The New Jersey Department of Health said in a news release that "another medically fragile child" who had a confirmed case of adenovirus at the Wanaque Center for Nursing and Rehabilitation died Saturday night.
"These children were all largely ventilator dependant and immuno-compromised", said NJDOH spokeswoman Donna Leusner.
The highly contagious adenovirus poses little to risk to healthy people.
A health department spokesman said: "The strain of adenovirus seen in this outbreak is associated with communal living arrangements and known to cause severe illness".
Adenovirus has not been confirmed in another person who died Friday afternoon, officials said. They ranged in age "from a toddler through young adults, but most are under 18".
The facility has been told not to admit any new patients until the outbreak ends.
In some versions of a story October 25 about a viral outbreak, The Associated Press misspelled the name of the New Jersey health commissioner.
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One staff member was also diagnosed but has since made a full recovery, officials said.
The state Department of Health Communicable Disease Service has been on site monitoring the outbreak.
The U.S. Centers for Disease Control was assisting state health officials with testing and "expertise", according to the New Jersey Department.
While noting that the adenovirus vaccine is only available for United States military personnel, the CDC said that to prevent the spread of the virus wash hands often, avoid touching eyes, nose, and mouth with unwashed hands, and avoid close contact with people who have the virus.
One of the teams will be deployed to the Wanaque Centre for Nursing and Rehabilitation in November.
In rare cases among people with weakened immune systems, the viruses may cause pneumonia or inflammation of the brain and the tissues around it.
From 2003 through 2016, the two most commonly reported adenovirus types in the USA were types 2 and 3, though four additional types - 1, 4, 7 and 14 - also caused illness, according to a 2017 report from the National Center for Immunization and Respiratory Disease of the CDC.