Health

No place to quarantine contagious kids in NJ care center where 7 died of respiratory infection, state officials say

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HASKELL, N.J. — The long-term care center where seven severely debilitated children died this month from a quickly spreading virus was not equipped to quarantine the strickened children, and five more children were diagnosed with the respiratory infection Thursday and Friday, state officials announced. 

The 227-bed Wanaque Center for Nursing and Rehabilitation did not have enough room to isolate the children when they became ill in the facility’s ventilator unit, said New Jersey’s state health commissioner, Dr. Shereef Elnahal. The adenovirus outbreak now has sickened 23 children. 

All of the children were on ventilators and had compromised immune systems, making any effort to quarantine them all but impossible, Elnahal said.

“There was not a place (at the center) where they could have been safely placed,” he said. 

► Oct. 25: Deadly virus outbreak kept from mom for weeks
► Oct. 24: 7th child dies of adenovirus infection in New Jersey health-care center
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The Wanaque Center is licensed to care for 92 children and 135 adults and can care for more than 60 children who depend on ventilators to breathe.

The cause of the outbreak and how the virus spread so quickly among the children remains unknown, Elnahal said. 

“I’ve seen respiratory outbreaks before, but I have not seen it in such a vulnerable group of patients,” said Elnahal, who previously worked for the federal Department of Veterans Affairs. “This is the worst (kind of) facility where this could have occurred, even if you have a facility that’s doing everything it can to prevent it.”

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He would not say how critical the 16 surviving children are or whether any have fully recovered.

A team of investigators and monitors from the New Jersey Health Department remained on site Thursday at the center, about 25 miles northwest of New York City. The facility has been barred from admitting new patients until the outbreak is declared to be over, which likely will be a minimum of four weeks, Elnahal said.

Wanaque Center representatives would not address several questions surrounding the outbreak:

  • When staff realized a significant problem.
  • How they responded to the outbreak.
  • Why government inspectors repeatedly found deficiencies in poor patient care and unsanitary practices that could help spread infection.
  • What center officials were doing in response to criticism from unions representing nurses and other workers over “worsening staffing levels, lack of adequate supplies, and severe cutbacks to job standards.”

The center’s private, for-profit owner, Wanaque Nursing & Rehabilitation, has retained a Philadelphia-based public relations agency to field questions about the outbreak. The agency issued a statement Thursday from the center’s administrator, Rowena Bautista, expressing sympathy for the families of those who died.

The nursing home is offering grief counseling to staff members, patients and families, she said.

“We are working side by side with medical experts from the (New Jersey) Department of Health and the CDC and will be in constant contact with them until this issue is fully resolved,” the statement read, referring to the federal Centers for Disease Control and Prevention.

State investigators have not found any violations of staffing levels at the center, Elnahal said.

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The five additional children that have become sickened from exposure to adenovirus, a common virus that causes mild illnesses like colds and coughs in healthy people but can be deadly to those with weakened immune systems, all were showing symptoms before Monday, state officials said. A laboratory confirmed the adenovirus diagnoses Thursday and Friday.

All of the children with confirmed cases became ill between Sept. 26 and Monday. State officials would not release additional information about their cases, citing patient privacy regulations. 

The outbreak has been confined to the ventilator unit at the center, which serves patients who need mechanical support to breathe.

As of Wednesday, the Wanaque Center had 49 children in the ventilator unit, which is licensed for 72 children, health officials said. An additional 20 beds are available for older children in another area. 

The first case of a patient with adenovirus was noted Sept. 26. The state Health Department was notified of a “cluster of respiratory illnesses” at the center Oct. 9 after the office closed for the day.

State officials began surveillance work at the facility the next morning. They have not listed specific death dates for any child except for the seventh victim, who died Tuesday night. 

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Health officials conducted a surprise inspection over the weekend and found “minor handwashing deficiencies.” The long-term care facility has been cited in annual government inspection reports from 2015 to 2018 for instances of poor patient care and unsanitary practices that could spread infection.

Elnahal described the most recent citations in August as low-level violations that would not pose a risk to patients. They were corrected by the time the department conducted the surprise inspection Sunday, he said.

Follow Scott Fallon on Twitter: @NewsFallon

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