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A28    SCIENCE
             Saturday 17 February 2018
            Report details harm to Cuba diplomats but offers no cause



            By  LAURAN  NEERGAARD                                                                                               cluding  some  findings  that
            and JOSH LEDERMAN                                                                                                   can’t  be  even  uncon-
             Associated Press                                                                                                   sciously  altered,  bolstering
            WASHINGTON (AP) — Doc-                                                                                              the doctors’ belief that the
            tors  are  releasing  the  first                                                                                    symptoms  were  not  mass
            detailed  medical  reports                                                                                          hysteria.
            about  the  hearing,  vision,                                                                                       At  least  six  people  had  a
            balance  and  brain  symp-                                                                                          change  in  work  perfor-
            toms  suffered  in  what  the                                                                                       mance  noted  by  supervi-
            State    Department    has                                                                                          sors  and  colleagues,  the
            called  "health  attacks"  on                                                                                       JAMA report found.
            U.S. diplomats in Cuba. Still                                                                                       Viruses  or  chemical  expo-
            missing: A clear diagnosis of                                                                                       sures  are  unlikely,  Smith’s
            just what happened to trig-                                                                                         team wrote, although they
            ger  their  mysterious  health                                                                                      couldn’t be “systematically
            problems.                                                                                                           excluded.”
            All together, the symptoms                                                                                          Advanced MRI scans spot-
            are similar to the brain dys-                                                                                       ted  “a  few”  changes  in
            function seen with concus-                                                                                          what are called white mat-
            sions,  concluded  a  team                                                                                          ter  tracts  of  the  brain  in
            of  specialists  from  the  Uni-                                                                                    some  patients,  with  three
            versity of Pennsylvania who                                                                                         showing  more  than  would
            tested 21 of the 24 embas-   In this Sept. 12, 2017, file photo, a customer sits at the lobby bar of the Hotel Capri in Havana,   be expected for their age,
            sy personnel thought to be   Cuba.                                                                                  the report said. But the au-
            affected.                                                                                          Associated Press  thors acknowledged those
            Whatever  the  cause,  the                                                                                          abnormalities  could  be
            Havana  patients  "experi-   clear  that  the  findings  are  injure  the  brain.  We  have  two  countries,  estranged  due to something earlier in
            enced  persisting  disability  preliminary,  essentially  a  to suspect that it's a conse-  for a half-century, restored  life.
            of a significant nature," the  listing  of  symptoms  and  quence of something else."  relations  under  President  For  many  the  symptoms
            Penn team concluded.         tests.  And  important  com-  The  mysterious  case  has  Barack Obama in 2015.        lasted months, and doctors
            Cuba  has  insisted  there  plications remain, including  sent  U.S.-Cuba  relations  The  new  report  outlined  designed customized reha-
            were no attacks.             that  there's  no  information  plummeting from what had  the  battery  of  testing  the  bilitation  therapy  that  did
            The  Journal  of  the  Ameri-  to  compare  the  patients'  been a high point when the  patients   underwent,   in-  seem to help.q
            can  Medical  Association  brain or hearing health be-
            Wednesday,  although  key  "Before  reaching  any  de- Spacewalking astronauts finish
            released  the  report  late  fore they went to Cuba.

            findings were first disclosed  finitive  conclusions,  addi-
            by  The  Associated  Press  in  tional  evidence  must  be   months of robot arm repair
            December.                    obtained  and  rigorously
            The  mystery  began  in  late  and   objectively   evalu-
            2016  when  U.S.  embassy  ated,"  JAMA  associated       By MARCIA DUNN               to  Earth  for  a  tuneup  and  long  and  more  than  440
            personnel  began  seeking  editor Dr. Christopher Muth    CAPE CANAVERAL, Fla. (AP)  then flown back up.            pounds (200 kilograms).
            medical  care  for  hearing  cautioned in an accompa-     —    Spacewalking    astro-  This  last  spacewalk  in  the  Vande  Hei  and  Kanai  ac-
            loss  and  ear-ringing  that  nying  editorial.  He  noted   nauts wrapped up months  series  should  have  been  complished  their  main  ob-
            they linked to weird noises  that many of the symptoms    of repair work Friday on the  completed  long  before  jectives  so  fast  that  they
            or vibrations — initially lead-  overlap  with  a  list  of  other   International Space Station  now,  but  was  postponed  had  time  to  tackle  ex-
            ing investigators to suspect  neurologic illnesses.       's big robot arm.            because  of  complications  tra  chores.  They  breezed
            "sonic  attacks."  Now,  of-  "It  really  looks  like  concus-  The Canadian-built, 58-foot  with the robotic hand that  through  those  as  well,  al-
            ficials  are  carefully  avoid-  sion  without  the  history  of   robot  arm  had  both  of  its  was  installed  last  month.  lowing  the  spacewalk  to
            ing  that  term,  as  doctors  head  trauma,"  report  co-  aging  mechanical  hands  Ground  controllers  even-    end a little early, at the six-
            involved in the probe won-   author  Dr.  Douglas  Smith   replaced  on  spacewalks  tually  solved  the  problem.  hour mark.
            der  whether  the  sounds  of  Penn's  Center  for  Brain   conducted   in   October  Further delays were caused  “Awesome job again, with
            were a byproduct of some-    Injury  and  Repair,  said  in   and  January.  NASA  astro-  by this week's late arrival of  everything   completed,”
            thing  else  that  might  help  a  podcast  provided  by   naut Mark Vande Hei and  a Russian supply ship.          Mission  Control  radioed.
            explain  the  full  symptom  JAMA.                        Japan's  Norishige  Kanai  The old mechanical hands  “We’re all happy here.”
            list:  memory  problems,  im-  He  said  that  sound,  heard   quickly moved one of those  are  original  space  station  Replied Vande Hei: “It was
            paired  concentration,  irri-  by  18  of  the  21  patients,   old  hands  to  a  long-term  parts,  in  orbit  since  2001.  great to be a small part of
            tability,  balance  problems  couldn't  be  to  blame:    storage  location  outside,  Each hand — a bulky bun-     a team in space represent-
            and dizziness.               "There is no known mecha-    and took the other one in-   dle  of  latches  —  is  more  ing a whole space team on
            Wednesday's report makes  nism  for  audible  sound  to   side  so  it  can  be  returned  than  3  feet,  or  a  meter,  the ground.”
                                                                                                                                The  astronauts  marveled
                                                                                                                                over  the  Earthly  vistas,
                                                                                                                                from  start  to  finish.    They
                                                                                                                                emerged from the orbiting
                                                                                                                                complex  as  the  sun  rose
                                                                                                                                over Peru, 250 miles below.
                                                                                                                                A half-hour later, they were
                                                                                                                                soaring  over  London  and,
                                                                                                                                15 minutes after that, over
                                                                                                                                Turkmenistan.
                                                                                                                                Four  other  men  live  at  the
                                                                                                                                space station.q
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