Four weeks after the last confirmed case of adenovirus at the Wanaque Center pediatric nursing facility, the viral outbreak that led to the deaths of 11 children appears to be over. The New Jersey Department of Health issued an enforcement action temporarily halting admissions of new patients “out of an abundance of caution” and is continuing to work with the Wanaque Center “to ensure they have infection control procedures in place.”
A cause of the outbreak has yet to be determined. But the Wanaque Center had been repeatedly cited for deficiencies in hand-washing and infection control, both before and after the outbreak, according to state and federal inspection reports. Employees claimed the facility delayed transferring critically ill children who had been infected over concerns that it would lose Medicaid funding.
The incubation period of the adenovirus virus is two weeks, and health department spokeswoman Donna Leusner said that typically, outbreaks are considered over after two incubation periods or four weeks have passed.
In addition to the state’s ban on new admissions, re-admissions of hospitalized patients to the respiratory unit who may have been transferred out during the outbreak will still require approval from the department and a patient’s family, officials said. Many parents have expressed concerns about bringing their children back to the Wanaque Center, but there are only three other pediatric long-term care facilities in New Jersey and all have long waiting lists.
The outbreak began around Sept. 26, when the first kids started getting sick with what was initially diagnosed as a respiratory ailment. But it would not be until two children were already dead that the Wanaque Center notified local health department officials on Oct. 9 of a cluster of respiratory illnesses, and the state did not send inspectors there until Oct. 21.
For weeks, the number of those infected by the virus seemed to be spiraling out of control. State health officials blamed that in part on issues in separating medically fragile residents without symptoms in the pediatric respiratory unit — where the adenovirus outbreak had begun — from those who had the virus. The problem was there were not enough pediatric beds in a facility licensed for 92 residents, officials said. The Department of Health also put out a statewide call for members of the New Jersey Medical Reserve Corp. to assist the facility in separating ill from asymptomatic patients.
State Health Commissioner Shereef Elnahal has sent a team of inspectors in follow-up inspections. The state has required Wanaque Center to hire a department-approved physician or physician’s practice with certification in infectious disease.