When a mystery illness rippled through the US embassy in Cuba in late 2016, the diplomatic fallout was rapid.

The US slashed the number of people at its Havana mission and expelled 15 Cuban diplomats after at least 24 American staff and family reported a mix of headaches, dizziness, eyesight, hearing, sleep and concentration problems.

Many of the affected diplomats said their illness came on after they heard strange noises in their homes or hotel rooms. Some reported that the sounds – which ranged from grinding to cicada-like to the buffeting caused by an open car window – appeared to be directed at them, and that their symptoms abated when they moved to another room.

Now, the dispute over the cause of the episode has spread into the medical world, where some doctors and scientists are furious with a situation they believe is being spun for political gain.

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A study published last week by American doctors who examined 21 of the diplomats has been criticised for starting from a position that the diplomats had been exposed to some unknown “energy source”. Sceptics insist this remains conjecture at best, and is far from proven.

In the immediate aftermath of the incidents, unnamed US officials claimed that the diplomats had been victims of “acoustic attacks”, from a device that operated outside the audible range of sound. Further anonymous briefings claimed that scientists had discovered abnormalities in white matter tracts in the diplomats’ brains.

While US officials have begun to row back from claims of an acoustic attack – a scenario an FBI investigation found no evidence for – the use of some other kind of energy weapon which happens to make a sound is still under investigation.

The US government asked doctors at the University of Pennsylvania to run tests on 21 of the diplomats. The results, published in the Journal of the American Medical Association (Jama), found no evidence of white matter tract abnormalities, though more advanced scans are underway. “They were similar to what you might see in the same age control group,” said Douglas Smith, director of the Centre for Brain Injury and Repair, who led the medical assessments.



But the study does describe a new syndrome in the diplomats that resembles persistent concussion. While some of those affected recovered swiftly, others have had symptoms last for months. The study concludes that the diplomats appear to have “sustained injury to widespread brain networks.”



Robert Bartholomew, an expert in mass psychogenic illness (MPI) who teaches at Botany Downs Secondary College in Auckland, said he was “floored by the study” and claims that it reads like US government propaganda. In the article, the doctors state that their objective is to describe “neurological manifestations that followed exposure to an unknown energy source,” but Bartholomew points out that there is no proof that any kind of energy source affected the diplomats, or even that an attack took place. “It’s like the authors are trying to get us to believe an attack has occurred,” he told the Guardian.



Mitchell Valdés-Sosa, director of the Cuban Centre for Neurosciences, who was part of a Cuban investigation into the incidents, said other explanations have been dismissed too soon. “When you look at the evidence, at what’s being presented, it doesn’t support the idea of widespread damage to brain networks.”

He believes that a small number of diplomats had real medical problems, the causes of which are unknown, which then sparked fears over attacks when they were linked to unusual noises. As concern spread through the diplomatic community, others experienced similar symptoms, developing MPI.

“There is no evidence of any kind of attack,” said Valdés-Sosa. “It would take a stretch of the imagination to explain the findings with this kind of, let’s say, novel technology. There are other explanations that have to be explored first.”

An editorial, published alongside the Jama study, also urges caution and calls for more evidence to be rigorously evaluated before people reach definitive conclusions. But Valdés-Sosa points out that while the study is referenced on the US state department’s website, which calls on people to reconsider travel to Cuba in light of “health attacks”, the editorial which raises a long list of caveats is not.

“This has been politicised,” Valdés-Sosa said. “I think people are using this to push for the rolling back of the relationships that had started to blossom during Obama’s presidency.”

Obama essayed a thaw in relations with Cuba during his final years in the White House. But Donald Trump has reversed the detente.

Smith conceded that the cause of the diplomats’ illnesses was still unknown. “The concept of this being an energy source is really our best guess, because we can’t think of anything else, but it’s absolutely not proven.” He added: “Whether there was an attack or not is not really in our purview.”

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Last month Todd Brown, diplomatic security assistant director at the state department, said US investigators were now considering whether people might have been deliberately exposed to a virus. Smith finds this unlikely: “This does seem like a directional phenomenon and I don’t know too many poisons or viruses or bacteria that come and go as you move from place to place.”

Smith also believes that MPI is an unlikely explanation for the mysterious sickness because the diplomats were all highly motivated to get back to work, and some of them had symptoms that lasted for months.



But Bartholomew argues that MPI has nothing to do with malingering and that it can be long-lasting. “The second most common type of MPI begins slowly and persists for months and years and is often characterised by neurological symptoms,” he said. “The number one suspect here is mass psychogenic illness.”

In response to claims that the issue had become politicised, Smith said: “Nobody on our team works for the government or has any conflict with respect to government. In fact, I think most people on the team were sceptical at first and were not expecting to find much here, and yet one after another independently came up with a view that there is something here, that this does appear to be a new syndrome.

“We have nothing to hide,” he added. We want to keep the privacy of the individuals intact, but we would be open to discussion about our findings, we’re not aligned with the government.”