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Home / Health / Health officials look for answers in deadly New Jersey viral infection

Health officials look for answers in deadly New Jersey viral infection



This is the result of six deaths reported Tuesday in medically ill children at the Wanaque Nursing and Rehabilitation Center in Haskell, New Jersey.

"They range from small children to young adults," said New Jersey Department of Health Commissioner. Shereef Elnahal reporters on Wednesday. "The vast majority are under the age of 18. Some have been hospitalized and some are being cared for in this facility."

The outbreak appears to be confined to the respiratory unit of the facility, he added

Time of deaths remains unclear, the health department was notified on 9 October about respiratory illness in the facility. The facility notifies parents ten days later, on October 1

9, according to health department spokeswoman Nicole Kirgan.

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"Health experts and other people do not think of the common cold as serious, but if If you are a child, handicapped, chronic disease, immunocompromised, elderly, multiple medical conditions, the common cold can be life-threatening, "Dr. David Gifford, Senior Vice President of Quality and Regulatory Affairs for the American Health Care Association [19659002] The association – whose affiliates represent nursing homes and other health care facilities across the country – does not own or operate its own facilities. Although the Wanaque facility is a standard member of the national organization, Gifford said that the association does not take over positions to represent individual institutions individually.

Gifford said that the time it takes to respond to a possible outbreak and notify families is variable. "There are so many nuances," he said, including how long health experts need to investigate a possible outbreak, breed a virus, and confirm their identity.

"Generally speaking, if you see a number of people in an institutional environment If you have a disease, start taking some precautionary measures regarding the spread," Gifford said, but that may not necessarily include the notification of families about something that originally resembles a cold.

In a statement, the Wanaque facility said: "It immediately notified all relevant government agencies when the virus was initially identified. "On Wednesday, an additional declaration from the institution said the health department" continues to work very closely with the facility to ensure that all infection control measures are adhered to. "

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The facility did not respond to multiple calls and emails for further comments. "It was instructed not to record new patients until the outbreak ends and they are in full compliance According to Elnahal, the outbreak can only be explained once when four weeks have elapsed without an additional case.

"Nursing homes do not call the Ministry of Health often," Gifford said, although there was a push for nursing homes Healthcare facilities should involve health departments earlier in outbreak investigations.

Adenoviruses are known to remain on unclean surfaces and medical instruments for a long time, can not be eliminated with common disinfectants, and rarely cause serious illness in healthy people. However, immunocompromised people are at greater risk for serious illness and, according to the US Centers for Disease Control and Prevention, may remain infectious long after their recovery.
"The strain of adenovirus observed during this outbreak is associated with municipal housing agreements and known to cause a serious illness," said the State Department of Health.

"It can be difficult, impossible to know how the virus got into the facility, what its source was or what its specific mechanism of propagation is is from person to person," said Elnahal. "But we're working with the CDC on this ongoing breakout investigation."

The state health department said on Tuesday that an inspection team at the facility found minor hand washing shortcomings on Sunday.
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In a review From the Centers for Medicare and Medicaid Services, the Wanaque Center received an above-average overall grade rating, but a below-average health inspection.
Based on an inspection conducted in August, CMS reported that "it was found that the facility did not provide a clean and comfortable physical environment for its residents." The review found carpets that "smelled of old carpet and mold".

On Wednesday Elnahal described it as a "minor, self-limited deficiency", which was subsequently corrected in the review of health inspectors.

An inspection report from May 2017 "noted that the facility failed to ensure compliance with infection control practices." The above mentioned deficiencies included improperly stored syringes used to measure liquid medication, over-table desks, and drug trays that were not properly cleaned and disinfected were. The deficiencies were reported as corrected one month later and were lower than the US average.

"It is rare for an inspection to have a facility without references," Elnahal said. "If there are a number of quotes, all at a low level, we ask for a corrective plan and we make sure that the facility goes through – and that's exactly what this facility has done here."

"If the results are severe enough to take further action, we will," he added.

Nurses at the facility had previously reported a lack of caregivers and supplies, according to a statement from the union, which represents the nursing staff. The health professionals and Allied employees said the shortage could have led to "poor infection control practices".

The union said it represents the 70 nurses who work at the Wanaque Nursing and Rehabilitation Center.

& # 39; Hardy & # 39; Viruses

Adenoviruses can cause mild to severe illnesses, although a serious illness is rarer. People with a weakened immune system or existing respiratory or heart disease have a higher risk of developing adenovirus infection, according to the CDC.

This adenovirus-type 7 outbreak "affects medically sensitive children with severe immune system impairments," the Department of Health said Tuesday.

"Adenoviruses usually produce flu-like illnesses with coughing and runny nose and feel bad, but it's better," William Schaffner, specialist in infectious diseases at Vanderbilt University, said earlier CNN. "But they can also cause conjunctivitis and, especially in children, diarrhea."
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In In rare cases, the viruses in immunocompromised individuals can cause pneumonia or inflammation of the brain and surrounding tissues. In extremely unusual cases, adenovirus infection could lead to death.

That is, most adenovirus infections are mild, with symptoms that usually last about 10 days after CDC. And for most patients, home remedies and over-the-counter medications to relieve symptoms are the only necessary treatment.

Unlike influenza, adenoviruses are not seasonal and can cause disease throughout the year. And while an adenovirus vaccine exists, it is only available to military recruits.

The viruses themselves are also "resistant to many common disinfectants and can remain infectious on environmental surfaces and medical instruments for a long time," according to the CDC. Adenoviruses are often transmitted by coughing and sneezing, by direct contact with an infected person or by touching objects and surfaces, such as door handles and light switches, where adenoviruses can remain infectious for days or weeks.

Adenoviruses Can Stay "" According to Dr. Alex Valsamakis, Head of Clinical Virology and Molecular Microbiology and Professor of Pathology at the School of Medicine at Johns Hopkins University, unstable on unclean surfaces at room temperature "

She described this virus family as "environmentally friendly."

"Wash your hands frequently and avoid touching your face," she told CNN before. "It's the easiest way to prevent something from being accidentally carried into the nose or mouth by your fingers."

Adenovirus infections "are usually sporadic – here a case, there is one case – so outbreaks are quite rare," Schaffner

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

This small number of cases is considered to be an underrepresentation of the actual number of cases, since most people who get sick either do not go to a doctor or their doctors do not look for this virus [19659002] and adenoviruses are still difficult to diagnose as they are not usually included in a series of tests to identify specific viruses, Schaffner said. He said that this is changing and for that reason he believes that the number of cases will increase.

However, Schaffner does not believe that people have to worry about adenoviruses. "They are mainly causing a whole range of small annoying infections that are spread by children, often from children to adults."

"But they are not nearly as serious as influenza."

CNN Nadia Kounang and Liv Kiely contributed to this report.


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