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Canada - New Brunswick monitoring more than 48 cases (10 fatal) of unknown neurological disease - 2015+ - officials say illnesses are due to unrelated

Source: https://www.cbc.ca/news/canada/new-brunswick/mystery-brain-disease-ellis-public-health-1.5976428

As toll rises from N.B.'s mystery brain disease, Public Health pledges 'regular updates'
Neurologist leading investigation says 6 people have died and case count is now at 44
Marie Sutherland ? CBC News ? Posted: Apr 07, 2021 6:00 AM AT | Last Updated: 3 hours ago

The death toll of a mystery brain disease found only in New Brunswick has risen to six people from a previously reported five, according to the Moncton neurologist leading the province's investigation into the disease.

In an interview with CBC News, Dr. Alier Marrero also said there are now 44 cases overall, up from the 43 originally reported in March.

But neither Dr. Marrero nor the province's Public Health officials will confirm when or where that sixth person died, or where and when the 44th case was reported...
 
There is a brain disease in wild birds in the US, avian vacuolar myelinopathy, that mimicked TSE's except that the holes were in white matter, not gray. Prions were ruled out, same with viruses and other infections. It turned out after decades of research that a complex interaction between an invasive aquatic plant, a cyanobacterium on the plant, and local bromide pollution was needed to create the neurotoxin. It worked up the food chain and had the most devastating effect in the top level predator.

AVM was thought to be limited to one state, initially, but was eventually found in six states. Something this complex could be involved in the New Brunswick outbreak.

https://flutrackers.com/forum/forum...opathy-bromide-pollution-was-the-missing-link
 
Source: https://www.cbc.ca/news/canada/new-brunswick/neuorological-brain-disease-new-brunswick-1.6003055

Cases of mysterious neurological disease rise to 47
Website offering regular updates on disease to be launched in coming days, Department of Health says
Aidan Cox ? CBC News ? Posted: Apr 27, 2021 5:00 AM AT | Last Updated: 2 hours ago

The government of New Brunswick says there are now 47 cases of a mysterious neurological disease, for which experts are still trying to figure out a source.

As of last Thursday, there have been 37 confirmed and 10 suspected cases of "a neurological syndrome of unknown cause," Bruce Macfarlane, spokesperson for the Department of Health, said in an email Monday.

That brings the number of cases up from 44. The province last reported a new case in early April.

There have been six deaths caused by the disease, with no new deaths reported Monday.

Macfarlane said the province is collaborating with local and national subject matter experts and health-care providers to investigate the individuals showing signs and symptoms of the syndrome.

"At this time, the investigation is active and ongoing to determine if there are similarities among the reported cases that can identify potential causes for this syndrome, and to help identify possible strategies for prevention.

"The investigation team is exploring all potential causes including food, environmental and animal exposures."

Macfarlane said most of the cases are in people who were living in areas around Moncton and on the Acadian Peninsula...
 
Shiloh said:
Source: https://www.cbc.ca/news/canada/new-b...wick-1.6003055

Cases of mysterious neurological disease rise to 47
Website offering regular updates on disease to be launched in coming days, Department of Health says
Aidan Cox ? CBC News ? Posted: Apr 27, 2021 5:00 AM AT | Last Updated: 2 hours ago

The government of New Brunswick says there are now 47 cases of a mysterious neurological disease, for which experts are still trying to figure out a source.

As of last Thursday, there have been 37 confirmed and 10 suspected cases of "a neurological syndrome of unknown cause," Bruce Macfarlane, spokesperson for the Department of Health, said in an email Monday.

That brings the number of cases up from 44. The province last reported a new case in early April.

There have been six deaths caused by the disease, with no new deaths reported Monday.

Macfarlane said the province is collaborating with local and national subject matter experts and health-care providers to investigate the individuals showing signs and symptoms of the syndrome.

"At this time, the investigation is active and ongoing to determine if there are similarities among the reported cases that can identify potential causes for this syndrome, and to help identify possible strategies for prevention.

"The investigation team is exploring all potential causes including food, environmental and animal exposures."

Macfarlane said most of the cases are in people who were living in areas around Moncton and on the Acadian Peninsula...
Click to expand...

What is a "confirmed" case or a "suspected" one when we don't have a diagnosis? Does a case become confirmed when CJD is excluded? Or is there a provisional diagnosis that they have not reported?

I'd love to see a case definition to know how wide of a net is being cast here.
 
Source: https://www.cbc.ca/news/canada/new-brunswick/neuorological-disease-new-brunswick-1.6004813

New Brunswick launches webpage dedicated to tracking mystery neurological disease
Webpage says cases have been found in people aged 18 to 85 years old
CBC News ? Posted: Apr 27, 2021 10:07 PM AT | Last Updated: 12 hours ago

The Government of New Brunswick has launched a webpage dedicated to providing updates on a mysterious neurological disease that's so far infected 47 people and killed six.

The webpage, which is part of the gnb.ca website, was lunched Tuesday and provides an overview of the province's investigation into the cause of the disease, the symptoms it causes and the cases that have been detected so far.

"Since early 2020, physicians in New Brunswick have been identifying a number of individuals with an unusual combination of neurological symptoms," says the site.

"Despite extensive medical investigation, a diagnosis for these individuals has not yet been determined."..
 
Count of cases being investigated is up to 48 as of 5-4-2021. Cases are being referred from the Creutzfeldt-Jakob Disease Surveillance System (CJDSS) when CSF is negative for the CJD marker protein. Public Health calls these 'atypical referrals' and says they represent 'a second cluster, distinct from the first, that was worth further investigation.'

(I'm not sure if that second cluster is rolled into the 48 case count, but I'm guessing it is.)

https://www2.gnb.ca/content/gnb/en/d...o_cluster.html
Some symptoms include, but are not limited to:
  • memory problems
  • muscle spasms
  • balance issues, difficulty walking or falls
  • blurred vision or visual hallucinations
  • unexplained, significant weight loss
  • behaviour changes
  • pain in the upper or lower limbs
Click to expand...
 
The above site indicates that the first cluster of these cases was initially suspected of having a link to cataract surgery, but that is now thought to be ruled out. One can imagine multiple risks from such surgery, ranging from contaminated medication or improperly sterilized instruments to infected matter. I hope they really are sure that this is not a novel prion disease as it seems easy to produce such a cluster because eliminating prions from surgical equipment is notoriously difficult.

It seems the main evidence against a prion disease is simply a negative result for the CJD prion.

I would also hope the epidemiology clearly rules out a contact cluster; the case rate does appear to be roughly constant over the past three years and not increasing.
 
alert said:
The above site indicates that the first cluster of these cases was initially suspected of having a link to cataract surgery, but that is now thought to be ruled out. One can imagine multiple risks from such surgery, ranging from contaminated medication or improperly sterilized instruments to infected matter. I hope they really are sure that this is not a novel prion disease as it seems easy to produce such a cluster because eliminating prions from surgical equipment is notoriously difficult.

It seems the main evidence against a prion disease is simply a negative result for the CJD prion.

I would also hope the epidemiology clearly rules out a contact cluster; the case rate does appear to be roughly constant over the past three years and not increasing.
Click to expand...

New Brunswick Cluster of Neurological Syndrome of Unknown Cause (gnb.ca)

The site is now updated to include the fact that the "first cluster" with links to cataract surgery was only three cases, making it less likely relevant. It is possible that those three are undiagnosed iatrogenic CJD cases and unrelated to this ongoing investigation, or alternatively that the cataract surgery is just a red herring.
 
Cluster of neurological syndrome of unknown cause - Canada - 2013-2020

Opening date: 10 May 2021 Latest update: 12 May 2021

Epidemiological summary

A cluster of neurological syndrome of unknown cause has been reported in New Brunswick, Canada. As of 6 May 2021, 48 cases have been reported, including six deaths. In some cases, more information is needed to determine if the cause of death was a result of this syndrome. Most cases have dates of symptom onset between 2018-2020, except for one case who experienced symptoms in 2013, the gender ratio is 1:1 and age ranges between 18 and 85 years.

Most cases live in the south-eastern and north-eastern regions of New Brunswick, around the Acadian Peninsula and Moncton areas. However, there is no evidence so far suggesting that residents of these regions are at higher risk. Some symptoms include memory problems, muscle spasms, balance issues, difficulty walking or falls, blurred vision or vision hallucinations, unexplained and significant weight loss, behaviour changes, and pain in the upper or lower limbs. A case definition was finalised on 5 March 2021 and sent to New Brunswick physicians to encourage case finding.

The Public Health Agency of Canada's Creutzfeldt-Jakob Disease Surveillance System (CJDSS) has actively investigated the possibility of human prion disease but to date all tests have been negative for known forms of human prion disease.

There is an ongoing investigation from the authorities.

Source: Canadian local health authorities

ECDC assessment
More information is needed to better assess this event. EU/EEA citizens living in or travelling to New Brunswick, Canada, are advised to contact their healthcare provider if they experience symptoms described in this cluster to determine whether they may be related to this cluster investigation.

https://www.ecdc.europa.eu/sites/def...5-may-2021.pdf
 
Source: https://www.cbc.ca/news/canada/new-brunswick/mystery-brain-disease-questionnaire-1.6043062

Public Health begins surveying members of mystery brain disease cluster
Luc LeBlanc hopes the questionnaire provides answers, but worries the clock is ticking
Karissa Donkin, Maeve McFadden · CBC News · Posted: May 28, 2021 5:00 AM AT | Last Updated: 6 hours ago

New Brunswick Public Health has started contacting people who have been diagnosed with a mystery brain disease to answer a questionnaire that they hope will yield vital clues about what's causing the illness.

That comes nearly four months after Public Health said it first drafted a case definition for the neurological illness, which has so far taken six lives and has sickened at least 48 people in total, primarily around the Acadian Peninsula and Moncton areas.

For patients and their families dealing with a disease where symptoms only get worse with time, four months is an excruciatingly long wait...
 
N.B. health minister says investigation into mysterious brain syndrome continues | CTV News

[snip]

Shephard said the clinic now has 81 registered patients since it opened in the spring, although only the original 48 are being studied by an expert committee. "Those first 48 are going to help us determine the path we need to go forward with -- either a potential diagnosis or the potential of going forward with an unknown neurological syndrome," she said.

[snip]
 
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