Clinical review finds no evidence of a cluster of a neurological syndrome of unknown cause24 February 2022
FREDERICTON (GNB) – A final investigation report into a potential cluster of a neurological syndrome of unknown cause was released today, offering several recommendations and potential solutions to improve processes related to surveillance and outbreak investigations.
“There can be no doubt these patients are seriously ill,” said Health Minister Dorothy Shephard. “This report means they are ill with other serious diseases, injuries or conditions. The committee noted that some of the patients were in urgent need of immediate followup assessment and care. I am confident our province’s specialists and other health-care providers are fully capable of providing that care, but I advised the patients and their families today that they are welcome to seek a second opinion through a referral from their primary care provider.”
Shephard accepted both Public Health New Brunswick’s final report and an oversight committee report that concluded that no such syndrome exists in New Brunswick.
The oversight committee includes six neurologists, one co-chair from each of the regional health authorities, and one representative from Public Health. It was established last June to provide independent clinical oversight and to make recommendations regarding the 48 cases that were initially identified as part of the cluster.
The clinical review found that each patient displayed symptoms that varied significantly and there is no evidence of a shared common illness or a syndrome of unknown cause. The full report is available online. Public Health released its own report, which is also available online and makes several recommendations to improve the way potential new diseases are reported and investigated.
Dr. Jennifer Russell, chief medical officer of health, said that Public Health is making recommendations that requires regulatory changes and action from levels of government.
“We have made several recommendations to ensure a situation like this does not occur again,” said Russell
Public Health New Brunswick’s recommendations include:
· In the future, Public Health New Brunswick may request a clinical review of cases by a second specialist physician prior to including cases in a cluster of unknown cause. If the two physicians do not agree, the case should be presented to a board of specialty doctors or an oversight committee for a decision.
· The Reporting and Diseases Regulation under the Public Health Act should be amended to require a suspect case of any existing or new variant of human or animal prion disease be reported to Public Health New Brunswick.
· Public Health New Brunswick should continue to build on collaborations with the Public Health Agency of Canada and other federal and provincial partners to improve and modernize the national Creutzfeldt/Jakob Disease (CJD) surveillance system and to establish or improve processes related to outbreak investigations that may arise from this surveillance, including those where prion disease has been excluded. To this end, it supports the creation of a federal, provincial and territorial working group that would support this review.
“The Public Health Agency of Canada is pleased that the investigation has come to a close and supports the investigation’s findings,” said Dr. Howard Njoo, Canada’s deputy chief public health officer. “Over the course of the investigation, the Public Health Agency of Canada provided specialized diagnostic laboratory and neuropathology services and expertise to rule out prion disease, and, through the Canadian Field Epidemiology Program, deployed several epidemiologists and assisted in the development of the epidemiological questionnaire.”
Public Health is recommending all patients who were advised they may have a neurological syndrome of unknown cause, or who may have a neurodegenerative disorder, to contact their primary care provider for a referral to the Moncton Interdisciplinary Neurodegenerative Diseases Clinic or another specialist physician.
The clinic is a cross-specialty, collaborative, precision medicine facility for neurocognitive disorders affecting adults. Its primary goal is to assess, diagnose and provide ongoing care and treatment to patients with progressive neurodegenerative diseases to improve their quality of life and provide family support.