THURSDAY, Nov. 1, 2018 (HealthDay News) — A 10th child has died in an adenovirus outbreak at the Wanaque Center for Nursing and Rehabilitation in Haskell, N.J., according to the state health department.

The health department said that at least 27 children at the center have become ill, CNN reported.

“To date, the individuals associated with the outbreak became ill between Sept. 26 and Oct. 29,” according to the health department. “The affected children had severely compromised immune systems — including respiratory problems — before the outbreak began.” “It can be difficult to impossible to know how the virus got to the facility, what its source was, or what its specific mechanism of spread is from person to person,” said New Jersey Department of Health Commissioner Shereef Elnahal, M.D., CNN reported. “But we are working with the U.S. Centers for Disease Control and Prevention on this ongoing outbreak investigation.”

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