Doctors in New Brunswick are being told to be on the lookout for symptoms of an unknown neurological disease that appears to be a new condition found only in the province and is believed to be linked to environmental causes.
At a public health update on COVID-19 Thursday, Dr. Jennifer Russell, the province’s chief medical officer of health fielded a number of questions about the mystery disease that was originally identified in the province in 2015.
In an internal memo obtained by Radio-Canada, sent on March 5 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 highlighted a cluster of 42 cases of a progressive neurological syndrome of unknown origin.
Symptoms similar to Creutzfeldt-Jakob disease
The disease has symptoms similar to those of the rare and fatal Creutzfeldt-Jakob disease, but “testing so far has ruled out known prion diseases,” the memo stated.
The first case of the disease was diagnosed in 2015, according to the memo. Three years later, in 2019, 11 additional cases were discovered, with 24 more cases discovered in 2020 and another six in 2021. Five people have died.
The symptoms 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 (BSE).
However, despite many similarities, tests for Creutzfeldt-Jakob disease have so far ruled out known prion diseases, the March 5 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.
On Thursday, Russell confirmed it is “most likely a new disease,” and noted “we haven’t seen this anywhere else” in Canada.
The cases have been reported to Health Canada’s Creutzfeldt-Jakob disease surveillance system, which determined that the rising number of cases should now be considered a cluster, Russell said.
At that point, she said, the March 5 memo was sent out to the province’s health-care professionals.
Doctors suspect environmental link
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.
“We don’t know yet where this is coming from,” but the leading hypothesis so far is that it’s environmental, Marrero said in an interview with CBC News on Thursday.
“We believe it is acquired from exposure to something in the environment … either food, water … toxins.”
Over the course of the six years since the disease first appeared in New Brunswick in 2015, case numbers have grown steadily and “clustered” in the Moncton and Acadian Peninsula areas of the province.
“We have seen clustering of cases in some areas and we don’t know why,” Marrero said.
According to the Public Health memo, the median age of the cases is 59 years, although female cases tend to be younger, with an average age of 54. Cases are distributed equally among men and women, the memo said.
The symptoms of the disease are typically not very specific in the initial stages.
“It’s usually behavioural changes … for instance, an excess of anxiety, a little bit of irritability, unexplained pains in the limbs, muscle spasms, insomnia,” Marrero said.
As the disease progresses over a course of 18 to 36 months, loss of balance and co-ordination have been observed, and “sometimes patients have abnormal and rapidly progressing brain atrophy.”
No public health threat
However, Marrero and Russell both stopped short of calling the cases a public health threat.
“Fear is usually bad advice because it will paralyze us,” Marrero said. “We are working very hard to figure this out, so we can stop it, so we can treat it.”
He advised that if anyone suspects they have symptoms of the disease, they should report them to their doctor, who will then refer them to the clinic.
Symptoms that might appear to be related to the disease could actually be caused by another condition, he said.
“For instance the patient could have multiple sclerosis, they could have Alzheimer’s disease … or some other condition that could be known and treated. So it’s important that they get referred and evaluated.”
“Right now, it’s just about awareness, making sure that physicians are watching for neurological symptoms like this so they can refer them to be assessed,” she said.
“We have a lot of work ahead of us in terms of trying to determine the cause.”
Internal documents, obtained by the New Brunswick Nurses Union and shared with CBC News, show universities weren’t trying to enrol more nursing students all these years — they were trying to afford the ones they already had.
“We’re in the midst of the crisis,” said Paula Doucet, president of the nurses union.
“Had they listened to us many years ago and put precautionary measures in place, we probably wouldn’t be having this conversation today.”
It was something that we needed to uncover.”– Paula Doucet, New Brunswick Nurses Union
With a critical shortage already looming back in 2005, the province entered an agreement with the University of New Brunswick and the University of Moncton to graduate more nurses.
The province would give them about $ 15,000 annually for each new nursing seat created. The universities were to add 100 seats to their year one classes.
But the number of students didn’t rise. It fell — a puzzling outcome that finally pushed the union to take the “extreme” step of making a right to information request to get answers.
“We kind of questioned over the years, because of the number of graduates that were coming out of the program … the numbers weren’t there,” said Doucet.
The union obtained several documents related to the 2005 agreement. They include emails between the universities and the Department of Post-Secondary Education, starting in 2018.
In the correspondence, the schools cite financial challenges related to the nursing program and question their ability to increase enrolment. They also express frustration at the lack of communication with government.
The documents also include the text of the 2005 agreement, which was never released publicly.
In addition to the funding for new seats, the agreement recognizes the high costs of training nursing students and says the province will give universities $ 3,300 annually for each nursing student they already have.
But in the emails, the universities tell government the costs to nursing faculties have exploded in the past 15 years, and the funding hasn’t been sufficient.
“There is no way we could contemplate increasing enrolment,” reads one message from UNB.
Why is teaching nursing so expensive?
Nursing is one of the most expensive programs to run at any university, because the costs increase rather than drop for each student taken on.
For example, it costs $ 24,000 to offer nursing to one student for one year at UNB, about three times the cost of a student in the arts and science program.
The University of New Brunswick and University of Moncton received provincial money for years to address the nurse shortage and create more seats for nursing students. But instead of creating seats, the universities dropped some. What happened? 3:00
Even with tuition being slightly higher than for other degrees— currently at $ 8,411 — the universities say they absorb an annual deficit of about $ 12,000 per nursing student and have always had to take money from other parts of their budgets.
What makes nursing so pricey is the hands-on training, which makes up more than a third of class hours.
It’s done in small groups of seven, which means rather than paying one professor to lecture to an auditorium full of students, dozens of additional experts have to be hired each semester.
The current nursing shortage has only compounded the problem, by driving up costs to hire those clinical experts.
Hospital nurses don’t have time to train students the way they used to, so universities have to recruit more professors instead.
Over the past 15 years, the costs to the faculty of nursing have risen twice as fast as those of other programs, according to an email from U of M to the province written in January 2019.
The emails show the universities expressing concern to the previous Liberal government.
Over the years, as part of the 2005 agreement, both UNB and U of M had to return money to the government when they missed targets for increased enrolment. U of M had to repay all of it, UNB half.
In 2018, the schools tell the province the agreement isn’t working and ask that it be revisited. They are told to wait until after the October election.
Then in January 2019, after the Progressive Conservatives have come to power, UNB submits a proposal to the province to address the nursing shortage.
It would see the province cover the entire shortfall, about $ 12,000 per nursing student, and UNB increase enrolment to full capacity — 800 students in its four years of the bachelor program, up from about 500 currently.
The university explains its costs rose from $ 16,800 per nursing student in 2011-2012, to $ 24,000 in 2017-2018.
That’s a 43 per cent increase over six years — or six per cent annually.
“The current provincial nursing shortage has magnified these costs since floor nurses are unavailable to be released from regular duties to supervise clinical training,” UNB writes.
Around the same time, UNB’s nursing faculty was asking school administration to scrap its licensed practical nurse bridging program because of money struggles. The program had been created in 2013 as an effort to address the nursing shortage.
But the school’s emails to the Department of Post-Secondary Education, and its request for a meeting to discuss the proposal, go unanswered.
“I think this makes three requests for a reply, with none,” George MacLean, UNB’s vice-president of academic, writes in March 2019.
Then suddenly, the school learns of the cuts coming its way.
While focusing on enrolment to defend the cut, Health Minister Ted Flemming said nothing of the other consequence of ending the agreement: the universities lost the $ 3,300 for each existing student to help with clinical training.
They need to invest, but there needs to be some accountability.– Paula Doucet, New Brunswick Nurses Union
“The minister said funding was cut because we never met the seat target,” wrote Karen Cunningham, UNB’s vice-president of administration and finance in an email.
“Absolutely no acknowledgement that clinical has a high cost and that is also cut in this decision.”
The cut, coupled with a PC-imposed tuition freeze, plunged UNB into a $ 2.5 million structural deficit, the emails reveal, with the university contemplating its options.
“I fear that we will be unable to continue to protect our people to the same extent now, however, with the result that many essential services to students and administrative support will suffer,” Eddy Campbell, UNB president at the time, says in an email.
Hundreds of future nurses turned down
All this was happening as UNB continued to have long wait lists for its nursing program, with hundreds of students being turned away each year.
Upon learning the 2005 agreement was being done away with, Campbell warns that nursing seats will decline in the fall.
Enrolment of first year nursing students fell to 136 in September 2019, the lowest number in more than a decade, and some 20 students fewer than last year.
“Funding has never been sufficient and this is part of the reason it became unsustainable and enrolment caps became necessary,” UNB wrote to the province when it was pleading for more money.
“With reasonable funding, there is growth possible within UNB’s structure.”
For Paula Doucet, it’s been a frustrating process learning why more nurses haven’t been graduating from New Brunswick’s universities.
“It was very disheartening, but it was something that we needed to uncover because the math didn’t add up,” she said.
In July, the Higgs government announced its 10-year nursing strategy, with $ 2.3 million this year focusing on bringing nurses from other countries and provinces, and $ 500,000 for the bridging program for licensed practical nurses to become registered nurses.
To Doucet, those are Band-Aid solutions.
“I really don’t think they understand the complexity as to why we have the nursing shortage that we do.”
Doucet said nursing programs are underfunded, but she believes there needs to be some accountability as well to make sure more nurses come through.
“The universities are not producing enough,” she said. “For supply and demand, we are nowhere in the ballpark of doing that.
“They need to invest, but there needs to be some accountability that the money that the government is giving universities is earmarked specifically for the faculty of nursing.”
No plan for new seats
The government doesn’t have any plans to increase funding for nursing faculties.
A spokesperson for the Department of Post-Secondary Education said it has asked the universities to fund their nursing programs within the regular operating grants they receive each year.
UNB gets $ 115 million from the province and U of M gets $ 66 million.
When asked why its nursing strategy didn’t specifically target the issue of nursing seats, the province said it was a question of efficiency.
“To address the current and future nursing shortage in our province, government is taking action to quickly train more registered nurses to work in the health care system now, versus only relying on new graduates in four years,” said Leigh Watson, communications officer for the department.
The bridging program that allows licensed practical nurses to jump to year three of the bachelor of nursing program now has 26 registered students.
While the health authorities say they need to hire 520 new nurses annually, the province disagrees with that number, and has estimated an additional 130 a year will do.
There are currently about 8,000 registered nurses in New Brunswick.
Earlier this month, the province’s auditor general came down on the 2005 agreement, questioning why $ 96 millions in incentives had been handed out to universities, without the promised increase in the number of nursing students.
CBC News reached out to both UNB and U of M for an interview, but they did not make anyone available.
The Nurses Association of New Brunswick, a regulating body for nurses, also declined to be interviewed, saying that without details about funding and the needs of the universities, it could not offer much to the story.
On the same day pro- and anti-vaccination views clashed in the New Brunswick Legislature, far from that clamour Marissa Gootjes took to the ice again to play hockey at a camp in Woodstock after a break of two years.
It was a refreshing return to regular life for her family after a measles outbreak in May forced them to whisk Marissa from school weeks before the end of her Grade 10 school year.
The 15-year-old brain cancer survivor has a compromised immune system after chemotherapy treatments that followed her diagnosis two years ago.
It has been a difficult time for the family, capped off by the measles setback. Marissa’s mother Jan Gootjes held back tears as she watched her daughter skating again.
“It’s so huge, because we watched her during treatment. She tried to stay in hockey and tried to play and she just couldn’t do it,” she said.
“It was very heartbreaking to see her struggle. She lost the ability to skate backwards completely. As soon as she would try to skate backwards she’d fall. And she lost so much conditioning. Just one skate across the ice and she’d just be gasping for breath and air.”
Marissa, the eldest of three girls, went back to Kennebecasis Valley High School in Rothesay, not far from her home in Quispamsis, last year for days that sometimes left her fatigued and nauseous. She came home to nap and cuddle with her dog, Bauer. She had the immune system of a newborn baby.
In May health officials in southern New Brunswick announced a measles outbreak of 12 confirmed cases. Nine of those cases were at Marissa’s high school.
Bill would make N.B. strictest in Canada
New Brunswick and Ontario require parents of schoolchildren to show proof their child has been vaccinated. Both provinces allow parents to exempt their children for medical or ideological reasons.
New Brunswick’s laws have been in place since 1982 for measles, mumps, rubella, diphtheria, tetanus and polio.
Following the outbreak in the Saint John area, New Brunswick’s Liberal government introduced proposed legislative changes in June that would change those laws to allow only medical exemptions, essentially making vaccination mandatory for all children in public school.
The law would also apply to children in licensed daycares and would make New Brunswick the strictest jurisdiction in Canada on immunization.
Marissa Gootjes, 15, is back on the ice after recovering from a malignant brain tumour and then being isolated during the measles outbreak. Now, Marissa and her parents are pushing for mandatory vaccinations in the province. 0:53
For three days this week, lawmakers are scheduled to hear from a long list of speakers with both pro and anti-vaccination views. It is an opportunity for the public to directly tell politicians how the proposed law should be shaped.
The speakers list included Dena Churchill, a former chiropractor from Nova Scotia who lost her licence after posting unfounded and disproved information about vaccination extensively on social media.
“I haven’t vaccinated my children,” Churchill told reporters outside the hearing. “I think vaccination should be left to the individual, to look at the individual circumstance and their health. So mandating any policy, I think, is really risky.”
Those arguments haven’t swayed Education Minister Dominic Cardy, who’s strongly supporting the bill.
“I think that in general, the people that are against science and against evidence undermine their own cause every time they open their mouths,” he told reporters.
“You just have to remember that if we’re going to follow the science, follow the evidence, there are no two sides to this debate — like there are no two sides to whether the earth is flat.”
Cardy said in his view the bill was about protecting vulnerable school children.
During the May measles outbreak, school officials immediately notified Jan Gootjes that her daughter might have been exposed to the potentially deadly disease.
‘Worst part for sure’
On the advice of her doctors, the Gootjes family took Marissa out of school the same day, rushed her to the hospital for emergency preventative treatment, and kept her at home for three weeks. She couldn’t go out or receive visits from friends for fear of re-exposure to measles.
“That was the worst part for sure: just feeling like she was getting back to normalcy and then having the rug pulled out from under her again,” said Jan Gootjes.
Gootjes is looking forward to seeing her daughter heading to class in September, hanging out with her friends, playing sports, and enjoying the school year.
But Marissa still won’t be able to receive vaccinations for at least another three months.
“And because she can’t be vaccinated, that’s a concern,” Gootjes said. “We have to depend on other people who can be vaccinated to do so, so that we have that herd immunity in place.”
Marissa’s view on vaccinations is that they should be mandatory.
“If everyone gets vaccinated, it means I can definitely go to school, and I will be safe,” she said.
“I think they should be mandatory. Because in the middle of May, an entire school had to just stop, almost get shut down. A lot of us had to go home just because a few people didn’t get the right shots. So I think it’s important that everybody does,” she said.
After hearing from the public this week, the law amendments committee will have an opportunity to recommend changes to the bill before it returns to the legislature for second reading.
If the bill passes, the changes would take effect Sept. 1, 2021.
SYDNEY, N.S. — After a blanked first end, nobody was predicting a record score in the game between Prince Edward Island and New Brunswick Tuesday afternoon at the Scotties Tournament of Hearts.
But after that cautious start, a back and forth of granite blows led to the highest scoring game in Scotties history.
Suzanne Birt's team from P.E.I. scored a single point in an extra end to defeat N.B.'s Andrea Crawford rink 13-12. The 25 points between the two teams surpassed the previous record of 23, set in 1988 and matched in 2009.
"It was a roller-coaster game. A lot of missed shot and made shots," Birt said after the marathon match. "The fans got their money's worth today."
It looked as though P.E.I. was going to cruise to victory after stealing five points in the second end. But New Brunswick wouldn't go away.
WATCH | Birt, Crawford combine for highest scoring game at Scotties:
Prince Edward Island's Suzanne Birt edges New Brunswick's Andrea Crawford 13-12 in Draw 10. The combined points of 25 sets a new record for the highest-scoring game at the Scotties Tournament of Hearts. 1:01
New Brunswick erased deficits of 5-0, 8-4 and 12-9, scoring three in the 10th to tie the game 12-12 and send it into extras.
Birt said she can't remember ever playing in a game that featured such dramatic swings.
"I think you just have to go back to basics. Take a deep breath and do what you're familiar with. Just try to make shots," she said.
With the win, Birt's team is tied atop the Pool B standings with Casey Scheiddeger's Team Wild Card at 4-1. Both have two games remaining in the preliminary round.
"We were here trying to get the best record going forward so our record is good right now but we have to stay focused," Birt said.
WATCH | Wild Card Scheidegger defeats N.W.T.'s Galusha, tied for 1st in Pool B:
Wild Card Casey Scheidegger beats North West Territories' Kerry Galusha 6-5 in Draw 10 at Scotties. Scheidegger improves to 4-1, Galusha falls to 3-2. 0:39
Birt's wasn't the only wild affair Tuesday afternoon.
Jennifer Jones scored five points in the first end against Yukon but it was a grind the rest of the way. At one point Yukon closed the gap to 7-5 before Jones finally closed out the game, 9-7.
"The ice was curling a bit more so you can actually make some finesse shots which earlier in the week we couldn't. It was more fun," Jones said.
The win improves Team Canada's record to 3-2 after Jones lost both games on Monday.
Jones credited the five-rock rule for the high scoring. It's the first year for the new rule at the women's national championship.
"The five-rock rule is great," she said. "I think it's way better. It keeps a lot of rocks in play. But to be honest I think the scores today was because of the curl in the ice."
Also, Saskatchewan defeated Newfoundland and Labrador 8-4 to improve to 3-2 and Scheidegger defeated Northwest Territories 6-5 to move to 4-1.
In total, 64 points were scored across the four sheets on Tuesday afternoon.
WATCH | Northern Ontario's McCarville beats B.C.'s Wark at Scotties:
Northern Ontario's Krista McCarville defeats British Columbia's Sarah Wark 8-7 in Draw 9 at the Scotties Tournament of Hearts. 0:37
"Something in the water, maybe? I'm not sure what led to it but a lot of shots missed and made," said Saskatchewan skip Robyn Silvernagle.
Scheidegger said the teams are still trying to figure out the ice and it's leading to some explosive scoring.
"I think it's just struggling with the ice a little bit. High pressure. I know ourselves included it took us a while to figure it out. I think that could be part of it," she said.
Ontario skip Rachel Homan delivers a rock against Manitoba on Tuesday morning at the Scotties Tournament of Hearts in Sydney, N.S. Homan suffered her first loss at the event, 6-5 to Manitoba’s Tracy Fleury. (Andrew Vaughan/Canadian Press)
In Pool A play, Rachel Homan suffered her first loss at the Scotties.
The Ontario skip dropped a 6-5 decision to former provincial rival Tracy Fleury, now representing Manitoba, in the morning draw.
Homan (4-1), a three-time Canadian champion, couldn't hold onto a 4-1 lead after scoring three in the second end and one in the third.
It was a much-needed victory for Fleury (3-2), who has now won three in a row.
Northern Ontario's Krista McCarville and B.C.'s Sarah Wark are locked in a three-way tie for third in Pool A. McCarville beat Wark 8-7 in an extra end on Tuesday morning to cause the logjam.
Alberta's Chelsea Carey (5-0) pulled in front of Homan for top spot in Pool A after a 10-5 win over Nunavut's Jenine Bodner.
In the other morning game, host Nova Scotia picked up its first win as Jill Brothers downed Quebec's Gabrielle Lavoie 7-4.
Another Pool A draw was scheduled for Tuesday evening.
The top four teams from each pool in the preliminary round will qualify for the championship round starting Thursday. The playoffs start Saturday and the final will be played Sunday.
The federal government is investigating 21 cases of E. coli in three provinces that are believed to be linked to the consumption of romaine lettuce.
The Public Health Agency of Canada says 13 individuals in Newfoundland and Labrador, five in New Brunswick and three in Quebec became sick with E. coli in November — 10 of which had to be hospitalized. No deaths have been reported.
Those who became ill are between 5 and 72 years old, and 71 per cent are female.
In Newfoundland and Labrador, the Department of Health and Community Services confirmed that all 13 cases happened in the Eastern Health region, and that all were diagnosed between Nov. 18 and 26.
The department said four of the 13 who were diagnosed were hospitalized.
No product recalls
Many of those diagnosed reported eating romaine lettuce before their illness started, and The Canadian Food Inspection Agency is working with public health officials to determine the source of the lettuce the individuals were exposed to.
At this time, there are no product recalls associated with the outbreak.
E. coli are bacteria that live naturally in the intestines of cattle, poultry and other animals. Most E. coli strains are harmless to humans, but some varieties cause illness.
E. coli are bacteria that live naturally in the intestines of cattle, poultry and other animals. Most E. coli strains are harmless to humans, but some varieties cause illness. (Flicker CC/National Institute of Allergy and Infectious Diseases (NIAID), NIH)
The risk to Canadians is low, according to the Public Health Agency of Canada, and Canadians are reminded to follow safe food handling practices for lettuce.
Most people with an E. coli infection will become ill for a few days and then recover fully. Some E. coli infections can be life threatening, though this is rare, the agency says.
The following is information from the Public Health Agency of Canada on how to protect against E. coli infection and how to identify symptoms.
What you should do to protect your health?
The following food safety tips for lettuce will help you reduce your risk of getting an E. coli infection.
Wash your hands thoroughly with warm water and soap for at least 20 seconds, before and after handling lettuce.
Discard outer leaves of fresh lettuce.
Wash your unpackaged lettuce under fresh, cool running water. There is no need to use anything other than water to wash lettuce. Washing it gently with water is as effective as using produce cleansers.
Keep rinsing your lettuce until all of the dirt has been washed away.
Don’t soak lettuce in a sink full of water. It can become contaminated by bacteria in the sink.
Ready-to-eat lettuce products sold in sealed packages and labelled as washed, pre-washed or triple washed do not need to be washed again.
Use warm water and soap to thoroughly wash all utensils, countertops and cutting boards before and after handling lettuce to avoid cross-contamination.
Store lettuce in the refrigerator for up to seven days. Discard when leaves become wilted or brown.
Bagged, ready-to-eat, pre-washed lettuce products should also be refrigerated and used before the expiration date.
What are the symptoms?
People infected with E. coli can have a wide range of symptoms. Some do not get sick at all, though they can still spread the infection to others. Others may feel as though they have a bad case of upset stomach. In some cases, individuals become seriously ill and must be hospitalized.
The following symptoms can appear within one to ten days after contact with the bacteria:
Severe stomach cramps
Watery or bloody diarrhea
Most symptoms end within five to ten days. While most people recover completely on their own, some people may have a more serious illness that requires hospital care, or may lead to long-lasting health effects. In rare cases, some individuals may develop life-threatening symptoms, including stroke, kidney failure and seizures, which could result in death.
There is no real treatment for E. coli infections, other than monitoring the illness, providing comfort, and preventing dehydration through proper hydration and nutrition. People who develop complications may need further treatment, like dialysis for kidney failure. You should contact your health care provider if symptoms persist.