The state Department of Health is sending a full-time disease control specialist to the facility where seven children have died following a viral outbreak, as part of an effort to stem the deadly respiratory infections that swept through the unit that had cared for them.
At the same time, officials say they are examining how to bolster infection control rules and regulations -- not just at the Wanaque Center for Nursing and Rehabilitation in Haskell, where the adenovirus outbreak occurred -- but at similar health facilities across the state.
At a press conference in Wanaque late in the day, Gov. Phil Murphy said his administration is "obsessed" with trying to find out what happened.
"We are completely and utterly gutted by the knowledge that seven precious young children have lost their lives," he said. "We don't have all the answers, but we're working to get them."
Health Commissioner Shereef Elnahal, who was at the afternoon briefing, said he is also planning to meet privately with the families of those stricken by the virus, which included kids as young as toddlers.
"This is a tragedy," said Elnahal in an interview earlier in the day. "It's extremely upsetting, given the patients involved. They are children."
They included immunocompromised youngsters, many on ventilators with trachea tubes, and some with developmental disabilities, who were all considered "medically fragile." A number were under guardianship.
"They are particularly vulnerable," observed the commissioner. "This has been wrenching for me. It's been wrenching for the governor."
State officials said they first became aware of the outbreak on Oct. 9, when they were alerted by the facility.
It became public earlier this week, after NJ Advance Media received an anonymous tip that there had been a number of deaths at the facility. However, neither the state Health Department nor the facility would confirm those fatalities until Tuesday.
Officials have since disclosed 18 case of adenovirus, a typically mild illness that mimics flu- and cold-like symptoms, which can pose serious complications to some people -- particularly those with weakened immune systems. Seven at the Wanaque Center have died, while others remain critically ill.
The Wanaque Center is a 227-bed, for-profit facility in northern Passaic County that includes a nursing home, rehabilitation center and a pediatrics center, which offers short- and long-term care. The facility is licensed for 92 pediatric beds. It has been barred from admitting new patients until the outbreak ends, the department said.
Elnahal would not say if the notification to the state came before any of the deaths occurred because of confidentiality rules.
Adenovirus is not a disease that mandates state notification, although every healthcare facility must alert the Department of Health if an infectious disease begins significantly spreading.
The commissioner said the state sees hundreds of respiratory outbreaks a year. "This happened in a place with a lot of vulnerable patients," he said.
Several state lawmakers, though, are raising questions about how the state initially responded to the outbreak and whether changes are needed.
Sen. Joseph Vitale, D-Middlesex, who chairs the Senate Health, Human Services and Senior Citizens Committee, said he is troubled by the long wait before parents were notified, as well as how long it took for the state to visit the Wanaque Center after it first learned there were sick children.
Paula Costigan, a Boonton resident whose son receives long-term care at the Wanaque Center, told NJ Advance Media she didn't learn about the outbreak until more than a week later.
"They called me on the 18th that he had a fever and that they're sending him to the hospital," she said.
Vitale said he did not want to overreact, but said he has questions over whether there was a breakdown in notifications, as well as in response to the spreading outbreak.
"What did (the facility) tell them and what was their response?" he asked. "How did it spread so quickly, and why did they wait so long to inform the parents?"
Vitale called for an increase in unannounced inspections to every other facility in the state caring for children and adults at risk."
Sen. Gerry Cardinale, Assemblywoman Holly Schepisi and Assemblyman Robert Auth, all Republican legislators who represent the district where the Wanaque Center is located, also said the state needs to take action.
"We are shocked and heartbroken," they said in a joint statement. "This deadly viral outbreak was clearly a preventable tragedy, and state officials must take immediate action to deliver justice to the families who are being forced to reckon with every parent's worst nightmare -- the loss of a child. The children who died were already at a high risk of infection. They needed more care and more oversight; not less."
The health commissioner said he is moving for additional oversight at the Wanaque Center, with the placement of a communicable disease specialist on site, who he said will remain there until the outbreak has ended. That could take several more months, he said.
"It will go on as long as people are continuing to be ill," he said of the declaration of an outbreak, which would not be lifted until four weeks after the last case of respiratory symptoms.
Representatives for the Centers for Disease Control and Prevention are already on site and assisting the state.
The CDC is assisting the state with expertise on infection control, said Elnahal, as well as conducting tests to confirming the type of adenovirus. The strain afflicting the children, whose names have not been disclosed, is usually associated with acute respiratory illness, according to the CDC.
Additionally, the state conducted a surprise inspection at the Wanaque Center over the weekend, documenting what were called "minor hand-washing deficiencies," although Elnahal doubted was a significant factor in the spread of the outbreak.
The commissioner said his concern right now is the clinical status of confirmed cases, and to make sure the state is informed of any worsening cases.
Spencer Kent may be reached at skent@njadvancemedia.com. Follow him on Twitter @SpencerMKent. Find the Find NJ.com on Facebook.
Ted Sherman may be reached at tsherman@njadvancemedia.com. Follow him on Twitter @TedShermanSL. Facebook: @TedSherman.reporter. Find NJ.com on Facebook.
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