"Havana syndrome" is the term widely used in the United States to describe symptoms reportedly suffered by staff at Washington's embassies in Cuba and other countries across the globe.
But the Biden administration has quietly renamed the malady to cut the reference to the capital city in which it was first observed.
"We refer to these incidents as 'unexplained health incidents' or 'UHIs,'" a State Department spokesperson told Newsweek.
The new title reflects the mysterious nature of the supposed disease, whose apparent effects have since spread far from Cuba to impact U.S. diplomats and officials in Austria, China, Russia, and even in Washington near the White House itself. Symptoms include dizziness, headaches, loss of hearing, and confusion, and even reports of lasting brain damage in some cases.
But little more is known about the ailment that has sent two successive U.S. administrations scrambling to search for a cause for the ailments that were first reported at the U.S. embassy in Cuba in late 2016. They were swiftly blamed, without conclusive evidence, on the Communist-led island state by then-President Donald Trump after coming to office in 2017. The effort to explain the phenomena has continued under Biden, who has established an interagency investigation.
So far, this probe appears to have produced more questions than answers.
"In coordination with our partners across the U.S. Government, we are vigorously investigating reports of possible unexplained health incidents wherever they are reported," the State Department spokesperson said. "The interagency is actively examining a range of hypotheses, but has made no determination about the cause of these incidents or whether they constitute an attack of some kind by a foreign actor."
The name change also reflects an ongoing debate over the best practices for naming and referring to new diseases.
Guiding this topic is a set of naming guidelines established by the World Health Organization (WHO) in May 2015. Through this effort, the United Nations-tied global health agency has actively sought to discourage creating undue association based on specific geography, among other things.
"It is clear that the naming of a syndrome based on signs or symptoms would be more useful than the name of the city where it was first reported," the WHO told Newsweek.
While the "WHO has not taken a position regarding the naming of this syndrome (or these syndromes)," the global health agency's protocols for naming "new human diseases" would appear to rule out such a name.
Rather, the WHO advocates for "generic descriptive terms" and the use of "specific descriptive terms" only as they relate to the nature of the disease itself, such as its severity, transmissibility or target age group. The document also recommends including the causal pathogen, if known.
Among the descriptors that "Disease names may NOT include" are "Geographic locations: Cities, countries, regions, continents."
Examples cited as poor choices include Middle East Respiratory Syndrome, Spanish Flu, Rift Valley fever, Lyme disease, Crimean Congo hemorrhagic fever, and Japanese encephalitis. Also discouraged are references to people's names, specific animals and foods, cultures, or terms that incite undue fear.
As the quest to get to the bottom of the illness continues, struggles over what to call it in some way parallel the pitfalls of naming another disease whose origins are still being probed.
The conversation over the importance of naming diseases came to the forefront of international attention at the beginning of 2020, when a novel coronavirus began to sweep the globe. In February, the WHO officially named the disease COVID-19 and deemed the virus that caused it "severe acute respiratory syndrome coronavirus 2" (SARS-CoV-2).
But because COVID-19 was first observed in the central Chinese city of Wuhan, Hubei province, early commentators branded it with a number of monikers such as "Wuhan virus" or "Chinese virus."
After the WHO name was released, some continued to deliberately defy the new convention to use these names in order to lay the blame on China. Among the holdouts were Trump and many of his conservative supporters.
Many within these same circles have also supported the notion that the novel coronavirus originated through a leak at the Wuhan Virology Institute, a facility where coronaviruses are handled and studied, rather than through zoonotic (animal-to-human) transfer, which was the explanation supported by most medical experts at the time.
The so-called "lab leak theory" has since gained traction among some experts, who, like the WHO itself, have since backed calls for further investigation.
In March, President Joe Biden ordered an analysis into the origins of COVID-19 from the U.S. Intelligence Community (IC). In May, he announced that "two elements in the IC lean toward" the natural origin theory, "one leans more toward" the lab leak, "each with low or moderate confidence," and "the majority of elements do not believe there is sufficient information to assess one to be more likely than the other."
As a result, he tasked these agencies, along with National Labs, to conduct a probe to be carried out over the next 90 days. An unclassified summary of these findings was released last week, but the results were inconclusive.
This time, four elements and the National Intelligence Council assessed "with low confidence that the initial SARS-CoV-2 infection was most likely caused by natural exposure to an animal infected with it or a close progenitor virus." One element assessed "with moderate confidence that the first human infection with SARS-CoV-2 most likely was the result of a laboratory-associated incident, probably involving experimentation, animal handling, or sampling by the Wuhan Institute of Virology," while three elements could favor neither explanation over the other.
Chinese officials, however, have vehemently rejected the leak theory, and have rejected any efforts to look into as a smear campaign. Some Chinese officials have gone so far as to suggest the virus originated within the U.S.
These theories typically involve Fort Detrick, a Maryland military facility with a long history of handling U.S. biological weapons and defense programs, which was the subject of reports of containment breaches in 2019.
The COVID-19 origins dispute has been at the center of failing relations between Washington and Beijing. As the international community grappled with COVID-19, the Trump administration severed all ties with the WHO, accusing the organization of catering to China.
When it comes to the "unexplained health incidents," Cuban officials have also rejected any notion that they were behind any sort of malfeasance as originally alleged by the Trump administration. At the time the incidents came to light in 2017, the administration was set on reversing diplomatic overtures established just a year earlier by President Barack Obama. Havana, like Beijing, has since accused Washington of politicizing public health issues.
Cuban diplomat José Ramón Cabañas, who served as the first Cuban ambassador to the U.S. until last fall, reacted to reports last month that the phenomenon had been reported in Germany.
"US media keeps alive the so called 'Havana Syndrome, now in Germany," Rodriguez tweeted. "But the question remains, if @StateDept has so many officials affected in so many countries, why they decided to affect only diplomatic ties with #Cuba?"
On Thursday, Cabañas also penned for the Latin American Information Agency a scathing takedown of the "Havana syndrome" affair, which he referred to as "a useful argument for the United States before its own public opinion and before third parties to justify the closure of the consular services of its embassy in the Cuban capital, discontinue immigration and citizenship services there, reduce the Cuban diplomatic presence in Washington, issuing travel alerts to Cuba, reducing the flow of visitors to that destination, putting into question the commitment of the Cuban authorities regarding security for foreign diplomats in their territory," in the article he shared with Newsweek.
And in a report published Monday, a panel of 16 scientists affiliated with the state-run Cuban Academy of Sciences also found no "scientifically acceptable" evidence that any such disease existed and identified potential bias in the U.S. media as playing a strong role in fueling the narrative at a time when the Trump administration had already sought to roll back relations with Havana.
"The term 'Havana syndrome' is not appropriate," Mitchell Valdes-Sosa, a prominent neuroscientist who leads the Cuban Neuroscience Center, said after the report's release in a statement shared by the Cuban Foreign Ministry. "You cannot name what does not exist. Such a heterogeneous variety of symptoms cannot be attributed to a common cause."
Biden has yet to set U.S.-Cuba relations back on the Obama-era path he supported as vice president. A six-decade trade embargo tightened by Trump and rooted in the U.S. reaction to late revolutionary leader Fidel Castro's adoption of communism remains in place, despite near-unanimous annual condemnation at the U.N. Security Council and an ongoing State Department policy review.
Complicating any notions of reconciliation with the island nation is an influential community of hardcore anti-communist Cuban Americans mainly centered in Florida, which wields a sizable tranche of electoral votes that Biden lost to Trump during last year's election. This mostly conservative bloc has called for a tougher approach toward Havana, and has sought to exploit rare protests that erupted in Cuba in July as an opportunity to inflict further pain on the country.
As the Biden administration's position on Cuba continues to formulate, there is little sign that the U.S. is any closer to establishing a credible explanation for what has now become a global phenomenon.
Among the most popular theories has been the use of secret sonic, microwave or infrared harassment by the likes of the Russian military's Main Directorate of the General Staff, known as the GU, or by its former name, the GRU. A number of experts found the symptoms of the health incidents to be consistent with such activities, reminiscent of the Cold War mentality that continues to dominate the U.S. debate on Cuba. But without proof, the theory remains speculative at best.
Other experts have attributed the sounds heard by staff in Havana to natural causes such as the chirping of a certain species of crickets, and hypothesized that what followed next was a psychogenic or a psychological rather than physical epidemic. This theory was supported by Robert W. Baloh and Robert E. Bartholomew in their 2020 book "Havana Syndrome: Mass Psychogenic Illness and the Real Story Behind the Embassy Mystery and Hysteria."
In what might be the latest incident, symptoms reported last month at the U.S. embassy in Hanoi delayed Vice President Kamala Harris's trip to Vietnam by several hours. Once at her destination, Harris made a brief reference to the "anomalous health incident" but gave no further details.
In remarks later that day, White House Press Secretary Jen Psaki used the term "Havana syndrome" to describe what took place in Vietnam, adding that it was "not a confirmed case at this point in time," but that this and other alleged cases were being taken "quite seriously."
With the U.S.-WHO relationship repaired under Biden, the international organization also continues to track the puzzling events related to what are now known as "unexplained health incidents." But here too, there was no definitive judgment on what the cause was or where it came from.
"WHO is keeping abreast of the ongoing events and reported findings regarding this syndrome, but has not at this point investigated the cause of this syndrome," the WHO told Newsweek. "To date, several hypotheses have been formulated which include non-ionizing radiation sources (microwaves and infrasound), but no clear etiology has been established."