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State health officials have said the outbreak can be declared over only once four weeks pass without an additional case. Symptoms may appear two to 14 days after being exposed to the virus, the state health department said.The children affected by the outbreak became ill between September 26 and November 12, according to the health department. The number has risen from 18 cases, including six deaths, announced last month by the health department.A staff member was also affected by the outbreak but has recovered.The outbreak in the Wanaque facility was caused by adenovirus type 7. This type is "most commonly associated with acute respiratory disease," according to the US Centers for Disease Control and Prevention."This is an extremely severe strain of adenovirus that couldn't have occurred in a worse place," Elnahal said Friday.Other types of adenovirus infections can cause flu-like symptoms, pinkeye and diarrhea.Eight cases of adenovirus have also been found among children at a second New Jersey facility, Voorhees Pediatric Facility. However, tests suggest that the culprit is adenovirus type 3, a different strain than the one in Wanaque.Patients at the Voorhees facility became ill between October 20 and November 9. A previous inspection by the state health department found no infection control problems and issued no citations.Health officials say they are stepping up efforts to strengthen infection control at such facilities in the state. The health department announced plans last month to deploy a team of infection control experts to visit University Hospital and four pediatric long-term care facilities this month, including the Wanaque and Voorhees facilities, where experts will train staffers and evaluate how these facilities prevent and control infections."Facility outbreaks are not always preventable, but in response to what we have seen in Wanaque, we are taking aggressive steps to minimize the chance they occur among the most vulnerable patients in New Jersey," Elnahal said in a statement.Adenoviruses are often spread by touching a contaminated person or surface, or through the air by coughing or sneezing. They are known to persist on unclean surfaces and medical instruments for long periods of time, and they may not be eliminated by common disinfectants, but they rarely cause severe illness in healthy people. However, people with weakened immune systems have a higher risk of severe disease, and they may remain contagious long after they recover, according to the CDC.The infections and deaths come amid questions -- from former Wanaque Center employees, the mothers of children who got sick at the facility, and Elnahal himself -- about whether facility standards are high enough and whether more could have been done to prevent this from happening.Elnahal said in a statement that the findings of a recent unannounced health inspection at the Wanaque facility "raise questions about whether these general longterm care standards are optimal for this vulnerable population of medically fragile children."In statements last month, the Wanaque facility said that it's working alongside health experts to investigate the outbreak and that it "promptly notified all appropriate government agencies when the virus was initially identified." According to state health department spokeswoman Nicole Kirgan, health officials were notified of respiratory illness at the facility on October 9, and the facility notified parents 10 days later, on October 19.The facility has declined multiple requests for comment. 3555

Swastikas have appeared in at least a handful of US cities since a massacre in Pittsburgh in which 11 worshippers were killed.On Wednesday morning, a New York resident posted pictures of swastikas that had been scrawled on homes in the Brooklyn Heights neighborhood.The Nazi symbols also appeared on Navy property this week in Bucks County, near Philadelphia. Warminster Township Manager Gregg Schuster posted online that local officials have been in contact with the Navy to get the symbols removed."The use of the swastika is a cowardly act," he said. "In light of what our neighbors in Pittsburgh recently went through, I hope we can refrain from using these symbols of hate. There is no place in Warminster for this disgusting act and I know our community will never accept this behavior."A swastika also was found scrawled on a piece of paper in an elevator Monday at the Eastman School of Music in Rochester, New York, according to CNN affiliate WHAM.Also this week, authorities said a synagogue in Irvine, California, had been vandalized with anti-Semitic graffiti.Someone spray-painted "F*** Jews" early Wednesday on the wall of Beth Jacob Congregation in Irvine, police said.Anti-Semitic incidents have been increasing in the United States in the last few years, according to the Anti-Defamation League.The Rabbinical Assembly, an international association of conservative rabbis, said last weekend's shooting is a reminder that anti-Semitism "is on the rise in America at a rate unprecedented in decades."There were 151 anti-Semitic hate crimes complaints in the city of New York in 2017, according to a report on the police department website. 1654

Sister Joan Emily Kaul served as a secretary for many parishes in the area on top of teaching. It was her smile that cut through to people’s hearts; bringing joy to many. 170

Shortly before 11 p.m. Thursday, patrol officers and paramedics responding to a 911 call found Sanchez and Mekrai in a car parked at Palm and Twining avenues in Otay Mesa, suffering from gunshot injuries, Lt. Matt Dobbs said. 225

The 2nd-generation Amazon Echo home assistant speaker retails for .99.But big box giant Target sold the product for various prices throughout 2018. Here’s how much it cost on some of the year’s biggest holidays: 224