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Health officials are looking for answers in fatal New Jersey virus infection

This is in line with the six deaths announced Tuesday among medically fragile children at the Wanaque Center for Nursing…

This is in line with the six deaths announced Tuesday among medically fragile children at the Wanaque Center for Nursing and Rehabilitation in Haskell, New Jersey.

“They range from young children to young adults,” said the New Jersey Department of Health Commissioner. Shereef Elnahal to reporters Wednesday. “Most people are under 18. Some have been hospitalized and some are taken care of at this facility.”

The outbreak seems to be limited to the plant’s respiratory system, he added.

While the time of death is unclear. The health department received notification of respiratory disease at the facility on October 9th. Notify parents ten days later, October 19, according to the health department spokesperson Nicole Kirgan.

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“Health consultants and other people do not think of the usual cold as serious, but When you are a child, disabled, chronic disease, immunosuppressed, elderly, multiple medical conditions, the cold can be life threatening, “says Dr. David Gifford, Senior Vice President of Quality and Regulatory Issues for the American Health Care Association. [19659002] The Association – whose member organizations represent nursing homes and other nursing homes across the country – do not own or operate individual premises. Although the Wanaque plant is a member of the national organization as a default, Gifford said that the association does not take a stand to individually represent individual facilities.

Gifford said that the time it takes to respond to a potential outbreak and report families is variable. “There are so many shades,” he said, among other things, how long health experts need to investigate a potential outbreak, cultivate a virus and confirm its identity.

“Generally speaking, if you see a number of people in an institutional environment who have a disease, you start taking some precautions about spreading,” said Gifford, but it may not necessarily include notifying families of something that initially resembles normal cold. 19659002] In a statement on Tuesday, the Wanaque plant said “immediately notified all appropriate authorities when the virus was originally identified. “On Wednesday, a further statement from the plant said the health department” continues to work very closely with the facility to ensure that all infection control measures are followed. “

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The facility did not respond to multiple calls and e-mails for further comment. It has been “instructed not to recognize any new patients until the outbreak ends and they are in full compliance”, according to the state health department. According to Elnahal, the outbreak only declared over four weeks without another opportunity.

“The sick homes do not call the health department as often,” said Gifford, although there has been pressure for nursing homes and health care institutions to have healthcare departments involved in outbreaks earlier.

Adenovirus is kä To continue on unclean surfaces and medical instruments for long periods of time must not be eliminated by common disinfectants and rarely cause serious illness in healthy people. But people with weakened immune systems have a higher risk of serious disease, and they can remain infectious long after they recover, according to the US Center for Disease Control and Prevention.

“The adenovirus strain seen in this eruption is associated with municipal living arrangements and known to cause serious illness,” states the State Department.

“It can be hard to know impossible how the virus came to the plant, what source it was or what specific spreading mechanism is from person to person,” said Elnahal. “But we’re working on CDC about this ongoing outbreak investigation.”

The state health department said Tuesday that an inspection team on the plant on Sunday found less handwash deficiencies.

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In a review of Centers for Medicare and Medicaid Services, the Wanaque Center was awarded an above average overall grade ranking but an under average health check assessment.

Based on an inspection conducted in August, CMS reported that “it was decided that the facility failed to provide a clean and secret physical environment for its residents.” The review found carpets like “smelled old carpet and mold”.

On Wednesday, Elnahal described these as “low level, self-deficiencies”, which was later resolved when the health inspectors were checked.

In May 2017 inspection report “it was established that the facility failed to ensure that infection control practices were followed.” Among the reported shortcomings were improperly stored syringes, which were used to measure fluid medication and bedside tables and medication washers that were not properly cleaned and disinfected. The shortcomings were listed as corrected one month later and were lower than the average in the United States.

“It’s rare that a plant would come out without any quote at any inspection,” said Elnahal. “If there are a number of quotations, all of which are low, we request a plan for correction. We make sure that the plant is reviewing – and that’s what this facility did here.”

“If the results are large enough to take further action, we will,” he added.

Nurses at the facility had previously reported a lack of healthcare and healthcare providers, according to a statement Tuesday from the union representing healthcare professionals. Healthcare professionals and allied employees said the shortcomings could have led to “poor infection control practices”.

The union said it represents the 70 nurses working at the Wanaque Center for Nursing and Rehabilitation.

& # 39; Hardy & quot; virus

Adenovirus can cause mild to severe disease but severe disease is less common. People with weakened immune system or existing respiratory or heart disease are at greater risk of developing serious disease of an adenovirus infection, according to CDC.

This outbreak, caused by type 7 adenovirus, “affects medically fragile children with severely compromised immune system,” said the health department Tuesday.

“Adenovirus usually produces flu-like disease with cough and runny nose and feeling lame but you’re getting better, “says Dr. William Schaffner, a contagious specialist at Vanderbilt University, told CNN earlier.” But they can also cause conjunctivitis and especially in children, diarrhea. “

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In rare cases, among people with weakened immune systems, the virus can cause pneumonia or inflammation of the brain and tissues around it. In extremely rare cases an adenovirus infection may result in death.

As said, most adenovirus infections are mild, with symptoms usually lasting about 10 days, according to CDC. And for most patients, home and non-prescription medicines to relieve symptoms are the only treatment needed.

Adenovirus, unlike influenza, is not seasonal and can cause disease throughout the year. And while an adenovirus vaccine exists, it’s only available for military recruits.

The virus itself is also “resistant to many common disinfectants and can remain infectious for long periods of environmental and medical devices,” says CDC. Adenovirus tends to spread through cough and sneezing, direct contact with an infected person, or touching objects and surfaces, such as door handles and light switches, where adenovirus can live and be infectious for days or weeks.

Adenovirus can “stay” stable at room temperature for weeks “on unclean surfaces, according to Dr. Alex Valsamakis, director of clinical virology and molecular microbiology and professor of pathology at Johns Hopkins University’s School of Medicine.

She described this family of viruses as “environmentally hard. “

” Wash your hands frequently and avoid touching your face, “she told CNN.” It’s the kind of the easiest way to prevent accidental transport of something from your fingers to your nose or mouth. “

Adenovirus Infections” usually occurring sporadically – here is a case where a case – such outbreaks pretty cute “, Schaffner

From 2003 to 2016, the two most commonly reported adenovirus types in the US were Type 2 and 3, but four additional types – 1, 4, 7 and 14 – also caused disease, according to a report from the National Center for Immunization and Respiratory Disease of the CDC, 2017. These six types accounted for 85.5% of 1,497 laboratory confirmed samples reported during the period.

This small number of cases is believed to be a underrepresentation of the actual number of cases due to the fact that most people get ill either do not go to a doctor or their doctor does not test for this virus. [19659002] Oc h adenovirus is still difficult to diagnose because they are not typically included in a panel of tests used to identify specific viruses, according to Schaffner. He said this is changing, and for this reason he believes that the number of cases will increase.

Although Schaffner does not believe that people need to be worried about adenovirus. “They mainly cause a lot of less difficult infections spread by children, often from child to adult,” he said.

“But they are not as serious as the flu.”

CNN’s Nadia Kounang and Liv Kiely contributed to this report.

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