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To Your Health: NLM update Transcript

Why US diplomats in Cuba became ill: 04/23/2018

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Greetings from the National Library of Medicine and MedlinePlus.gov

Regards to all our listeners!

I'm Rob Logan, Ph.D., senior staff, U.S. National Library of Medicine (NLM).

Here is what's new this week in To Your Health, a consumer health-oriented podcast from NLM, that helps you use MedlinePlus to follow up on weekly topics.

Although it is inconclusive why US diplomats developed diverse health problems after working in the American embassy in Havana, new insights might emerge via better data collection methods, suggests a study accompanied by an editorial recently published in the Journal of the American Medical Association.

The study finds 18 of 21 American diplomats, who worked in the Havana embassy in Cuba from late fall 2016 to August 2017, reported persistent sleep disturbance and vision problems. The study adds 17 of the 21 assessed diplomats reported subsequent cognitive difficulties while 15 reported significant headaches.

The study finds physical exams and other testing confirmed balance problems in 17 of the 21 diplomats. The study notes cognitive abnormalities were found in 17 of the 21 diplomats and 15 of the 21 envoys had unusual eye movements. In addition, the study suggests severe hearing loss occurred among three of the 21 diplomats that were assigned to the Havana embassy.

Most of the diplomats in the case study were assessed from five to seven months after the initial onset of their condition.

More positively, an editorial that accompanied the study notes (and we quote): 'Many of the individuals had prolonged symptoms that began to resolve over the course of months, and, in many cases, after receiving rehabilitative therapies' (end of quote).

Similarly, the study's three authors explain most of the impacted workers were motivated to return to work after a recovery period, which dismisses the possibility of a shared, or mass psychogenic illness among the envoys.

However, as the editorial suggests, the question remains what exposures at the embassy are associated with the ensuing health problems the diplomats experienced. Both the study and the editorial suggest it is difficult to associate environmental hazards, such as a non-lethal attack using ultrasound, or even the possibility of an infection, with the diplomat's subsequent symptoms and health problems.

The editorial's two authors write (and we quote): 'At this point, 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' (end of quote).

On the other hand, the editorial's authors suggest new insights about the diplomats' condition might emerge via improved data collection methods for future envoys working in Cuba or other nations.

For example, the editorial's authors write (and we quote): 'it would be helpful for government employees traveling to Cuba to undergo baseline testing prior to deployment to allow for a more informed interpretation of abnormalities that might later be detected after a potential exposure' (end of quote).

The editorial's authors, who include a JAMA associate editor, add (and we quote): 'before reaching any definitive conclusions, additional evidence must be obtained and rigorously and objectively evaluated' (end of quote).

So, while the Havana embassy illnesses remain a medical mystery, the study and the editorial suggest there is a straightforward future path to de-mystify what happened.

Meanwhile insights into undiagnosed and rare diseases, provided by the Human Genome Research Institute, is found within the 'start here' section of MedlinePlus.gov's rare diseases health topic page.

Links to the latest relevant journal research articles about rare diseases are available in the 'journal articles' section of MedlinePlus.gov's rare diseases health topic page. Links to pertinent clinical trials that may be occurring in your area also are available in the 'clinical trials' section.

To find the rare diseases health topic page, please type 'rare diseases' in the search box on MedlinePlus.gov's home page, then, click on 'rare diseases (National Library of Medicine).'

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It was nice to be with you. Please join us here next week and here's to your health!