Chronology

• February 2020 – At ongoing committee meeting between CJDSS, PHNB and RHA representatives regarding CJD surveillance in NB, questions are raised on the number of CJD cases being observed in the province and the need for further analysis.
• March 2020 – State of Emergency Declared due to COVID-19 pandemic
• September 2020 - letter sent by a NB neurologist to PHNB expressing concerns regarding the identification of a growing number of atypical, rapidly progressive dementia, including several cases of CJD in the province.
• September 2020 – Meeting with PHNB, CJDSS and referring neurologist to discuss a number of cases of atypical, rapidly progressive dementia, including several cases of Creutzfeldt-Jakob Disease (CJD) – 29 cases at this time
• December 2020 – Follow up email to September meeting, indicating that these cases are grouped into a cluster of a progressive neurological syndrome of unknown etiology – 33 cases at this time. The first draft of the case definition was shared with PHNB at this time.
   

• January 2021 –The definition, a product of collaboration between the CJDSS and the main referring neurologist, was updated to include confirmed and suspect cases, and was accepted by PHNB.
• February 2021 – creation of a multidisciplinary teams of provincial and national partners to provide subject matter expertise on investigation. PHNB takes the lead of the investigation.
• March 2021 – memo to NB physicians and Healthcare Professionals advising them of this cluster
• March 2021 – PHNB posts an alert on the Canadian Network for Public Health Intelligence
• April 2021 – creation of the MIND clinic, funding provided by the Department of Health
• April 2021 – Cluster closed at 48 cases
• May 2021 – GNB launches new website to keep public informed of the cluster with unknown etiology
  
• May 2021 – first epi surveillance questionnaire interview is conducted (last was in September 2021)
• June 2021 – creation of an oversight committee to conduct a clinical review of cases
• August 2021 – first clinical review is conducted (last review completed in February 2022)
• October 2021 - PHNB sends memo advising health care professionals that new referrals to cluster now require sign-off by 2 specialists with a reminder that notifications must be made to PHNB for all notifiable diseases or events under the Public Health Act.
• October 2021 – release of Epidemiological Summary of Enhanced Surveillance Interviews
   

• January 2022 – first letter sent to physician (Jan 10) and patients (Jan 24) with results of the clinical findings (last will be sent in February)
• February 2022 – Oversight committee release their findings
• February 2022 – GNB releases report and concludes investigation
  
   

CJD – Creutzfeldt-Jakob Disease
CJDSS – Creutzfeldt-Jakob Disease Surveillance System
MIND Clinic – Moncton Interdisciplinary Neurodegenerative Diseases Clinic
GNB – Government of New Brunswick
PHNB – Public Health New Brunswick
RHA – Regional Health Authority