Two specialists must sign off on potentially new cases of mystery disease, memo says

A memo sent to health-care providers across New Brunswick on Tuesday is calling for two specialty physicians to sign off on any new cases of patients who are identified as "potentially having" an unknown mystery brain disease, according to a copy of the memo obtained by Radio-Canada.

The memo, which is signed by Dr. Yves Léger, the acting deputy chief medical officer of health, doesn't say what prompted the new guidelines.

But it comes as the province prepares to provide an update Wednesday at 2 p.m. on its investigation into a cluster of 48 patients, who have symptoms ranging from memory problems to balance issues and hallucinations. 

The province will release a report from Public Health epidemiologists, which may detail the findings of lengthy interviews conducted with patients and their families this past spring and summer. The interviews asked the patients about their lifestyles, including what they ate, where they lived and worked, all to try to find links and commonalities between members of the cluster.

Separate from the epidemiological report, Public Health has formed an oversight committee, made up primarily of neurologists from the province, that will "review clinical and investigative work associated with this cluster." 

"The six neurologists will review all the case files of the 48 affected patients, provide second opinions on the identified cases, ensure due diligence, and rule out other potential causes," the memo says.

It's not yet clear when that committee will report back on its findings. 

Neither group of investigators include neurologist Dr. Alier Marrero, who discovered the cluster and is treating the patients at a specialized clinic in Moncton.

The committee also doesn't include any environmental experts. Both Marrero and Dr. Neil Cashman, a professor in the University of British Columbia's faculty of medicine and a neurologist, have previously pointed to a possible environmental cause.

Part of the memo describes the illness as a "potential progressive neurological syndrome of unknown cause in New Brunswick." 

A previous memo issued by the office of the chief medical officer of health in March seemed more certain that the syndrome is something new and unknown.

"Preliminary investigation conducted in late 2019/early 2020 determined this to be a distinct atypical neurological syndrome," the March 2021 memo says.

At a news conference in June, Health Minister Dorothy Shephard described the illness as a "potentially new and unknown syndrome" and said public health would no longer be using terms like confirmed or suspected cases.

New research published earlier this month concluded eight deceased members of the cluster did not die from something new and unknown. It's not yet clear what effect this new information has had on the province's investigation into the cluster.