Medical problems of U.S. Havana embassy personnel explained

The collaborative study shows the power of a large interdisciplinary team that spans specialties and universities,” said Balaban, who has studied the circuits to the brain relating to balance disorders, anxiety, and migraines in patients at the University of Pittsburgh. “A holistic integrative approach is vital for understanding the scientific basis of this complex disorder.”

“This is a perfect example of how academic medicine brings together expertise and collaboration in the name of discovery and science,” said Dr. Henri R. Ford, dean and chief academic officer of the Miller School of Medicine.

The onset of symptoms
Beginning in late 2016 and continuing into 2017, a number of U.S. diplomats and family members stationed in Havana began to report complaints of sudden-onset dizziness, ear pain, and tinnitus. Most of the affected individuals reported hearing an unexplained noise before the symptoms began. They noted the sound was loud, localized, at a high frequency and could follow them throughout a room. Several individuals reported that if they went outside their front door, the noise immediately stopped. Others reported a sensation of pressure passing through their head and abdomen in certain parts of the room that could be relieved by moving a few feet away.

In February 2017, Hoffer, a former military officer with security clearance, was contacted by the U.S. State Department about an individual who reported hearing an odd noise followed by intense ear pain and tinnitus. By the next morning, the individual was dizzy and had mild cognitive issues, such as processing emails slowly and forgetfulness.

Evaluating the cases
Over the next few months, the Miller School team conducted evaluations of all individuals who suspected they were affected between 4 and 60 days after exposure, as well as a larger group of 105 embassy workers who denied any “exposure” to noise or a pressure sensation.

The evaluations were carefully coordinated and conducted by multidisciplinary medical teams from otolaryngology and neurology. “Our broadly scoped team of 15 audiology and neurotology specialistsdraws on our advanced vestibular testing technology for diagnosis and treatment and management, thanks to the Miller School’s longstanding investment in our clinical program,” said Snapp.

All of the 25 individuals with symptoms noticed unsteadiness and features of cognitive impairment, according to the study. Dizziness (92 percent) and cognitive complaints (56 percent) were the most common symptoms. Formal testing revealed that 100 percent of individuals had an otolithic (balance) abnormality and evidence of cognitive dysfunction, as documented by a battery of standardized measures.

After the evaluations, a number of the patients were treated for balance, cognitive and emotional disorders. “We reviewed options for therapeutic interventions to address their physical, mental, and emotional issues,” said Levin.

Considering the cause
While the Miller School study did not attempt to determine the cause of the symptoms in the U.S. Embassy residents, the authors noted that intense ultrasonic radiation can produce “a syndrome involving manifestations of nausea, headache, tinnitus, pain, dizziness, and fatigue,” based on occupational health literature. “The exposure responsible for these findings is unknown,” said the co-authors. “It would be imprudent to exclude any potential directed or non-directed energy sources at this time.”