An Assessment of Illness in U.S. Government Employees and Their Families at Overseas Embassies (2020) / Chapter Skim
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Section 3: Clinical Features
Section 3: Clinical Features
Pages 10-16
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From page 10... ...
ASSESSMENT AND FINDINGS Clinical Features of Personnel Who Spent Time in Havana The committee compiled signs and symptoms reported by DOS employees that spent time in Havana, based on information provided by the four clinical evaluation sites (Miami, Penn, NIH, Dalhousie) in presentations to the committee or in publications, as well as the signs and symptoms of affected employees interviewed by the committee in person.
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From page 11... ...
The most common and distinctive features of the initial onset and acute phase of the illness in Havana personnel were the sudden onset of a perceived loud sound, sometimes described as screeching, chirping, clicking, or piercing, a sensation of intense pressure or vibration in the head, and pain in the ear or more diffusely in the head. Most individuals reported that the sound or these other sensations seemed to originate from a particular direction or that they perceived them only in certain physical locations.
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Laboratory Test Results and Physical Examination Findings Reported for Embassy Personnel DOS personnel underwent physical examinations and different tests at different study sites, at different times during the course of their illness. The committee did not have access to primary reports or complete data.
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From page 13... ...
Thus, these data indicate a high level of impairment in many patients at the time of testing, but do not provide any information about potential causative agents or specific mechanisms of injury. Vestibular laboratory tests such as the video head impulse test, caloric test, vestibular evoked myogenic potentials, rotary chair test, and oculomotor examinations can provide information on the structural integrity of peripheral (inner ear)
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results months to years after initial symptoms. They subsequently reported that among 40 Havana patients compared to 48 healthy controls, there were small group differences in the average brain volumes in specific lobes, a decrease in mean diffusivity in the midline inferior cerebellum, and differences in functional connectivity in auditory and visuospatial networks (Verma et al., 2019)
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All of these evaluations are routinely available in any modern large hospital, but may require plans in advance for referring Embassy personnel to such a facility as soon as possible after onset. SUMMARY The most distinctive clinical aspects of the illnesses described in DOS Havana personnel are the nature of the onset and the initial features: the sudden onset of a perceived loud sound, a sensation of intense pressure or vibration in the head, and pain in the ear or more diffusely in the head.
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From page 16... ...
2019. Havana syndrome: Neuroanatomical and neurofunctional assessment in acquired brain injury due to unknown etiology.
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