NJ DOH Update: 8th Fatality In Nursing Center Reporting Adenovirus 7 Cluster

NJ DOH Twitter Announcement

#13,627


On Tuesday, the New Jersey Department of Health issued a Statement On A  Cluster Of Pediatric Infections/Fatalities Due To Adenovirus 7 at a rehabilitation & Nursing center in Haskell, NJ.  At that time 18 pediatric cases have been reported at this nursing facility, resulting in 6 deaths. 

Adenovirus 7 is one of roughly 4 dozen adenovirus serotypes - that are a common cause of (generally mild) respiratory illnesses in both adults and children. 

Serious illness - in anyone, but particularly in immunocompromised or medically fragile individuals -  can sometimes occur (see last month's Heath Dept. Reports A Cluster Of Severe Adenovirus Cases In Upper Michigan).

Late yesterday the NJ DOH released the following update, announcing another pediatric death at this facility. Lab tests are not back on this latest fatality, but the presumption right now is it is linked to this adenovirus cluster.

Department of Health confirms 8th Death at Wanaque Center for Nursing and Rehabilitation

Another medically fragile child with respiratory illness at the Wanaque Center for Nursing and Rehabilitation in Haskell unfortunately passed away at the facility late this afternoon.

The Department of Health does not currently have laboratory confirmation of adenovirus in this child, so the total number of confirmed adenovirus cases associated with this outbreak remains at 23 — although there have now been eight deaths. Among the 23 confirmed adenovirus cases, there have been seven pediatric deaths.

October 22 remains the most recent date of illness onset. To date, confirmed cases became ill between Sept. 26 and Oct. 22.

The facility has agreed to cease new admissions for the duration of the outbreak and yesterday established a 24/7 hotline for families affected. The Wanaque Center is also offering professional grief counseling to anyone impacted.

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.

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. The strain of adenovirus seen in this outbreak (#7) is associated with communal living arrangements and is known to cause severe illness — especially in those with compromised immune systems.

The Department is working very closely with the facility to ensure all infection control measures are being followed.

As far as symptoms go, adenovirus infections are indistinguishable from other viral respiratory infections, including influenza. Some of the other `likely respiratory suspects’ would include human metapneumovirus (hMPV), parainfluenzavirus, respiratory syncytial virus (RSV), and scores of Rhinoviruses (Common cold).

Unless there is lab confirmation, doctors generally classify these illnesses as ILIs, or Influenza-like Illnesses (or sometimes ARI Acute Respiratory Infection), when making a clinical diagnosis.

Even during the fall of 2009, during the peak of the 2009 H1N1 pandemic, only about 27% of respiratory samples sent into the CDC tested positive for influenza (see ILI’s Aren’t Always The Flu).

Graph based On CDC Flu Data early October 2009

 
While influenza A & B get most of our attention due to their often high morbidity and mortality, they only cause a fraction of the respiratory illnesses that occur each year.  Most respiratory illnesses are mild, and self limiting, but nearly all are capable of producing severe illness.

While flu shots are far from 100% effective, - many people who get the seasonal vaccine, and then go on to get the `flu' - are actually hit by one of the other common viral players, which are not covered by the shot.

Good reasons why practicing good flu hygiene (washing hands, covering coughs, & staying home if sick) should be a year-round practice, even if you've had your  flu shot.