, Director of Clinical Virology and Molecular Microbiology and Professor of Pathology at the Faculty of Medicine of the University Johns Hopkins.

She described this family of viruses as "ecologically resistant".

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"Wash your hands frequently and avoid touching your face," she told CNN. "It's the easiest way to avoid inadvertently transporting something from your fingers into your nose or mouth."

Infections "usually occur sporadically – in this case, there is one – so epidemics are rather rare," said Schaffner.

Between 2003 and 2016, the two most commonly reported types of adenovirus in the United States were types 2 and 3, although four additional types – 1, 4, 7 and 14 – also caused the disease, according to one 2017 report of the National Center for Immunization and Respiratory Diseases of the CDC. These six types represent 85.5% of the 1,497 laboratory-confirmed samples reported during the period.

It is thought that this small number of cases is an underrepresentation of the actual number, as most people who become ill do not consult a doctor, or their doctors do not look for this virus.

And viruses are always difficult to diagnose because they are usually not part of a set of tests used to identify specific viruses, according to Schaffner. He said that the situation was changing and that for this reason he thought that the number of cases would increase.

Still, Schaffner does not think people need to worry about adenoviruses.

"They mainly cause a whole host of embarrassing minor infections transmitted by children, often from children to adults," he said. "But they are not as bad as the flu."

CNN's Ray Sanchez, Michael Nedelman, Nadia Kounang and Liv Kiely contributed to this story.

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