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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
Tell the truth. Don't blame people. Be strong. Do your best. Try hard. Forgive. Stay the course.-Presidential historian Jon Meacham, speaking of Bush's life code 161

that reportedly occurred at the Maryland congressman's home shortly before 4 a.m. ET on Saturday — hours before Trump first tweeted criticism about Cummings and his home city.It is currently unknown if any property was taken from the home, the BPD said.On Saturday, Trump attacked Cummings, the chair of the House Oversight Committee, as a "bully" and slammed Baltimore, as a "disgusting, rat and rodent infested mess," suggesting that "no human being would want to live there."At a rally in Cincinnati Thursday night, Trump claimed Baltimore's homicide rate is higher than in countries like El Salvador, Guatemala and Honduras. Continuing his remarks on Baltimore, Trump compared the homicide rate to that of Afghanistan, where tens of thousands of people have been killed over the course of the US war there. "I believe it's higher than -- give me a place that you think is pretty bad," Trump said to a member of the crowd. "The guy says Afghanistan. I believe it's higher than Afghanistan."Trump's tirade against Cummings is the latest verbal assault against a minority member of Congress who is a frequent critic of the President. Last month, Trump -- in racist language that was later condemned by a House resolution -- told four progressive Democratic congresswomen of color to "go back and help fix the totally broken and crime infested places from which they came." Three of the four were born in the US, and the fourth is a naturalized US citizen.Responding to some of the President's tweets over the weekend -- in which Trump suggested the congressman needed to spend more time fixing his district -- Cummings said on Twitter: "Mr. President, I go home to my district daily. Each morning, I wake up, and I go and fight for my neighbors. It is my constitutional duty to conduct oversight of the Executive Branch. But, it is my moral duty to fight for my constituents."Cummings has spent decades fighting for the city that is home to his district. It's also the same municipality in which Cummings was born and raised -- and a fundamental part of his story. The son of former sharecroppers, Cummings was born in 1951 and graduated from Baltimore City College High School in 1969.Cummings grew up in the Civil Rights era and recently discussed how, even at a young age, he was part of that movement to integrate parts of his neighborhood."We were trying to integrate an Olympic-size pool near my house, and we had been constrained to a wading pool in the black community," Cummings told ABC's "This Week" earlier this month. "As we tried to March to that pool over six days, I was beaten, all kinds of rocks and bottles thrown at me."The Maryland Democrat said Trump's racist remarks regarding four other members of Congress echoed the same insults he heard as a 12-year-old boy in 1962, which he said were "very painful.""The interesting thing is that I heard the same chants. 'Go home. You don't belong here,'" he told ABC News' George Stephanopoulos. "And they called us the N-word over and over again." 3013
that he was in severe pain after falling ill. "When we try to talk to him, he is just screaming in pain and saying help him please! It is the most devastating thing ever!!" the fundraising post read. His death comes amid a wave of fatalities among American tourists visiting the Caribbean nation this year. At least eight deaths have been reported in 2019.The island's tourism minister, Francisco Javier García, said the deaths are a medically and statistically normal phenomenon. Autopsies show the tourists died of natural causes, García said. This story was originally written by Robert Garrison of 602
Southwest High School - 1685 Hollister Street, San Diego, CA 92154 - In front of school on Hollister StreetVallecitos School District-- Lunch will be available from 11 a.m. to 1 p.m. at Vallecitos Elementary School (5211 5th St, Fallbrook, CA 92028). 250
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