Why no one can agree on what really happened to the u.s. diplomats in havana triblive

Sometimes called acoustic attacks, the events are often accompanied by a sound variously described as high-pitched, low-pitched, piercing squeals, grinding metal and incapacitating before the onset of symptoms such as ringing in one ear, vertigo, nausea, recurrent headaches, fatigue, cognitive issues, problems sleeping and even hearing loss in a few cases.

Yet in June, the United States said the two incidents were medically confirmed and added them to a list of American diplomats and family members who had been posted in Havana and suffered from strange medical problems. That brought the total cases to 26. Asked about the May incident, a State Department spokesperson said: “We would refer you to the government of Cuba for questions about its report.”

Inconsistencies, secrecy and shifting hypotheses that sometimes seem straight out of science fiction have marked the U.S. government’s effort to get to the bottom of what happened in Havana since the first Cuba cases were reported in late 2016, a time when U.S.-Cuba relations were on the cusp of change with President Donald Trump soon to take office.

Sonic weapons, microwaves, a possible directed energy weapon, maybe even a combination of ultrasound and electromagnetic pulses — a technology commonly used to keep pests outside homes — toxins, heavy metals including lead and mercury, drugs, a virus and a mass psychogenic illness (a nervous system disorder brought on by collective stress that causes physical symptoms) have all been advanced as possible causes for the diplomats’ medical problems.

But a year after a significant staff reduction at the U.S. Embassy ordered in the wake of the alleged attacks, there are still no definitive answers on who or what made the diplomats sick. There are also widely divergent views among the two groups of doctors who have actually examined the diplomats, as well as among other researchers who have weighed in, on what the underlying medical cause that produced the symptoms is.

“This episode has gotten way out of hand with wild speculation and competing theories from specialists,” said Robert Bartholomew, a New Zealand scientist who believes mass psychogenic illness played a role in the diplomats’ symptoms. “It can only be understood by sticking to the science, not the science fiction. This is such a convoluted saga that it may take years to sort out and agree on a diagnosis.”

But with the State Department calling the incidents attacks, it seems to favor the weapon hypothesis. “Information suggests our personnel were deliberately targeted,” said a State Department spokesperson without being more specific. “Based on investigative and medical findings, we do not believe this trauma was caused by naturally occurring phenomena.”

“There is no smoking gun. At this point it’s best to stay very open-minded,” said James Giordano, a professor of neurology at Georgetown University and an expert in neurological weapons. He was asked by the State Department to come up with an explanation of what would have been capable of causing the inner ear problems that doctors and researchers at the University of Miami School of Medicine and the University of Pittsburgh say the affected diplomats share.

All 25 patients examined in Miami who were truly symptomatic had a “physical injury in or around the inner ear,” he said. The most common symptoms in that affected group were dizziness (92 percent), cognitive problems (56 percent), and hearing loss and ringing in the ears (both 32 percent), Hoffer said during a recent telephone call-in on the Havana incidents for Pentagon personnel.

The State Department hasn’t directly blamed Cuba for causing the health incidents, but some in the Trump administration think the Havana government knows more than it is letting on. The Cubans say their investigation has been thwarted by lack of cooperation from U.S. authorities. The Cuban scientific delegation complained that without access to the U.S. patients or their medical records. it’s difficult to draw conclusions.

While in Washington, the Cuban scientists urged cooperation between scientific communities in both countries, but they said the only data shared with them by the State Department was a University of Pennsylvania report that appeared in The Journal of the American Medical Association early this year. They’d already been through it with a fine-tooth comb.

The work by University of Miami doctors and researchers in cooperation with the University of Pittsburgh, which is expected to be published soon in a peer-reviewed publication, wasn’t shared with them. Among these researchers’ hypotheses is that directed energy can result in cavitation bubbles formed by dissolved nitrogen and oxygen in body fluids that can burst and cause damage.

Meanwhile, researchers at the University of Pennsylvania who treated and examined 21 of the initial 24 U.S. diplomats suffering from the mysterious ailment have published the most comprehensive report to date in JAMA. Their preliminary conclusion was that the patients — 10 men and 11 women — were suffering from concussion-like brain injuries that weren’t associated with head trauma as might be expected. That raised concerns about a new, unknown mechanism for causing traumatic brain injury.

In its Aug. 14 issue, JAMA published four letters from groups of doctors and scientists from around the world who said there were flaws in the Penn study and doctors should not have discounted the possibility of a functional neurological disorder, an inner ear disorder or mass psychogenic illness, commonly referred to as mass or collective hysteria.

In a March editorial that appeared in JAMA, Dr. Christopher Muth and Dr. Steven Lewis, both neurologists at Rush University Medical Center in Chicago, urged caution in interpreting the findings. They pointed out that not only was there “some variability between patients in terms of symptoms that each experienced” but there were no baseline evaluations to determine if the patients had preexisting conditions. Some of the symptoms were based on reports by the patients themselves instead of through standardized examinations, and the diplomats were evaluated a mean of 203 days after the onset of their symptoms.

Without a baseline study, they said, it can’t be determined whether the hearing loss experienced by three patients, who were fitted with hearing aids as part of their treatment, resulted from exposure to the sounds they said they heard. Still, they said the similarities among the 21 cases evaluated at that point do “merit consideration of a common medical, environmental, or psychological event as their potential cause.”

The ailment has nothing to do with hypochondria and is not a made-up illness. Those suffering from stress-induced mass psychogenic illness have real symptoms such as headaches, insomnia, fatigue and dizziness and may require treatment to recover. A famous example is the 1999-2002 Kokomo Hum where nearly 100 residents of the Indiana city reported getting sick after hearing a humming sound. No acoustical source of the hum was ever identified.

If researchers truly wanted to get to the bottom of the Havana illnesses, he said, they should have conducted a social network analysis that looked at how the patients might be acquainted and whether they had knowledge of others becoming ill. “If patients were unaware that others were falling ill, it rules out mass psychogenic illness,” he said.

Part of its mandate includes risk mitigation, but the official declined to comment on any security measures that may have been undertaken. The State Department, however, recently reduced the tour of duty for diplomats in Havana from two years to one, a reflection of “the more challenging conditions affecting U.S. diplomats on the ground,” the official said.