Seven children have died and others remain ill from a viral outbreak at a nursing home and rehabilitation center in New Jersey, health department officials said.
Officials with the New Jersey Health Department said Wednesday that the seven “medically fragile children” were among 18 confirmed cases of an adenovirus among pediatric patients this month at the Wanaque Center for Nursing and Rehabilitation in Haskell, not far from the New York border. Experts say the outbreak highlights the challenge of controlling infectious diseases in nursing homelike environments.
Adenoviruses are ubiquitous viruses that can cause a variety of illnesses, from the common cold and conjunctivitis (pinkeye) to more severe diseases such as bronchitis and pneumonia, according to the Centers for Disease Control and Prevention. A spokeswoman for the state’s health department said that at least one of the patients who died was a toddler.
New Jersey Gov. Phil Murphy (D) said in a statement that he was “heartbroken by the news that several children have lost their lives in an adenovirus outbreak at the Wanaque Center for Nursing and Rehabilitation, and pray for the full recovery of the other children impacted."
The governor added that he has spoken with the state health commissioner, “who has assured me that the Department of Health has recommended vital measures to enhance protections against the further spread of infection and will continue its active on-site surveillance. I am confident that the steps being taken by state and local officials will minimize the impact to all those who remain at the facility, including patients and employees.”
The strain responsible for the outbreak in the long-term-care facility in New Jersey is adenovirus 7, known for causing pneumonia and other respiratory illnesses.
State health department officials said Wednesday in a statement that the strain “is associated with communal living arrangements and known to cause severe illness.”
The state, with help from CDC, is investigating the outbreak. Health officials said in a statement that investigators have found “minor handwashing deficiencies” at the nursing home and rehabilitation center, which has 135 long-term-care beds and 92 pediatric beds, according to the health department. The department said it is working with the facility on “infection control issues.”
Health officials said the center has been told not to admit any new patients during the outbreak.
The Wanaque Center for Nursing and Rehabilitation could not immediately be reached for comment. According to the center’s website, it offers short-term and long-term care, from physical and occupational therapies to hospice care, and has a pediatrics center for “medically fragile” children.
Amesh Adalja, a senior scholar at the Johns Hopkins University Center for Health Security, said that by adulthood, most people in the United States have been sickened by an adenovirus and recovered on their own. In patients with compromised immune systems, however, the viruses can be deadly.
Adalja, an infectious-disease physician, said there is a nationwide problem with hospital-acquired infections — even more so with nursing home and rehabilitation centers, where, he said, “infection control is not as rigorous” because such facilities are not always set up to help prevent outbreaks.
“It’s not surprising that this ferocious of a spread happened in a nursing-home setting,” he said, adding that “nursing homes are one of the weaker links in the chain of infection control.”
Adalja noted that he does not know how the faculty in New Jersey is handling the outbreak, but he said the outbreak is considered “particularly severe” given the high number of fatalities.
There have been similar outbreaks in the past.
In 2006 and 2007, adenovirus 14 sickened at least 140 people across four states — New York, Oregon, Texas and Washington, according to CDC. Nine of them died, CDC said.
Adenoviruses have also been a problem in military training centers, where men and women are under extreme physical and emotional stress and live in close quarters. For that reason, Adalja said, a Food and Drug Administration-approved vaccine for certain strains is given to members of the military. But when outbreaks occur, he said, it prompts questions about whether vaccines should be available to the general public.
To prevent transmission, CDC recommends that people avoid close contact with those who may be ill as well as practice good handwashing techniques and avoid touching the eyes, nose and mouth with unwashed hands.
There is no treatment for adenovirus, according to CDC, but the majority of cases clear up on their own.