The New Jersey Health Department confirmed that 18 cases of adenovirus have now hit the Wanaque Centre for Nursing and Rehabilitation in Haskell, northwest of New York.
The outbreak of the virus, which can cause cold and flu-like symptoms, is affecting medically fragile children.
Some of those are on ventilators and have had trachea tubes inserted, reported news.com.au.
Department spokeswoman Nicole Kirgan said: “Unfortunately, the particular strain of adenovirus (7) in this outbreak is affecting medically fragile children with severely compromised immune systems.
“The strain has been particularly associated with disease in communal living arrangements and can be more severe.”
The Centres for Disease Control and Prevention (CDC) said the virus strain is usually associated with acute respiratory illness.
The health department has not released the ages of the children who have died, but said the deaths at the Wanaque Centre for Nursing and Rehabilitation took place in the past month.
The Wanaque facility has been “instructed not to admit any new patients until the outbreak ends”.
Dr William Schaffner, an infectious disease professor at Vanderbilt University Medical Centre, said these kinds of fatalities are not common, but they’re known to happen.
He said: “Here I think you have this kind of nasty combination of very fragile children and this particularly aggressive virus.”
Adenoviruses attack soft tissue linings in the respiratory tract, eyes and nervous system and often cause mild illness, particularly in young children, but people with weakened immune systems are at risk of getting severely sick.
The New Jersey Health Department says it is conducting “an on-going outbreak investigation”.
Local media says initial reports from investigators indicate staff had “minor hand washing” procedural deficiencies.
The Centres for Medicare and Medicaid Services recently gave the facility a “below average” performance rating, reported NJ.com.
The 2017 report said the facility “failed to ensure infection control practices were followed.”
However, the facility was given an “above-average” overall score based on its staffing levels and quality of resident care.
An outbreak of adenovirus 7 at a US Navy training centre in 1997 sickened some 350 people.
What is the Adenovirus and how is it treated?
Adenoviruses are a group of viruses that typically cause respiratory illnesses, such as a common cold, conjunctivitis, croup, bronchitis, or pneumonia.
In children, adenoviruses usually cause infections in the respiratory tract and intestinal tract.
There is no cure for adenovirus infections.
If a child is infected, treatment is supportive and is focused on relieving the symptoms associated with the infection.
Because the infection is caused by a virus, antibiotics are not effective.
Strict hand-washing is important to prevent the spread of adenoviruses to other infants, children, and adults.
Governor Phil Murphy said in a statement that he was "heartbroken" about the deaths.
He had been briefed by the health commissioner, Dr Shereef Elnahal, who told him that the department is on site and trying to prevent the virus from spreading further.
He said: "I am confident that the steps being taken by state and local officials will minimise the impact to all those who remain at the facility, including patients and employee.”
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