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The kids started getting sick on an unseasonably warm day in late September.
Yet it would not be until Oct. 9 – and after the death of two children – when the Wanaque Center for Nursing and Rehabilitation notified the state health department of a viremic outbreak in New Jersey. And then another 12 days before the state inspectors walked in the door.
The devastating adenovirus outbreak at the Wanaque Center in Haskell. How did the outbreak persist?
Wanaque was managing the crisis. Wanaque was managing the crisis. Wanaque was managing the crisis.
The State's Response to the State of Human Health, Senate and Human Services will review when it holds a hearing on Dec. 3 to discuss the outbreak, said Sen. Joseph Vitale, the committee chairman said.
Death stalked the Wanaque center. Still, they are sending them away to the hospital, workers allege
"We will ask as many questions as we can, but this will be one of them," said Vitale, D-Middlesex.
"Vitale said, adding" we wanted to be cautious "," we want to know when it is reported.
"No doubt we are all concerned about this, and a layperson, I say something is here," he said.
Death stalked the Wanaque center. Still, they are sending them away to the hospital, workers allege
Wanaque notified the state and local health departments about the outbreak after business hours on Oct. 9., Department spokeswoman Donna Leusner.
"The state immediately counsels the facility on infection control protocols, to be implemented immediately," Leusner said.
The next day, the Communicable Disease Department – along with the U.S. Centers for Disease Control and Prevention and the Wanaque to recommend infection control practices, she said.
The Health Survey, Survey and Field Operations Office on Oct. 21 and conducted a surprise inspection. A state inspection specialist has remained on site.
The state carried out a second surprise inspection by NJ Advance Media quoting workers at the Wanaque Center who thought it was wrong to send them to the hospital because they did not want to lose money.
Leusner said: "The decision to wait two weeks before sending in is based on the incubation period.
The incubation period of the adenovirus virus is two weeks, the department said.
"It would have been possible to determine that an incubation period was worthwhile," spokeswoman Dawn Thomas said.
"Containing the virus ultimately depends on facility management and clinical practice for all patients, for every patient, and the Department of Health is taking every action it can to hold the facility accountable for this," Thomas said.
Wanaque Center's for-profit owner, Continuum Healthcare, which has gotten back and forth, did not return calls on Friday.
"The Commissioner believes that DOH staff responded appropriately to each time point, given the information we had," she said.
Adenovirus is actually a group of viruses that are rarely fatal. They may also cause gastroenteritis and conjunctivitis. They tend to affect infants and children, according to the Centers for Disease Control and Prevention.
Illnesses from the virus are usually mild and usually recover in a matter of days. But in some cases, infections from adenovirus can be potentially life-threatening, particularly those with weakened immune systems.
All of the pediatric patients at Wanaque Center are medically fragile. Most need ventilators to help them breathe. Some had severe birth defects and significant health problems.
Why these died, however, remains puzzling to some.
"These kids were really fragile and severe adenoviruses certainly can be fatal," observed David Cennimo, an epidemiologist at University Hospital in Newark and a professor of medicine at Rutgers University Medical School. "It's a bad breath and you can end up on a ventilator.
Not involved directly or knowing specifics about their cases, he said he wondered if there were secondary infections. There are many unanswered questions, he added.
"I do not understand it, it's a medical care facility.
State health officials, while they continue to investigate, said they may never know the answer to the virus spread.
"It's impossible for us to know what exactly are the factors related to the spread," said Christina Tan, the state's epidemiologist who heads the health department's Communicable Disease Service. "There are many factors."
Adenovirus is not an airborne threat. It does not get spread through a building and ventilation system, like Legionnaire's Disease, explained Tan. Rather, the virus moves through respiratory droplets or contact.
The state inspects these facilities every nine to 15 months, Leusner said.
The Wanaque Center had been repeatedly reported for deficiencies in handwashing and infection control, both before and after the outbreak, according to the state and federal inspection reports.
During an inspection last month, the state of disposable wipes, sanitizers, masks, gloves, and gowns are available on each wing, and generally in every room for the staff and visitors to the room. The report states that they are also guidelines, and that they are sick, and observed staff cleaning the rooms with germicidal cleaning solutions.
But the report noted deficiencies in handwashing procedures, where members of the staff did not wash their hands long enough.
Washing hands is imperative. Not a quick rinse, but for at least 20 seconds. They teach health care professions to sing "Happy Birthday" to themselves about twice. At Wanaque Center, state inspectors found that some nurses were not getting along, in terms of timing.
It was made to be a high likelihood that it would have been moved by someone who was caring for the kids.
"I would be concerned that whoever was caring for the kids was the contact vector of them," Cennimo said.
Vital, the health committee chairman, said he hopes to find out whether the outbreak is spiraling because of human error or systemic weaknesses. Maybe it's both. he said.
"These children are medical fragile and depend on other people for their survival," Vitale added. "It should not have happened to this degree.
NJ Advance Media Staff Writer Spencer Kent contributed to this report.
Ted Sherman can be reached at [email protected]. Follow him on Twitter @TedShermanSL. Facebook: @ TedSherman.reporter. Find NJ.com on Facebook.
Susan K. Livio can be reached at [email protected]. Follow her on Twitter @SusanKLivio. Find NJ.com Politics on Facebook.
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