SEVEN VIRAL DEATHS AMONG CHILDREN IN A NEW JERSEY HOSPITAL
COMPILATION AND COMMENTARY
BY LUCY WARNER
OCTOBER 24, 2018


WE HAVE A DANGEROUS DISEASE OUTBREAK TODAY IN A LARGE HOSPITAL IN NEW JERSEY. WHAT I GLEAN FROM THIS MATERIAL BELOW IS THAT AN ADENOVIRUS (PRONOUNCED “ADD-I-NO-VIRUS”) COMMONLY CAUSES SORE THROATS AND EYE INFECTIONS, MOST OF WHICH USUALLY CLEAR UP WITHOUT SPECIFIC TREATMENT; HOWEVER, IT CAN INFECT THE LIVER OR OTHER VITAL ORGAN OR INVOLVE ANOTHER SECONDARY BACTERIAL INFECTION, ESPECIALLY IN IMMUNOSUPPRESSED PATIENTS SUCH AS THOSE WITH AIDS OR AN ORGAN IMPLANT.

CLEANING WITH SEVERAL EFFECTIVE DISINFECTANTS OR USING HEAT “CAN MAKE THE VIRUS INACTIVE” WHICH DOESN’T SOUND THE SAME TO ME AS THAT IS “KILLS THEM.” SOME OF THOSE LITTLE CRITTERS CAN FORM SPORES, WHICH ARE NOT DEAD. THEY ARE JUST DRY AND IN A RESTING STATE, OFTEN IMMUNE TO THE DISINFECTANT ROUTE, AND AS SOON AS THEY ARE IN A SUITABLE ENVIRONMENT, THEY COME BACK TO LIFE AND START MULTIPLYING. THE ARTICLE DOES SAY THAT IT “CAN REMAIN INFECTIOUS” OVER TIME ALSO. LACK OF SANITATION IS VERY LIKELY THE CAUSE, THOUGH CLOSE CONTACT CAN SPREAD IT RAPIDLY FROM PERSON TO PERSON, THROUGH THE AIR AND BY CONTACT WITH INFECTED SURFACES.

THIS LOOKS TO ME TO BE A LIKELY FAILURE BY HOSPITAL STAFF HERE. THE NURSING HOME AND THE CHILDREN’S WING HAVE BEEN GIVEN A GRADE OF “AVERAGE,” SO WE MAY SOON HEAR OF A LAWSUIT OVER THIS. THIS BBC ARTICLE DOESN’T SAY WHEN THE FIRST DEATH OCCURRED, OR WHEN ANY PRESUMABLY INCREASED INCIDENCE OF KNOWN NON-FATAL CASES BEGAN, BUT IT IS NOT USUALLY A DEADLY VIRUS. ONE ARTICLE DID SAY THAT IMMUNOSUPPRESSED INDIVIDUALS CAN HAVE MUCH MORE SERIOUS INFECTIONS, INCLUDING AN INFECTION OF THE VITAL ORGANS. IT USUALLY CAUSES SORE THROATS AND EYE INFECTIONS. PINKEYE WAS SPECIFICALLY MENTIONED.

THE PROBLEM WITH THAT IS THAT BASICALLY HEALTHY PEOPLE WHO ARE IGNORING A MINOR SYMPTOM MAY BE CARRIERS. WHEN THEY WALK INTO THE HOSPITAL TO VISIT A PATIENT, THEY MAY BE BRINGING A DEATH WITH THEM. ALSO, THE UPKEEP GRADE OF THE HOSPITAL IS ONLY “AVERAGE;” IT IS ONE OF THE LARGEST WITH OVER 200 PATIENTS; AND THEIR PATIENTS ARE VERY LIKELY IN GREATER DANGER OF BECOMING SICKER THAN AVERAGE BECAUSE THEY ARE ALREADY WEAKENED. A FAMILY VISIT MAY BE THE FIRST CAUSE OF THIS MYSTERY OUTBREAK. THE BBC ARTICLE DOES MENTION THAT THE CHILDREN WHO ARE HOUSED THERE ARE SERIOUSLY ILL AND “MEDICALLY FRAGILE,” SO A SIBLING VISITING WITH A SORE THROAT MAY BE THE INITIAL TRIGGER.

STILL, SOMETHING HAD TO START THIS EPIDEMIC AND GOOD HOSPITAL UPKEEP SHOULD HAVE STOPPED IT. DO THEY HAVE ISOLATION ROOMS, I WONDER? IF IT IS DUE TO A NEWLY MUTATED VIRUS, THAT’S VERY BAD NEWS. THIS HOSPITAL MAY BE IN LEGAL TROUBLE NOW BASED ON A LAPSE IN CARE FOR SUCH AN ENDANGERED POPULATION. THEIR CARE LEVEL IS RATED AS “AVERAGE.” IT’S POSSIBLY JUST A CASE OF POORLY WASHED HANDS. I’M SURE WE’LL HEAR MORE INFORMATION LATER.

NOTICE THAT WHILE TODAY’S “BBC” ARTICLE STATES THAT THE HOSPITAL IS “PRIVATELY OWNED,” THE “HEALTH.USNEWS” STORY DESCRIBES IT AS BEING ONE OF “FOR-PROFIT, CORPORATE OWNERSHIP.” SOMETIMES I DISTRUST CORPORATIONS MORE THAN PRIVATE OWNERS, THOUGH BOTH CAN BE DISHONEST AND POORLY MANAGED. I WILL SAY AGAIN, THAT MISMANAGEMENT MAY NOT BE THE CAUSE OF THIS OUTBREAK AT ALL. A FAST-MOVING VIRUS WITH MINIMAL SYMPTOMS MAY GO UNDETECTED UNTIL IT HAS BECOME DEADLY.

AFTER THIS BBC ARTICLE, READ THE NEXT THREE AT health.usnews.com, https://quizlet.com/16529633/adenoviruses-flash-cards/, AND https://cmr.asm.org/content/21/4/704 CALLED “ADENOVIRUSES IN IMMUNOCOMPROMISED HOSTS.”


https://www.bbc.com/news/world-us-canada-45959886
Seven children killed in virus outbreak at US health centre
OCTOBER 24, 2018 36 minutes ago

PHOTOGRAPH -- The outbreak occurred at the Wanaque Center GOOGLE MAPS

The death toll from a viral outbreak at a medical care centre in the US state of New Jersey has risen to seven children, with 11 more infected.

The strain of adenovirus at the Wanaque Center for Nursing and Rehabilitation was "associated with communal living" and "known to cause severe illness", officials said in a statement.

The children affected were "medically fragile", the statement added.

The state investigation is ongoing. The centre is now closed to new patients.

The health facility in Haskell is privately owned. The centre did not immediately respond to a request for comment from the BBC.

According to an earlier Department of Health release, state officials began investigating on Sunday and continued on Tuesday.

On Sunday, an inspection team found "minor handwashing deficiencies" at the centre, which also provides short- and long-term adult nursing and rehabilitation services.

It is still unclear how and when exactly the outbreak began.

Local news site NewJersey.com reported that a letter had been sent to parents of patients about an outbreak on 18 October, but officials did not confirm any details about the virus until Tuesday.

The state health department said it was working with the Wanaque Center "to ensure that all infection control measures are being followed". It said the Centers for Disease Control (CDC) was helping with its investigation.

Children in the centre's paediatric ward are seriously ill - many are disabled, in comas, or cannot walk or speak, the North Jersey Record reported.

The children affected have not been identified.

Image copyrightSMITH COLLECTION/GADO
Image caption
A colourised TEM (transmission electron microscopic) image of adenovirus

What is an adenovirus?

Adenoviruses are a type of virus usually spread through close contact (like touching an infected surface or shaking hands), coughing, and sneezing, according to the CDC.

Different strains of adenoviruses* can cause a range of illnesses, including common cold symptoms, bronchitis, pneumonia and diarrhoea.

Serious complications are uncommon, but the CDC notes those with "weakened immune systems, or existing respiratory or cardiac disease" are at a higher risk of severe sickness from adenovirus infections.

Officials say the strain affecting children at the clinic, number seven, is associated with communal living and "can be more severe".


THIS HOSPITAL IS LARGE WITH 227 BEDS, AND OVERCROWDING IS ONE FACTOR THAT INCREASES THE RATE OF DISEASE SPREAD. THE VIRUS DOESN’T HAVE TO WAIT AS LONG TO FIND A SUITABLE VICTIM. CHILDREN, ALSO, CAN’T RESIST TOUCHING EACH OTHER AND HAVE NO FEAR OF BREATHING IN VERY CLOSE PROXIMITY TO THE OTHERS. EVEN WITHOUT POORLY MAINTAINED SANITATION, THE VIRUS WILL MAKE ITS’ WAY AROUND THE RESIDENTS.

Wanaque Center for Nursing and Rehabilitation in Haskell, New Jersey
https://health.usnews.com/best-nursing-homes/area/nj/wanaque-center-for-nursing-rehabilitation-315229
Location: 1433 Ringwood Ave, Haskell, NJ [See Map] | (973) 839-2119

Overview
Wanaque Center for Nursing & Rehabilitation in Haskell, NJ, has an overall rating of Average. It is a very large facility with 227 beds and has for-profit, corporate ownership. Wanaque Center for Nursing & Rehabilitation is not part of a continuing care retirement community. It participates in Medicare and Medicaid.

Average Overall Rating Learn More
Accepts Medicaid
Accepts Medicare
Very large (227 Beds)
Not a Continuing Care facility ?
For-profit, corporate
Resident Council ?



THERE IS MORE OF THIS INFORMATION, MOST OF IT PRETTY TECHNICAL, BUT THE MOST BASIC THINGS ARE WRITTEN BELOW. THE THING TO NOTICE IS THAT IT WILL HAVE MINOR SYMPTOMS USUALLY, LIKELY INCLUDING SWELLING LYMPH NODES AND IRRITATED MUCUS PRODUCING CELLS. HIGH FEVER IS NOT A MENTIONED SYMPTOM. THIS DOES TELL ME, THOUGH, THAT PAYING NO ATTENTION TO SYMPTOMS LIKE THESE AND GOING OUT INTO THE RAIN WITHOUT PROTECTIVE CLOTHING REALLY IS A DANGEROUS THING TO DO, JUST LIKE OUR MOTHERS ALWAYS TOLD US.

https://quizlet.com/16529633/adenoviruses-flash-cards/

Adenoviral Pharyngitis/Conjunctivitis: Causative Agent
Adenovirus
45 types infect humans (>100 known serotypes)
Most common: serotype 1
Non-enveloped, icosahedral
Fibers on capsid represent VAPs
Linear, double-stranded DNA genome
Remains infectious in environment for extended periods
Transmitted easily on medical instruments
Inactivated easily with heat and various disinfectants
Oncogenic in animals, but never verified in humans

Adenoviral Pharyngitis: Pathogenesis
Virus can causes lytic (acute), latent, and transforming infections
Virus infects mucoepithelial cells
Attaches to specific surface receptors
Multiplies in cell nucleus
Cells escape to epithelial surface
Cell destruction initiates inflammation
If the virus infects lymphoid tissue, it is typically latent in nature
Can be reactivated in opportunistic times
Different viruses affect different tissues
Adenovirus type 4 causes sore throat and lymph node enlargement
Children/military most at-risk
Adenovirus type 8 causes extensive eye infection
Children most at-risk



THIS SHORT ARTICLE IS ABOUT ADENOVIRUSES VERSUS RETROVIRUSES AND MORE, WHICH YOU MAY NEVER HAVE READ BEFORE. A RETROVIRUS ALSO, IT IS MY UNDERSTANDING, MUTATES MUCH MORE RAPIDLY THAN OTHER TYPES OF VIRUS OR BACTERIA, THEREFORE BEING A SORT OF MOVING TARGET FOR WOULD-BE DEVELOPERS OF A VACCINE. THIS ARTICLE DOES TELL ME THAT “ADENOVIRUS” IS NOT THE NAME OF A SPECIFIC VIRUS, BUT OF A CATEGORY INSTEAD, AND THE NEWS ARTICLES ABOVE JUST DON’T SAY THE PRECISE INDIVIDUAL NAME OF THAT ADENOVIRUS, IF THERE IS ONLY ONE CAUSING THE DEATHS.

http://www.differencebetween.net/science/health/difference-between-adenovirus-and-retrovirus/
Difference Between Adenovirus and Retrovirus
Adenovirus vs Retrovirus

Viruses are considered as the bane of our existence. This is because viruses have been known to wipe out entire communities or populations before. I believe that most of you can remember or have even heard of the black plague or the smallpox scare, in which a lot of people have died. More recently, the SARS scare have rattled a lot of countries. Furthermore, viruses are also so resilient that they can even attach to birds before they are transmitted to human beings, such as the avian flu virus. This is the reason why many countries have upgraded their programs in protecting their citizens from diseases brought about by other forms of viruses and researching new ways of fighting against them.

Still, there are other strands [sic] of viruses that continue to plague us even as we speak. There are many types of viruses that still roam around us even with all this technologically breakthroughs [sic] on viral immunity. In some countries, chickenpox and measles outbreaks still occur, although they are said to be seasonal in nature. Cough and colds may be due to some viral strains. And because of this, scientists are always in motion to study viruses and to look for newer ways to entirely rid of these pesky organisms.

But before they can entirely eradicate these viruses, they have to know about them. A virus is considered as an infectious pathogen or agent that will replicate only after it has come in contact with a living cell. Viruses affect not only animals but plants as well. Most viruses contain 2 or 3 major parts, genetic information made up of RNA or DNA, a molecule chain to carry these genetic materials, and a protein coat to act as protection. Most viruses usually have these parts. But although there may be a lot of viruses out there, we will focus ourselves to the difference between an adenovirus and a retrovirus.

An adenovirus is considered as the largest among the non-enveloped viruses. This term indicates that the virus has no protective protein- coating, called capsids, to wrap the genetic information stored inside the virus. This virus contains a double-stranded DNA. It has been proven that this virus is the cause for about 10% of upper respiratory infections in children and adults.

A retrovirus, on the other hand, is an example of an enveloped virus. In this case, it has a protective protein coat that makes it more resilient and has a higher tendency to cause diseases. It is considered as an RNA virus and can integrate itself to its host cells, thus, causing damage to the cell.

You can read more about this topic since only basic details are provided here.

Summary:
Viruses come in many shapes and sizes, and only replicate when inside living cells.
An adenovirus is a non-enveloped virus, meaning it has no protective coating.
A retrovirus is an example of an enveloped virus, making it more resilient and causes higher tendency of infection or diseases.



https://cmr.asm.org/content/21/4/704
Adenoviruses in Immunocompromised Hosts

SUMMARY

Summary: The number of patients with acquired immunodeficiency has grown steadily as a result of both a larger number of patients receiving solid organ and hematopoietic stem cell transplants and their longer survival times. The use of newer, more potent immunosuppressive regimens has increased the frequency of severe adenovirus infections. Human adenoviruses are a large group of viruses, represented by at least 52 serotypes with various genotypes divided into genomic clusters, and these may cause a broad variety of clinical manifestations. The development of molecular methods has increased the sensitivity and rapidity of adenovirus infection diagnosis. The implementation of PCR assays has significantly contributed to the identification of patients with disseminated adenovirus disease. More recently, the development of real-time PCR assays has permitted virus quantification and patient follow-up. There is no treatment for adenovirus with demonstrated efficacy, although cidofovir is widely used. Sensitive diagnostic tests for adenovirus can contribute to the early diagnosis and successful treatment of life-threatening adenovirus infections, especially in complex immunocompromised patients. The development of improved adenovirus therapy still remains a challenge. Adenovirus genetic diversity should be considered for diagnosis, typing, and therapeutic interventions.

INTRODUCTION

Adenovirus infections were traditionally associated with respiratory, ocular, or gastrointestinal disease, occurring mainly in children and U.S. military recruits as endemic infections or during outbreaks. Over the last years, adenoviruses have increasingly been recognized as significant viral pathogens, with high morbidity and mortality, among immunocompromised patients. This phenomenon may be associated with the growth of the immunocompromised population, especially of patients with acquired immunodeficiencies and more aggressive interventions, with the development of more sensitive diagnostic methods, and with the increased awareness of this virus as a pathogen.