As physicians and public health experts try to wrap their heads around the cause or causes of a national outbreak of acute flaccid myelitis (covered here a couple of weeks ago on The PediaBlog), reports of another outbreak caused by a different virus in a nursing home for medically-fragile children in New Jersey has many parents on edge this week. So far, ten children have died at the Wanaque Center in Haskell, NJ from complications of adenovirus. Since the end of September there have been 28 confirmed cases of adenovirus infections at the nursing and rehabilitation center’s pediatric unit.
In healthy children, adenovirus causes mild upper respiratory infections (runny nose, cough, and fever), impressive cases of conjunctivitis (“pink eye”), and diarrheal illnesses. The symptoms that result from an infection typically resolve on their own after a week or so without the need for a prescription. Adenovirus is much more serious and invasive in children with weak immune systems, and in children with complex chronic medical conditions, it can threaten life itself with lower respiratory and neurologic complications. Susan Scutti calls adenovirus “environmentally hardy,” which explains how a pediatric nursing home would be a logical location for an outbreak:
The viruses, unlike the flu, are not seasonal and can cause illness throughout the year. And while a vaccine exists, it’s available only to military recruits.
The viruses themselves are also “resistant to many common disinfectants and can remain infectious for long periods on environmental surfaces and medical instruments,” the CDC says. They tend to be spread by coughing and sneezing, direct contact with an infected person, or touching objects and surfaces, such as door handles and light switches, where the viruses can live and remain infectious for days or weeks.
The viruses can “stay stable at room temperature for weeks” on unclean surfaces, according to Dr. Alex Valsamakis, director of Clinical Virology and Molecular Microbiology and a professor of pathology at the Johns Hopkins University School of Medicine.
It’s a reminder to all of us, especially as the influenza season has already kicked off, to get a flu shot if you haven’t already, stay home if you feel sick, cover your mouth when you sneeze or cough, and above all, WASH YOUR HANDS!