Report on US diplomats in Cuba reveals damage, but no diagnosis

There is no information about the patients’ brain or hearing health before they went to Cuba

Doctors are releasing the first detailed medical reports about the hearing, vision, balance and brain symptoms suffered in what the US State Department called “health attacks” on US diplomats in Cuba.

Still missing: a clear diagnosis of just what happened to trigger their mysterious health problems.

All together, the symptoms are similar to the brain dysfunction seen with concussion, said specialists from the University of Pennsylvania who tested 21 of the 24 embassy personnel thought to be affected.

Whatever the cause, the Havana patients “experienced persisting disability of a significant nature”, the team said. Cuba has insisted there were no attacks.

The Journal of the American

Medical Association released the report on Wednesday.

The mystery began in late 2016 when embassy staff began seeking medical care for hearing loss and ear-ringing that they linked to weird noises or vibrations – initially leading investigators to suspect “sonic attacks”.

Now, officials are avoiding that term, as doctors wonder whether the sounds were a by-product of something else that might help explain the full symptom list: memory problems, impaired concentration, irritability, balance problems and dizziness.

Wednesday’s report makes clear that the findings are preliminary, essentially a listing of symptoms and tests. And important complications remain – for example, there is no information about the patients’ brain or hearing health before they went to Cuba.

“Before reaching any definitive conclusions, additional evidence must be obtained and rigorously and objectively evaluated,” Jama associate editor Dr Christopher Muth said in an editorial. He noted that many of the symptoms overlap with a list of other neurologic illnesses.

“It really looks like concussion without the history of head trauma,” report co-author Dr Douglas Smith of Penn’s Centre for Brain Injury and Repair said in a podcast provided by Jama.

He said sound heard by 18 of the 21 patients was not to blame: “We have to suspect that it’s a consequence of something else.”

The case has sent US-Cuba relations plummeting from what had been a high point when the two countries restored relations under Barack Obama in 2015.