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Mystery Brain Disease Cluster: New Brunswick, Canada (2015 Onward)

EnolaGaia

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Researchers are attempting to identify the cause and nature of a severe neurological condition that has generated two clusters of cases in New Brunswick over the last 6 years.
Mysterious brain disease 'cluster' under investigation in Canada

Officials in Canada are racing to find the cause of a mysterious brain disease that has afflicted more than 40 people in the New Brunswick province, according to news reports.

Symptoms of the mystery illness resemble those of Creutzfeldt-Jakob disease (CJD), a rare and fatal brain disorder; and include memory loss, hallucinations and muscle atrophy ...

Earlier this month, Canadian officials alerted doctors in the New Brunswick area that they were monitoring a cluster of 43 cases of neurological disease of unknown cause, The Guardian reported. The first identified case dates back to 2015, but officials have noted a rising number of cases in recent years, with 24 cases reported in 2020 and six so far in 2021, according to CBC News. Five deaths have been linked with the disease. ...

Doctors first suspected the cases were CJD, which is caused by abnormally folded proteins called prions. But tests conducted so far show no evidence of CJD, nor of any other related prion disease. ...

Multiple research teams are now investigating the cause, which could be a brand-new illness or several different disorders that are already known. ...

Patients with the illness have developed progressively worse symptoms over 18 to 36 months, from unexplained pains and spasms to cognitive decline, muscle wasting and teeth chattering ...

Most cases so far have been identified in the Acadian Peninsula in northeast New Brunswick and near Moncton, a city in southeast New Brunswick ...

FULL STORY: https://www.livescience.com/mystery-brain-disease-cluster-canada.html
 
This Guardian article provides some more details on the investigation and range of symptoms.
Mystery brain disorder baffles Canadian doctors

Residents first learned of the investigation last week after a leaked memo from the province’s public health agency asked physicians to be on the lookout for symptoms similar to Creutzfeldt-Jakob disease – a rare, fatal brain disease caused by misformed proteins known as prions. ...

A number of the symptoms including memory loss, vision problems and abnormal jerking movements triggered an alert with Canada’s CJD surveillance network. Despite the initial similarities, screening produced no confirmed cases of CJD.

“We don’t have evidence to suggest it’s a prion disease,” said Dr Alier Marrero, the neurologist leading New Brunswick’s investigation. ...

Marrero says patients initially complained of unexplained pains, spasms and behavioural changes – all symptoms that could be easily diagnosed as anxiety or depression.

But over 18 to 36 months they began developing cognitive decline, muscle wasting, drooling and teeth chattering. A number of patients also began experiencing frightening hallucinations, including the feeling of insects crawling on their skin. ...

“I don’t really know if we even have a defined syndrome. There just isn’t enough information yet,” said Valerie Sim, a researcher of neurodegenerative diseases at the University of Alberta.

She noted that key markers for degenerative neurological illnesses had not been documented and that the wide range of symptoms in the cluster was “atypical” for most brain diseases. At the same time, certain cancers, dementia or even misdiagnoses could explain the scope of symptoms, she said. ...

FULL STORY: https://www.theguardian.com/world/2021/mar/30/mystery-brain-disorder-baffles-canadian-medicine
 
Given the lack of confirmation of prion involvement with this new mystery syndrome, researchers are looking into environmental toxins as a possible cause.
What's causing N.B.'s mystery neurological disease? Worried residents want answers

... Dr. Neil Cashman understands the concern.

Cashman, a professor in the University of British Columbia's faculty of medicine, is a neurologist with a special expertise in prion diseases ...

Cashman has a pretty good idea what this mystery disease is not.

All the evidence, he said, points to this not being a prion disease such as Creutzfeldt-Jakob disease.

"There is no evidence, not a hint — even in the three autopsies that have been performed — of a human prion disease. That came as a surprise to me, frankly," he said. "So in essence, this is something new, and we need to get on the stick and figure out what this is."

Cashman said he's tapping into his expertise in neurology and environmental toxins to look for other explanations.

The fact that the cases are limited to certain regions "fits with the notion of an environmental toxin," he said.

A possible culprit might be B-methylamino-L-alanine (BMAA), an environmental toxin made by certain bacteria that can accumulate in fish and shellfish.

Domoic acid, another toxin produced by bacteria and that accumulates in shellfish, sardines and anchovies, is another possibility. So is lead, which can be responsible for clusters of neurodegeneration. ...

FULL STORY: https://www.cbc.ca/news/canada/new-brunswick/mystery-neurological-disease-neil-cashman-1.5957196
 
This is horrific.

I'm wondering about genetics. A few pairings between high risk (relatively speaking) people and then you have a pool which, when subjected to a so far unknown trigger, leads to noticeable clusters.
 
"We are very, very worried about it," Godin said. "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."


Interesting possiblity considering the illness is linked to CJD.
 
... Interesting possiblity considering the illness is linked to CJD.

The only linkage (to date) lies in the similarity of symptoms. Tests run on patients and deceased victims have consistently failed to turn up any evidence of CJD or any other prion-based cause.
 
The only linkage (to date) lies in the similarity of symptoms. Tests run on patients and deceased victims have consistently failed to turn up any evidence of CJD or any other prion-based cause.
So cannabilism is still on the table :p
 
Tests run on patients and deceased victims have consistently failed to turn up any evidence of CJD or any other prion-based cause.

I'm wondering why they don't say they have discounted genetics...
 
I'm wondering why they don't say they have discounted genetics...

I don't think they've explored any genetic link so far. Genetic issues aren't among the ones mentioned in any of the news reports I've seen. There's not even any mention of having surveyed the known patients for any familial relationships.
 
A "cluster" may in theory be no more than several random cases that happen to be near to each other.

If something is random, that does not mean that it will be evenly spread. The normal operation of probabilities will result in some cases that are close together (in time and/or geographically) and some areas or periods where there are no cases.

(This could be the same principle that makes a draw of 6 consecutive numbers in the lottery seem somehow "suspicious" compared to a draw of 6 numbers that more obviously appear random.)

One possible explanation is that there is nothing happening at all: just a number of unfortunately people who have fallen ill in the same area within a short space of time. IF it is this, then they will have no more success in investigating the cause than they would have in investigating what is "causing immunity" in the areas where, randomly, there are fewer cases of a disease.

This is only hypothetical, and I dare say the experts have considered this in more detail than I have. There may well be a common cause that needs to be identified.
 
Do they have the results of the/did they do an investigation after the first cluster of deaths?

The two clusters refer to known locations from 2015 onward, not a series of outbreaks one after the other. Specific results of the testing done to date isn't published anywhere anyone cites in the news articles.
 
This Guardian article provides some more details on the investigation and range of symptoms.


FULL STORY: https://www.theguardian.com/world/2021/mar/30/mystery-brain-disorder-baffles-canadian-medicine

That article mentions the difficulties of diagnosis -

News of the unknown illness has prompted concern but experts have cautioned against drawing premature conclusions.

“I don’t really know if we even have a defined syndrome. There just isn’t enough information yet,” said Valerie Sim, a researcher of neurodegenerative diseases at the University of Alberta.

She noted that key markers for degenerative neurological illnesses had not been documented and that the wide range of symptoms in the cluster was “atypical” for most brain diseases. At the same time, certain cancers, dementia or even misdiagnoses could explain the scope of symptoms, she said.

The saga also exposes the frustrating reality of medicine: diagnosing a patient can be tough and it is a task riddled with unknowns. Neurologists can often deploy a number of tools in treating a patient when the root cause of an ailment is unclear, “and then the patient somehow recovers. You come away never knowing what they actually had,” said Sim.

“We see odd neurological syndromes from time to time. Sometimes we figure them out. Sometimes we don’t.”
 
Although they claim to have eliminated prion diseases, after deer were mentioned l keep thinking about chronic wasting disease, an illness affecting deer in North America. lt has been shown to be transmissible to monkeys.

Alternatively, perhaps a new form of Lyme disease?

Or simply, as @Mikefule has suggested, the kind of randomly-occurring conglomeration of cases of neuro symptoms that are bound to occur.

maximus otter
 
Update ...

A committee established by Canadian health authorities released their report after reviewing the initial 48 cases forming the patient base for suspecting a new mystery disease. The committee concluded the patients were suffering from a variety of known conditions rather than a single mystery ailment.
Oversight committee rules out mysterious brain disease in New Brunswick

Nearly a year after New Brunswick health officials raised the alarm about a mysterious brain disease afflicting the province’s residents, an expert committee has determined there is no evidence of such a disease.

“The committee has concluded that no such syndrome exists,” Health Minister Dorothy Shephard told a news conference Thursday. ...

Last March, provincial health officials alerted doctors, nurses and pharmacists about a cluster of residents with an unknown and potentially new neurological syndrome with symptoms similar to those of Creutzfeldt-Jakob disease, but CJD was ruled out in the New Brunswick cases.

“It most likely is a new disease. We haven’t seen this anywhere else,” chief medical officer of health Dr. Jennifer Russell said at the time. The cluster of 48 patients reported symptoms such as rapidly progressing dementia, muscle spasms and atrophy. ...

But after questions were raised about the existence of a new syndrome, Shephard appointed a committee of six neurologists from the province, along with co-chairs from the two regional health authorities and a medical officer of health, to conduct a clinical review. Shephard noted last October that 46 of the 48 cases were diagnosed by a single neurologist.

In their report released Thursday, the committee rules out a common illness among the 48. Although some of the patients had unusual symptoms, the committee wrote, “there is no evidence of a cluster of neurological syndrome of unknown cause.” ...

Instead, the committee found possible alternative diagnoses for 41 of the patients, including Alzheimer’s disease, various forms of dementia, post-concussion syndrome and cancer. Ten of the 48 patients have died and six of them had autopsies completed. “These diagnoses included such conditions as Alzheimer’s disease, Lewy body disease, or cancer,” the report says. ...
FULL STORY: https://globalnews.ca/news/8642475/nb-expert-report-brain-disorder/
 
Update with conspiracy theory:

https://www.theguardian.com/world/a...nada-email-leak-new-brunswick-mystery-illness

But leaked emails viewed by the Guardian tell a starkly different story and suggest senior research scientists in Canada’s public health agency (PHAC) remain increasingly concerned over the cause – and the debilitating symptoms – of an seemingly unexplained illness that disproportionately affects younger people.

Johanne Boucher: ‘I can’t even order a coffee. All I can do is write. I don’t know what I have. The disease remains unknown.’
‘What’s going on with me?’ Canadian victims of mystery illness suffer alone
In an October 2023 email exchange with another PHAC member, Coulthart, who served as the federal lead in the 2021 investigation into the New Brunswick illness, said he had been “essentially cut off” from any involvement in the issue, adding he believed the reason was political.

Coulthart, a veteran scientist who currently heads Canada’s Creutzfeldt-Jakob Disease Surveillance System, did not respond to a request for comment by the Guardian. But in the leaked email, he wrote that he believes an “environmental exposure – or a combination of exposures – is triggering and/or accelerating a variety of neurodegenerative syndromes” with people seemingly susceptible to different protein-misfolding ailments, including Alzheimer’s disease and Parkinson’s disease.

Coulthart argues this phenomenon does not easily fit within “shallow paradigms” of diagnostic pathology and the complexity of the issue has given politicians a “loophole” to conclude “nothing coherent” is going on.

“I believe the truth will assert itself in time, but for now all we can do … is continue to collect information on the cases that come to us as suspect prion disease,” Coulthart wrote
 
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