Published Date: 2021-03-23 12:24:19
Subject: PRO/EDR> Undiagnosed neurological illness - Canada: (NB) fatal, RFI
Archive Number: 20210323.8256422
UNDIAGNOSED NEUROLOGICAL ILLNESS - CANADA: (NEW BRUNSWICK) FATAL, REQUEST FOR INFORMATION
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[1]
Date: Mon 22 Mar 2021
Source: CBC (Canadian Broadcasting Corporation) News [abridged, edited]
https://www.cbc.ca/news/canada/new-b...hart-1.5959280
News last week [week of 15 Mar 2021] that a cluster of cases of an unknown neurological disease has been found in New Brunswick immediately had residents of several communities on edge.
First diagnosed in 2015, according to a Public Health memo sent this month [March 2021] to medical professionals, the disease appears to be concentrated in the Acadian Peninsula in northeast New Brunswick and the Moncton region in the southeast. 3 cases have been identified, and 5 people have died.
Although the mystery illness has similarities to Creutzfeldt-Jakob disease, known as CJD, a rare and fatal brain disease, the memo noted that "testing for CJD so far has ruled out known prion diseases."
But there's been little further information provided by Public Health, and on Saturday [20 Mar 2021], peninsula mayors said the lack of information has fuelled rampant speculation.
"We are very, very worried about it," said Yvon Godin, the mayor of Bertrand, a village at the northern tip of the peninsula.
"Residents are anxious, they're asking 'Is it moose meat? Is it deer? Is it contagious?' We need to know, as fast as possible, what is causing this disease."
On Monday [22 Mar 2021], Green Party Leader David Coon blasted Public Health's handling of the cases on several levels, saying it's "unacceptable that information involving the health of so many people is being concealed."
Researchers started to gather a year ago to look at this, Coon said. He noted that the case numbers took a jump in 2019, when 11 cases were identified, and again in 2020 when 24 cases were identified.
Chief Medical Health Officer Dr Jennifer Russell has said that 35 of the 43 cases are on the Acadian Peninsula but has not provided further details about where, specifically, they were identified.
Dr Jennifer Russell, the province's chief medical officer of health, has said that 35 of the cases are on the Acadian Peninsula, which encompasses about 14 towns and villages. 8 suspected cases are in the Moncton area.
The provincial Public Health department has not responded to requests for information about where, specifically, in the northeast or the Moncton area the cases have been identified.
And on Monday [22 Mar 2021], the senior scientist heading up the federal arm of the investigation said he could not provide specific information either.
"That is very sensitive information, especially in a very small jurisdiction, population-wise, such as New Brunswick," Michael Coulthart said in an interview. "I can tell you that it is available to us but we cannot share it further."
Coulthart is the director of the federal Creutzfeldt-Jakob Disease Surveillance System, which is providing support to New Brunswick's own investigation of the cluster. He said he wanted to assure anxious New Brunswickers that experts across the country are working to get to the root cause.
"We're undertaking this investigation with all possible vigour and consulting with a wide range of experts, and all of the kinds of expertise that we need are available in Canada.
What is it?
An unknown neurological disease with similarities to Creutzfeldt-Jakob disease, a rare and fatal brain disease
When was it discovered?
A single case was diagnosed in 2015. 3 years later, in 2019, 11 additional cases were discovered, with 24 more cases discovered in 2020, and another 6 in 2021. 5 people have died.
When was it made public?
A [5 Mar 2021] internal memo from Public Health to healthcare professionals was obtained by Radio-Canada and reported by Radio-Canada and CBC News on Wednesday [17 Mar 2021].
Where are the cases?
The disease has so far only been identified in New Brunswick. It appears to be concentrated in the Acadian Peninsula in northeast New Brunswick and the Moncton region in the southeast.
How many cases are there?
43 cases have been identified. Of those, 35 are in the Acadian Peninsula and 8 are in the Moncton region.
Who has been affected?
The disease affects all age groups and affects males and females equally, according to the Public Health memo. About half of the affected individuals are between 50 and 69 years of age.
What are the symptoms?
Symptoms include changes in behaviour, sleep disturbances, unexplained pain, visual hallucinations, coordination problems, and severe muscle and brain atrophy.
Is it contagious?
Because the cause has not been determined, it is not yet known whether the disease is contagious.
What are the possible causes being researched?
- Despite many similarities, tests for Creutzfeldt-Jakob disease have so far ruled out known prion diseases.
- Scientists are currently looking into the possibility that this is a new variant of a prion disease -- or a new disease entirely.
- Neurologists and scientists suspect the cause might be exposure to an as-yet-undetermined environmental toxin.
Who's researching it?
- The disease is the subject of investigation by an all-Canadian team of neurologists, epidemiologists, scientists, researchers, and other experts.
- In New Brunswick, Moncton neurologist Dr Alier Marrero is leading the research. In Ottawa, senior scientist and Creutzfeldt-Jakob Disease Surveillance System director Michael Coulthart is leading the research.
[Byline: Marie Sutherland]
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[2]
Date: Thu 18 Mar 2021
Source: CBC (Canadian Broadcasting Corporation) News [abridged, edited]
https://www.cbc.ca/news/canada/new-b...alth-1.5953478
Public Health is closely monitoring a cluster of more than 40 New Brunswick patients with symptoms similar to those of Creutzfeldt-Jakob disease, a rare and fatal brain disease.
In an internal memo obtained by Radio-Canada, sent on [5 Mar 2021] by the office of the chief medical officer of health to the New Brunswick Medical Society and to associations of doctors and nurses, the department notes the existence of a cluster of 42 cases of a progressive neurological syndrome of unknown origin.
A 1st case was diagnosed in 2015, according to the memo. 3 years later, in 2019, 11 additional cases were discovered, with 24 more cases discovered in 2020 and another six cases in 2021. Five people have died.
The disease affects all age groups and appears to be concentrated in the Acadian Peninsula in northeast New Brunswick and the Moncton region in the southeast.
"We are collaborating with different national groups and experts; however, no clear cause has been identified at this time," the memo states.
According to preliminary data from a research group on the subject, headed by neurologist Alier Marrero of Moncton's Dr Georges-L. Dumont University Hospital Centre, the disease is not genetic and could be contracted from water, food, or air.
No other cases have been reported in Canada. "For now it has only been found here," Marrero said.
Moncton neurologist Dr Alier Marrero, says it's too early to assume the current cases are of a prion disease, an ultra-rare disease for which there is no effective treatment.
The symptoms of the cases detected since 2015 are similar to those of prion diseases, which include Creutzfeldt-Jakob disease and some of its variants, including mad cow disease, or bovine spongiform encephalopathy, or BSE.
However, despite many similarities, tests for Creutzfeldt-Jakob disease have so far ruled out known prion diseases, the Public Health memo states. Scientists are currently looking into the possibility that this is a new variant of a prion disease -- or a new disease entirely.
"These are patients who have clinical features that correspond to prion diseases, of which Creutzfeldt-Jakob disease is one," but show no evidence of having Creutzfeldt-Jakob disease or any other form of prion disease, Marrero said in an interview.
The identified cases were all reported to the Canadian Creutzfeldt-Jakob Disease Surveillance System. Public Health said the location of the cases -- in the northeast and Moncton region -- reflects where the patients lived at the time they were referred to the system, not before that.
Marrero cautioned against rushing to assume the current cases are of a prion disease, an ultra-rare disease for which there is no effective treatment.
"Before coming out with a definition of a new condition, you need to have a lot of information to be sure that you are not diagnosing something else," such as a disease that is treatable, he said.
Symptoms progress over 18 to 36 months
Chief Medical Officer of Health Dr Jennifer Russell said the [5 Mar 2021] memo was intended to alert physicians to this diagnostic possibility when a patient presents certain symptoms.
In an email, New Brunswick Medical Society spokesperson Eric Lewis confirmed the society received the memo and distributed it to physicians on [9 Mar 2021].
Symptoms health professionals will watch out for include changes in behaviour, sleep disturbances, unexplained pain, visual hallucinations, coordination problems, and severe muscle and brain atrophy. Symptoms progress over a period of 18 to 36 months, according to Marrero.
Russell said she is monitoring the situation closely, and that further research is needed to understand the "common links" that could be causing the disease.
"At this point, we have more questions than answers," she said.
[With files from Nicolas Steinbach/Radio-Canada]
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[As of 28 Feb 2021, since January 1998, 36 cases of CJD in New Brunswick have been reported to the Canadian CJD surveillance system (
https://www.canada.ca/en/public-heal...ce-system.html), the number of new cases reported in March 2021 appears to be much higher. The report also mentions that the disease symptoms are similar to CJD, but diagnostic tests have ruled out known prion diseases.
The latest report also highlights that there may be a possible common exposure to an as-yet-unidentified toxin. Other differential diagnoses to be considered include metabolic disorders, vascular dementia, infections (encephalitis), and immune-mediated diseases. However, the timeline and clustering of cases are peculiar and indicative of a likely common source.
Further information in this regard from public health personnel and scientists will be helpful to understand the underlying cause. - Mod.UBA
