The U.S. Centers for Disease Control and Prevention (CDC) Friday notified the New Jersey Department of Health that a Mercer County child who died last week tested positive for the respiratory illness enterovirus D68 (EV-D68).

Map of New Jersey/ National Atlas of the United States
Map of New Jersey/ National Atlas of the United States

“Our thoughts remain with the family at this very difficult time,” said Health Commissioner Mary E. O’Dowd. “While the child has tested positive for EV-D68, the cause of death has not yet been determined and it is unclear if EV-D68 played a direct role or was a contributing factor in his death.”

The Mercer County’s child’s death is the first New Jersey child death involving EV-D68.

The CDC also notified the Department Friday of an additional confirmed case of EV-D68 in a Middlesex County child.  Including tonight’s two new confirmed cases of EV-D68, the state currently has nine confirmed cases of EV-D68 in the following counties: Camden, Burlington, Mercer, Middlesex, Morris Essex, Passaic and Sussex.

Related: Rhode Island: Child dies from Staphylococcus aureus sepsis associated with enterovirus D68 infection

From mid-August to October 3, 2014, CDC or state public health laboratories have confirmed a total of 538 people from 43 states and the District of Columbia with respiratory illness caused by EV-D68. The 43 states are Alabama, Arkansas, California, Colorado, Connecticut, Delaware, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.