A severely ill child with a confirmed case of adenovirus died last night in a North Jersey hospital.
Officials say the child had been a resident of the Wanaque Center for Nursing and Rehabilitation in Haskell and was among 34 pediatric adenovirus cases that have been associated with the current outbreak, including a total of 11 deaths.
“The grief from the loss of a child is overwhelming and we extend our deepest sympathies to this family and all of the families who have had to endure these terrible losses,” said Health Commissioner Dr. Shereef Elnahal.
At the direction of the Commissioner, the Department yesterday put out a statewide call for members of the New Jersey Medical Reserve Corp. (NJMRC) to assist the facility in separating ill from asymptomatic patients. The Department requested volunteer Respiratory Therapists holding active licenses to assist with pediatric care. In addition, the call also included nurses and nurse aides with experience caring for pediatric populations with chronic illnesses.
"DOH called for MRC volunteers as of yesterday afternoon,” added Commissioner Elnahal. “Several logistical matters, including reporting structure, are still being finalized. That information will be delivered to the MRC as it is available."
As a result of a continuously decreasing census, the facility now has sufficient space to be able to separate patients. In light of this, the Department is requiring the Wanaque Center to complete separation of the pediatric respiratory patients by Wednesday, Nov. 21.
The Department of Health on Wednesday,
took enforcement action against the Wanaque Center, prohibiting new admissions to the entire facility and requiring it to hire a certified Infection Control Practioner (ICP) and a Department-approved physician or physician practice with board certification in infectious disease. That decision came as a result of serious infection control deficiencies cited in ongoing inspections.
The curtailment of admissions to the pediatric respiratory unit will remain in effect until Wanaque satisfies the Department’s directive that it separates pediatric residents without symptoms from those who have the virus, including grouping children by lab test status and symptoms. As part of the enforcement action, the Department must approve any requests to re-admit former pediatric respiratory residents.
The children associated with the outbreak became ill between Sept. 26 and Nov. 12 and have severely compromised immune systems. An additional positive adenovirus case was confirmed late last night. One staff member was also confirmed with the virus but has since recovered.
Per the Department’s directive, separation of pediatric residents in the respiratory unit is ongoing and several patients have already been relocated. The Department is working closely with the facility, federal and local health officials to conduct respiratory illness surveillance.
A Department of Health Communicable Disease Service staff member is on site at the facility. The Centers for Disease Control and Prevention (CDC) is assisting with lab testing and expertise. Federal and state inspection teams have also been on site on multiple occasions.
While the directive to separate patients moving forward will ensure that Wanaque is a safer environment for children in the future, containing the current outbreak remains a challenge of infection control — requiring that every staff member, for every patient, is following all protocols. That work is ongoing.
The NJMRC is a network of community-based, locally organized units comprised of nearly 5,000 volunteers who stand ready to deploy and assist with public health emergencies. In addition to Health Professional volunteers, such as doctors, nurses, Emergency Medical Technicians (EMTs), therapists, dentists, counselors, and veterinarians, who can provide clinical services, the NJMRC also includes community health volunteers. Community Health volunteers serve a variety of important functions including reception and clerical services, information technology, language translation, assistance to disabilities and access and functional needs individuals, hospitality, food services and security.
The strain of adenovirus that has sickened so many children at Wanaque is a type (#7) that is common to communal settings such as nursing homes and military bases. It is known to cause severe illness. These immune-compromised children are not eligible for the vaccine that was developed for this strain of the virus.
Adenovirus has an incubation period of two to 14 days, meaning that symptoms typically appear two to 14 days after exposure to the virus. The Department will not consider the outbreak over until four weeks after the last illness onset, which is Nov. 12.