18 cases of adenovirus have been confirmed by state officials at the Wanaque Center for Nursing and Rehabilitation.

The health department confirmed they are investigating a total of 18 cases of adenovirus, including the six pediatric deaths. But the virus, which the department said was particularly associated with communal living facilities, had severely affected children at the facility who had fragile and compromised immune systems. A team was sent back Tuesday.

Adenoviruses can cause a wide range of illnesses, including the common cold, sore throat, bronchitis, pneumonia, diarrhea, pink eye, fever, bladder infection, inflammation of the stomach or neurologic diseases.

The department said that ages and specific medical information about the conditions the children were facing are not being released to protect patient privacy. The 2001 paper said civilian outbreaks of the type 7 infection had not been frequently reported because of a lack of lab resources, and that the full impact on chronic-care facilities and hospitals is likely underestimated.

State officials were first notified of respiratory illnesses at the center on October 9, officials said.

New Jersey Gov. Phil Murphy issued a statement, saying he was "heartbroken" over the deaths.

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They usually spread through close contact like touching an infected surface or shaking hands, coughing, and sneezing.

In some cases, adenoviruses can be spread through the stool of an infected person, such as while changing a diaper.

The centre helps educate "medically fragile children", according to its website. The young child's death was the seventh death associated with the outbreak at the Wanaque Center for Nursing and Rehabilitation. Those with weakened immune systems may also carry and transmit the virus after they have recovered from an illness, the CDC says.

The center's administrator says its fully cooperating with county, state and federal agencies and has sought out their medical guidance with respect to the virus.

"The Department continues to work very closely with the facility to ensure that all infection control measures are being followed", the department's communications director, Donna Leusner, said in a statement Wednesday.