Cuban mystery21 U.S. diplomats in Cuba suffered “acquired brain injury from an exposure of unknown origin”: Experts

Published 20 February 2018

In late 2016, U.S. government personnel in Havana, Cuba, visited the embassy medical unit after experiencing unusual sound and sensory phenomena and the onset of neurological symptoms. Researchers who examined the twenty-one diplomats say that concussion-like symptoms were observed in the 11 women and 10 men after they reported hearing intensely loud sounds in their homes and hotel rooms and feeling changes in air pressure caused by an unknown source. The symptoms were consistent with brain injury, although there was no history of head trauma. The experts who examined the American diplomats concluded: “The unique circumstances of these patients and the clinical manifestations detailed in this report raise concern about a new mechanism for possible acquired brain injury from an exposure of unknown origin.”

In late 2016, U.S. government personnel in Havana, Cuba, visited the embassy medical unit after experiencing unusual sound and sensory phenomena and the onset of neurological symptoms. The U.S. Department of State convened an expert panel in July 2017, which came to a consensus that the initial findings were most likely related to neurotrauma from a non-natural source and the department recommended further investigation of the symptoms. The University of Pennsylvania’s Center for Brain Injury and Repair was selected to coordinate the evaluation, treatment and rehabilitation of these patients. This article in JAMA reports the preliminary findings.

JAMA says that 21 government personnel (11 women and 10 men) identified by the State Department and evaluated an average of 203 days following exposure to reported sound (described as “buzzing,” “grinding metal,” “piercing squeals,” or “humming”) and sensory phenomena (described as pressure-like or vibrating and likened to air “baffling” inside a moving car with the windows partially rolled down).

The study conducted by the Center measured audible and sensory phenomena coming from a distinct direction but from an unknown source (exposure); descriptions of symptoms; and personnel experience with rehabilitation and return to work (outcomes).

The study design was a case series, which describes the clinical course or outcomes of a group of patients. The researchers note that they could not control for exposures or differences that could explain patient outcomes and they cannot prove a causal relationship.

The authors of the study, Randel L. Swanson and Douglas H. Smith, both of the University of Pennsylvania, and their coauthors, found that:

In this case series of 21 individuals exposed to directional audible and sensory phenomena, a constellation of acute and persistent signs and symptoms were identified, in the absence of an associated history of blunt head trauma. Following exposure, patients experienced cognitive, vestibular, and oculomotor dysfunction, along with auditory symptoms, sleep abnormalities, and headache.

The study concluded: “The unique circumstances of these patients and the clinical manifestations detailed in this report raise concern about a new mechanism for possible acquired brain injury from an exposure of unknown origin.”

— Read more in Randall L. Swanson et al., “Neurological Manifestations Among US Government Personnel Reporting Directional Audible and Sensory Phenomena in Havana, Cuba,” JAMA (15 February 2018) (doi:10.1001/jama.2018.1742); Christopher C. Muth and Steven L. Lewis, “Neurological Symptoms Among US Diplomats in Cuba,” JAMA (15 February 2018) (doi:10.1001/jama.2018.1780); and Rita Rubin, “More Questions Raised by Concussion-like Symptoms Found in US Diplomats Who Served in Havana,” JAMA (15 February 2018) (doi:10.1001/jama.2018.1751). Listen to an interview with authors from the University of Pennsylvania, Philadelphia, here. Download a transcript here.