AFP | A screen shot taken on October 26, 2017 from Cuban Television shows environmentalists analysing sounds in areas where officials from the US embassy in Havana were allegedly affected by mysterious attacks.

A US congressional delegation visited Cuba this week but the diplomatic standoff between the two countries over alleged "sonic attacks" on American diplomats in Havana continues. Now medical experts are weighing in.

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The spat dates back to 2016 when at least two dozen people who worked at the US Embassy in Havana began suffering from a mix of dizziness, headaches, hearing loss, sleep problems and cognitive issues.

Those afflicted said the symptoms started after they heard mysterious, loud sounds in their homes or hotel rooms that were sometimes accompanied by the sensation of movement in the air. The noises appeared to be directed at the victims and were no longer audible if the person switched rooms or even moved a few feet. Sometimes the sounds were undetectable by other people in the same room.

American tourists and staff at the Canadian Embassy in Havana reported similar incidents.

The US government initially alleged that the diplomats were being subject to attacks by some sort of sonic weapon, but investigators and scientists have largely debunked that theory. In January, the FBI issued a report saying it had no evidence that the illnesses were caused by sonic waves.

In late 2017, US President Donald Trump took action, withdrawing most of the embassy’s personnel, expelling 15 Cuban diplomats from the US and issuing a travel warning citing possible “health attacks".

But more than a year after the government workers reported the incidents, investigators and doctors are still unable to say what happened. What is clear, though, is that the victims suffered physical damage and that the symptoms resemble those of traumatic brain injury or concussion.

Doctors at the University of Pennsylvania studied 21 of the affected diplomats and published their findings in the February 15, 2018 issue of the Journal of the American Medical Association (JAMA). “The similarities among the 21 cases merit consideration of a common medical, environmental, or psychological event as the potential cause," the report said, adding that the diplomats appear to have “sustained injury to widespread brain networks".

How or why that happened, though, the doctors couldn’t say. "A unifying explanation for the symptoms experienced by the US government officials described in this case series remains elusive, and the effect of possible exposure to audible phenomena is unclear," they wrote in JAMA.

The researchers said that while they couldn’t rule out a virus or chemical agent as the cause two other theories that had been proffered as explanations the diplomats didn’t have any of the typical signs of viral infection, such as fever. And it is unlikely that a chemical agent could have such a targeted effect on neurological systems without touching other organs, they said.

The Cubans, for their part, have steadfastly held that they are not responsible for the illnesses and launched an investigation into the incidents. “Cuba has never, nor would it ever, allow that the Cuban territory be used for any action against accredited diplomatic agents or their families, without exception,” the Cuban government said in a statement last August.

The Trump administration isn’t convinced. The president has said he believes the Cuban government is responsible, and Secretary of State Rex Tillerson has called the attacks “deliberate". Trump has rolled back some of the measures that former president Barack Obama took to normalise relations with the island nation, issuing tighter restrictions on travel to Cuba and on financial regulations.

A congressional delegation visited Cuba last week and discussed the matter with officials there.

“I have no idea what happened to our diplomats here," Rep. Jim McGovern said at a press conference after the meetings. "US agencies who are investigating this matter, who I met with also, don’t seem to have clue what happened here. And we may never know what happened."

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