Trenton, NJ: Dept of Health reports 11.5.2018 – Laboratory tests have confirmed another medically fragile child with adenovirus as part of an ongoing outbreak investigation at the Wanaque Center for Nursing and Rehabilitation in Haskell.

A total of 29 pediatric adenovirus cases have been associated with this outbreak. In addition, a staff member at the facility — who has since recovered — also became ill as part of the outbreak. There have been 10 deaths associated with this outbreak.

The most recent date of illness onset was on Nov. 5.  Update: 11th child died Nov 19, 2018.

To date, the individuals associated with the outbreak became ill between Sept. 26 and Nov. 5. The affected children had severely compromised immune systems — including respiratory problems — before the outbreak began.

Unless there is another death associated with this outbreak, the Department will begin updating case counts and dates of illness onset on its adenovirus webpage.

Adenovirus has an incubation period of two to 14 days, meaning that symptoms typically appear two to 14 days after exposure to the virus. This later onset of illness is not unexpected due to the long incubation period of adenovirus. The Department will not consider the outbreak over until four weeks after the last illness onset.

The facility will not admit new residents for the duration of the outbreak.

This is an active investigation of an outbreak of adenovirus so it is possible that lab tests will confirm additional cases. A Department of Health Communicable Disease Service staff member is on site at the facility and monitoring the outbreak. The Centers for Disease Control and Prevention (CDC) is assisting with lab testing and expertise.

A Department of Health team of infection control experts and epidemiologists are visiting University Hospital and four pediatric long-term care facilities — including Wanaque — this month to conduct training and assessments of infection control procedures, Commissioner Elnahal announced last week. The team so far visited the Wanaque Center on Nov. 1 and University Hospital on Nov. 2.

Adenovirus is a respiratory virus which can cause mild or serious illness, though serious illness is less common. Symptoms may include common cold, sore throat, bronchitis, pneumonia, diarrhea, pink eye, fever, bladder inflammation or infection, inflammation of the stomach and intestines and neurological disease.

On Oct. 30, the Department released the final report from the Oct. 21 unannounced inspection of the Wanaque Center for Nursing and Rehabilitation in Haskell.

What are the symptoms of adenovirses?
Adenoviruses are a group of viruses that most commonly cause respiratory illness. They can result in
mild to severe illness and cause illnesses such as:
• Cold-like symptoms
• Sore throat
• Bronchitis
• Pneumonia
• Diarrhea
• Pink eye (conjunctivitis)
• Fever
• Bladder inflammation or infection
• Inflammation of the stomach and intestines
• Neurologic disease (conditions that affect the brain and spinal cord)
Who gets adenoviruses?
Anyone can get infected with an adenovirus at any age, but infections happen in children more than
adults. People with weakened immune systems or existing respiratory or cardiac diseases are more
likely than others to get very sick from an adenovirus infection.
How are adenoviruses spread?
Adenoviruses are common in places with large groups of children, such as child care settings, schools,
and summer camps. Adenoviruses are very contagious and usually spread from infected people to
others through:
• Close personal contact such as touching or shaking hands
• The air by coughing or sneezing
• Touching objects or surfaces with adenoviruses on them then touching your mouth, nose or eyes.
It is also possible to get infected when changing a diaper on a child who is infected. You can also get
sick from eating food prepared by someone who didn’t wash their hands properly after going to the
bathroom.
Who is at risk for serious illness?
People with weak immune systems, or existing respiratory or cardiac disease, are at higher risk
of developing severe illness from an adenovirus infection. They may also need treatment in a
hospital to help them recover.
How is adenovirus diagnosed?
A health care provider may want to do a physical exam and possibly one or more of these tests
to see if a virus or bacteria caused the infection.
• Blood test
• Urine test
• Swab from inside the nose
• Stool test
• Chest X-ray
What is the treatment for adenovirus?
Most children get better on their own in a few days. Some infections, such as pink eye or
pneumonia can last longer. Antibiotics will not cure adenovirus infections because antibiotics
only kill bacteria. Adenovirus is caused by a virus.
What can be done to prevent adenovirus infections?
You can protect yourself and others from adenoviruses, and other respiratory illnesses, by
following a few simple steps:
• Wash your hands often with soap and water
• Avoid touching your eyes, nose and mouth with unwashed hands
• Avoid close contact with people who are sick
If you are sick you can help to protect others:
• Stay home if you are sick
• Cover your mouth and nose when coughing or sneezing
• Avoid sharing cups and eating utensils with others
• Refrain from kissing others
• Wash your hands often with soap and water, especially after using the bathroom