WANAQUE — Four more children have been diagnosed with adenovirus at the Wanaque Center for Nursing and Rehabilitation in Haskell bringing the number residents and patients with confirmed cases to 23, according to the state Department of Health.

Seven "medically fragile children" have died from the virus.

All those affected, whose age range from infant to young adult, became ill between Sept. 26 and Oct. 22. The center has stopped admitting new patients until the outbreak ends.

Adenoviruses commonly cause respiratory illness. They can result in mild to severe illness, produce cold-like symptoms and cause illnesses such as sore throats, bronchitis, pneumonia, diarrhea, pink eye, fever, bladder inflammation or infection, inflammation of the stomach and intestines and neurologic diseases.

The strain of adenovirus in this outbreak is associated with communal living arrangements and is known to cause severe illness—especially in those with compromised immune systems. The Centers for Disease Control and Prevention is also involved with the investigation.

State health officials continued investigating how adenovirus became present and spread at the 227-bed facility.

The DOH said it is possible that lab tests will reveal additional cases and a representative remains on site for the duration of the outbreak. A DOH inspection team on Sunday found minor hand-washing deficiencies. Health officials said they continued to work with the center on infection control issues.

State Health Commissioner Shereef Elnahal told NorthJersey.com on Thursday the facility did not have any place to quarantine children once they were diagnosed. He said that with all the vulnerable patients at Wanaque, it was the worst place for such an outbreak to occur.