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A ninth child has died in a New Jersey rehabilitation facility that is now suffering an adenovirus outbreak, according to officials.

The child who died Saturday was medically-fragile with a respiratory illness and had a confirmed case of adenovirus before October 22, the Health Department said.

The department confirmed 25 pediatric cases have been associated with the outbreak. Twenty-five children have been sickened in the outbreak, as has one staff member at the facility. In addition, a premature baby died following the discovery of a bacterial infection at Newark's University Hospital this month, state health officials have said.

Adenovirus causes severe flu-like symptoms but can be even more risky than the typical flu virus. The outbreak won't be declared over until the center can go four weeks without patients being newly infected. The strain of adenovirus in the outbreak is linked to "communal living arrangements" and can be especially unsafe to people with weakened immune systems. Eleven other children remain sick.

"This is a tragic situation, and our thoughts are with the families who are grieving right now", New Jersey Health Commissioner Dr. Shereef Elnahal said in a statement.

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The first symptoms showed up September 26, and the state was notified of an outbreak October 9, officials said.

State health officials said an inspection of the Wanaque Center last weekend found "handwashing deficiencies" and "infection control issues", according to a statement.

She also said the centre is working with the state Health Department and the Centers for Disease Control and Prevention in addition to offering professional grief counsellors and setting up a 24/7 hotline.

Health Department spokeswoman Donna Leusner said Thursday the person had already been ill so the diagnosis does not necessarily mean the virus is still spreading.

The 227-bed, for-profit facility, which is closed to new patients, has a pediatric center and also cares for elderly residents.