- The Washington Times - Wednesday, February 14, 2018

Doctors say a “novel mechanism” was used in attacks against American diplomats in Cuba, but they do not know what device could cause symptoms that mimic a concussion but occur without any head trauma, according to a report published Thursday in a scholarly medical journal.

Physicians at the University of Pennsylvania’s Center for Brain Injury and Repair said the release of their findings is a matter of public health concern, in that it’s unclear how many people were exposed to the same powerful force as the diplomats.

“I’ve already been emailed by various individuals who have been in Havana and have symptoms that they’re concerned about,” said co-author Dr. Douglas Smith, a professor of neurosurgery and director of the Center for Brain Injury and Repair in the university’s Perelman School of Medicine.

“It could be things like an ear infection or just an illness,” Dr. Smith said, adding that his team is working to develop diagnostic criteria specific to the symptoms and experiences of the embassy workers.

Their findings, published Thursday in the Journal of the American Medical Association, provide a laundry list of symptoms with an unclear source. The physicians hope that by identifying all of the resulting trauma, they can work backwards to pinpoint the cause of the injuries.

“There’s no head impact here, yet the constellation of symptoms look extremely like persistent concussion,” Dr. Smith said, adding “what else could cause damage to the brains network that would resemble concussion without that big mechanical hit?”

According to the State Department, U.S. Embassy workers in Havana reported concussion-like symptoms from December 2016 through August. The Cuban government has said it did not engage in any kind of attack or other activity that could have caused the symptoms.

Twenty-four people were identified as suffering from the mysterious attacks, and 21 were referred to Dr. Smith and his team or evaluation and treatment. The evaluated individuals included 11 women and 10 men with an average age of 43 years old.

Each had complained of severe health effects after reporting hearing sustained, high-pitched and grating noises along with physical sensations of pressure and vibration while in their homes or hotel rooms.

The sounds were described as “buzzing,” “grinding metal,” “piercing squeals” and “humming” and ranged in length from 10-second bursts to more than 30 minutes. They immediately produced headaches, dizziness, nausea and ear pain.

The occurrence of the sounds could jolt the individuals from their sleep, and some reported covering their ears to no avail. They could find relief by moving into another room or behind a concrete wall.

While the attacks were popularly referred to as “sonic” at the time, Dr. Smith said audible sound doesn’t cause the damage observed in the individuals.

Further, most people can recover quickly from a concussion, with about 20 percent having persistent symptoms. But Dr. Smith said this entire cohort described a worsening of symptoms over time, at least three months after the initial exposure.

More than 70 percent reported having difficulty with concentration and memory, making it challenging to complete tasks or recall specific words. Mood changes like irritability, nervousness, sadness and feeling more emotional were observed in half the group.

Other persistent symptoms included visual problems, difficulty focusing and controlling eye movement, sensitivity to light and difficulty reading. At least three individuals had such severe hearing loss they were fitted with hearing aids.

Dr. Smith described the individuals as highly motivated, saying it’s possible their symptoms were exacerbated by their intense focus on rehabilitation and desire to return to work. Other limitations of their observations are that they have no accurate baseline of the individuals’ health before the attacks.

It’s also possible many more people have been exposed but with lesser severity, Dr. Smith said.

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