Cases Of Havana Syndrome Grow While Cause Remains A Mystery : Consider This from NPR Since 2016, a number of U.S. diplomats and federal employees have reported symptoms of a mysterious illness, the so-called Havana Syndrome.

The list of symptoms include hearing loud sounds, nausea fatigue, and dizzying migraines, among others.

The cause of this mystery illness is a source of curiosity, but it remains unknown.

Last year the State Department commissioned a study by the National Academies of Sciences for researchers to investigate Havana Syndrome.

NPR's Sarah McCammon spoke to Dr. David Relman, a Stanford professor who headed the investigation.

One possible cause their group came to was a form of microwave radiation that occurs in a pulsed or intermittent form.

In participating regions, you'll also hear a local news segment that will help you make sense of what's going on in your community.

Email us at considerthis@npr.org.

Havana Syndrome: Over 200 Cases Documented Yet Cause Remains A Mystery

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AUDIE CORNISH, HOST:

One winter night, about four years ago, Marc Polymeropoulos suddenly woke up feeling sick.

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MARC POLYMEROPOULOS: I was awoken, you know, in the middle of the night, but I had just had incredible vertigo, dizziness. I wanted to throw up.

CORNISH: Marc was in a Moscow hotel room. He was there on CIA business. He had just become the agency's No. 2 official for clandestine operations in Europe. And as he told NPR's Greg Myre last October, he thought he had come down with maybe food poisoning. A few months later, he was still having headaches, crippling migraines.

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POLYMEROPOULOS: I started this kind of incredible journey of seeing, you know, multiple doctors, multiple MRIs and CT scans and X-rays. Ultimately, a neurologist diagnosed me with what they call occipital neuralgia.

CORNISH: That diagnosis would explain his migraines. But the root cause was a mystery. And an even bigger mystery was why, that same year, other U.S. government employees around the world were also experiencing the same symptoms.

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UNIDENTIFIED REPORTER #1: The Trump administration announced Friday that it is pulling more than half of its staff out of the American Embassy in Havana.

CORNISH: The same symptoms Marc Polymeropoulos came down with in Moscow had also been observed in a group of U.S. diplomats and intelligence officials in Havana, Cuba.

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UNIDENTIFIED REPORTER #1: This comes after diplomats and staff suffered mysterious health attacks that caused minor brain injuries. Cuba has denied...

CORNISH: Havana syndrome, as the mystery illness came to be known, has since been reported elsewhere around the world - in India, Austria, just last week at the Colombian Embassy in Bogota.

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UNIDENTIFIED REPORTER #2: Two hundred Americans have now come forward to report possible symptoms of the mysterious illness called Havana syndrome.

UNIDENTIFIED REPORTER #3: It's serious, it's widespread, and it poses real danger to American diplomats and intelligence officers around the world.

UNIDENTIFIED REPORTER #4: So there are growing suspicions that Russian intelligence officers are behind a mysterious illness called Havana syndrome.

CORNISH: At least that was one theory that emerged in the years after Marc Polymeropoulos fell sick in that Moscow hotel room. It was an illness that forced him to reluctantly retire at age 50 in 2019.

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POLYMEROPOULOS: I just couldn't sit at a computer or go to meetings. The headaches were just too debilitating.

CORNISH: And it led to a dispute with the CIA over his medical treatment.

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POLYMEROPOULOS: I spent 26 years in an organization that I still love, and I believe that the CIA is an indispensable institution. I believe in its mission. So the idea of kind of talking about this publicly is really difficult for me.

MARK ZAID: We're looking for answers. The key thing first is we want to ensure timely and proper medical treatment. And then we want answers.

CORNISH: Lawyer Mark Zaid has represented Marc Polymeropoulos and several other former U.S. intelligence officials with Havana syndrome. Marc and others like him eventually did receive specialized treatment at Walter Reed National Military Medical Center. Some former intelligence officials think the government isn't sure what's going on, but lawyer Zaid believes they just aren't being transparent.

ZAID: We're tired of the subterfuge of the U.S. government hiding this information.

CORNISH: CONSIDER THIS. The number of people suffering from the so-called Havana syndrome is growing. The U.S. government says it's taking steps to help them, but the underlying cause of the illness is still a mystery.

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CORNISH: From NPR, I'm Audie Cornish. It's Wednesday, October 20.

It's CONSIDER THIS FROM NPR. Last year, the State Department commissioned a study by the National Academies of Sciences, and they wanted researchers to find out how real Havana syndrome was. Dr. David Relman is a Stanford professor who chaired the study.

DAVID RELMAN: And the mechanism that we found most plausible was a form of microwave radiation that occurs in a pulsed or intermittent form.

CORNISH: The theory that U.S. officials were subjected to microwave attacks is a popular one. Some think the intent was to injure them or maybe to steal secrets from their phones and computers. Russia, China and Cuba all deny any such actions. CIA Director William Burns spoke to NPR earlier this year about what or who could be behind the illness. Here's an exchange he had with Mary Louise Kelly.

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MARY LOUISE KELLY: The government describes these as anomalous health incidents, which sounds a lot more benign than attacks. Are they attacks?

WILLIAM BURNS: You know, I - you know, we use the term incidents across the U.S. government. But you know, the truth is, Mary Louise, that what matters most to me is the reality that whatever you call these, they're harming, you know, our colleagues here, my colleagues at CIA. And that's what we're determined to get to the bottom of.

KELLY: When you say you're trying to figure out what's causing them and who is causing...

BURNS: Right.

KELLY: ...Them, that suggests that this is someone taking action.

BURNS: That's certainly a very strong possibility. You know, the National Academy of Sciences, a year ago in a very extensive report that they did, suggested that the most plausible theory for what caused this was some form of directed energy. And that sort of narrows then, you know, the number of potential suspects who could have used this, have used it historically and have the reach to do this in more than one part of the world, too. So yeah, we're very focused on getting to the bottom of this.

KELLY: Is it Russia?

BURNS: It could be. But I honestly cannot - I don't want to suggest until we can draw some more definitive conclusions who it might be. But there are a number of possibilities.

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CORNISH: Now, there is no one in charge right now of overseeing the State Department's response to Havana syndrome. A temporary point person, Pamela Spratlen, recently left the department. She had been serving as a senior adviser of the Health Incidents Response Task Force. A bipartisan group of senators have been pressing Secretary of State Antony Blinken to appoint a replacement.

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NED PRICE: The secretary has no higher priority than the health and the safety and the security of our workforce.

CORNISH: State Department spokesman Ned Price spoke to reporters last week.

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PRICE: We believe those who come forward. We take every single report of an anomalous health incident extraordinarily seriously.

CORNISH: Now, Price didn't say when Spratlen will be replaced, but said there are teams of security engineers and occupational safety experts conducting surveys and inspecting locations where incidents have been reported.

Earlier this month, President Biden signed the Havana Act, which provides financial support to diplomats and other federal officials who have suffered brain injuries on the job. But supporting government employees who get sick - well, that's not enough, says Mark Zaid - again, the lawyer representing some of those workers.

ZAID: The U.S. government needs to do a deep dive to see whether or not this has been happening for years, and did they ignore it or not.

CORNISH: Zaid, who we heard from earlier, wants to know what the Biden administration knew about the emergence of Havana syndrome and when.

ZAID: And if they ignored it, what are they going to do about it for those people who suffered, you know, years ago and maybe were never taken care of?

CORNISH: How these brain injuries are happening - well, that's the big unanswered question - a question researchers working on that National Academy of Sciences report tried to answer.

RELMAN: To us, this was a very perplexing, very unusual syndrome with features that many of us had really heard nothing about before.

CORNISH: Again, that's medical researcher David Relman. The State Department asked Relman's team to look at three areas - the nature of the illness, the, quote, "mechanisms" that might explain how it happened and how it could be treated. The group reviewed a number of studies, reports and spoke to some of the patients.

Relman spoke to NPR's Sarah McCammon about what they learned.

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RELMAN: We spoke to about eight individuals, most of them having served in Havana, but several from China. And we found that to be incredibly insightful for us.

SARAH MCCAMMON, BYLINE: What did you hear from them directly?

RELMAN: We heard about how the case began, how their experience occurred. And some of them told us some very dramatic stories about crawling out of the room and finding that everything resolved and in some cases then returning to find that everything resumed again back - the exact same spot. So it was this dramatic sense that everything was taking place at a particular spot. That's something, for us, could not be explained by natural phenomenon that we had heard about.

MCCAMMON: And for those who haven't read your report, what is your team's best guess about what's going on here?

RELMAN: So we deliberately chose to focus on just a handful of mechanisms that had been suggested to us by work that had been published already or by suggestions from our sponsors. These included microwave radiation, chemicals and in particular pesticides, infectious agents that might have been common in Cuba, which is where many of the cases that we looked at had taken place, and then finally psychosocial mechanisms. And the mechanism that we found most plausible was a form of microwave radiation that occurs in a pulsed or intermittent form.

MCCAMMON: Yeah, explain more. How would that cause these symptoms?

RELMAN: Well, there's still a lot of missing information and lack of molecular understanding of how this might occur. But we looked at a variety of reports in the open source literature. We looked at a number of studies that have been done looking at small animals that have been subjected to microwave radiation as well as cells in isolation. And we found circumstantial evidence that suggested that this form of microwave radiation in pulsed form might set up a certain form of pressure wave within the head that would then reverberate and cause damage to cells and pathways where normal neurotransmitters are communicating. And we believe, although we can't show with direct evidence, that this phenomenon could account for at least some of the clinical features that we heard about and read about.

MCCAMMON: And, Dr. Relman, we should note that the State Department still considers your team's conclusions from the report to be a hypothesis. How confident are you that microwaves are what's behind these symptoms?

RELMAN: We were not confident. And I have to be clear. We view this as plausible, but again, we didn't have any direct evidence that this could explain the entire story for sure or even parts of it.

MCCAMMON: Would victims have to be intentionally targeted, intentionally hit with these microwaves?

RELMAN: We thought about what the various sources of such pulsed microwave energy might be. And, again, we were not familiar with or read into the exact circumstances of these cases, so we couldn't comment on the situational information that might have either supported or refuted this idea. But when we look at the world around us, we know there's plenty of microwave radiation. However, most of it comes in the form of a continuous wave - things like microwave ovens or cellphones. But we could not come up with an easy scenario in which these natural but less common pulsed forms of microwave radiation might have explained these cases. And that left us with this very sort of disconcerting notion that it had been produced deliberately by other actors whose purposes we really weren't in a position to fathom.

MCCAMMON: Before this syndrome - Havana Syndrome was reported, how much was known in the medical community about these kinds of symptoms potentially being linked to microwaves?

RELMAN: Relatively little. As I say, we were able to find some literature. But, again, there just isn't a lot of reported literature in humans. But, you know, the bottom line is that this is still a perplexing story that still needs further investigation.

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CORNISH: That's Stanford professor David Relman.

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CORNISH: You're listening to CONSIDER THIS FROM NPR. I'm Audie Cornish.

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