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U.S. Diplomats Evacuated in China as Medical Mystery Grows

Americans working at the United States Consulate in Guangzhou, China, developed unexplained ailments after hearing strange sounds in at least two apartment complexes, including The Canton Place apartments, above.Credit...Lam Yik Fei for The New York Times

GUANGZHOU, China — A crisis over a mysterious ailment sickening American diplomats and their families — which began in Cuba and recently appeared in China — has widened as the State Department evacuated at least two more Americans from China on Wednesday.

The Americans who were evacuated worked at the American Consulate in the southern city of Guangzhou, and their colleagues and family members are being tested by a State Department medical team, officials said. It is unclear how many of them are exhibiting symptoms, but a State Department spokeswoman said Wednesday evening that “a number of individuals” had been sent to the United States for further testing.

For months, American officials have been worried that their diplomats have been subjected to targeted attacks involving odd sounds, leading to symptoms similar to those “following concussion or minor traumatic brain injury,” the State Department says.

The cases in China have broadened a medical mystery that started in 2016, when American Embassy employees and their family members began falling ill in Havana. In all, 24 of them were stricken with headaches, nausea, hearing loss, cognitive issues and other symptoms after saying they heard odd sounds. The issue has roiled relations with Cuba, which immediately fell under suspicion, and led the United States to expel Cuban diplomats.

But with Americans now exhibiting similar symptoms in Guangzhou, American officials have raised suspicions about whether other countries, perhaps China or Russia, might be to blame.

That is sure to complicate already strained relations with both countries over a variety of economic, political and security issues. Russia has been accused of meddling in the 2016 American presidential election, trade disputes have erupted with China and American officials fear that the Chinese are undermining relations with North Korea ahead of a summit meeting with President Trump planned for next week.

The new illnesses in China come just weeks after American officials reported finding their first case here in Guangzhou, where a consulate employee got sick. Some American officials in this city live in apartment complexes filled with other foreigners and wealthy Chinese; that is where the ailing employees were subjected to unusual noises.

But it remains unclear whether the illnesses are the result of attacks at all. Other theories have included toxins, listening devices that accidentally emitted harmful sounds or even mass hysteria.

The mystery spread to China this spring, when the first employee fell ill, and fears escalated last month when the government warned other employees to seek medical attention if they experienced unusual ailments. So far this week, another employee, his wife and their two children were evacuated after the parents exhibited neurological symptoms. Officials said they expected that at least some others would be flown out of the country as well.

The illnesses appear more widespread than the State Department initially reported last month, when it said that one person had “reported subtle and vague, but abnormal, sensations of sound and pressure.”

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Secretary of State Mike Pompeo has made investigating the medical cases in China and Cuba a priority for the State Department.Credit...Tom Brenner/The New York Times

Secretary of State Mike Pompeo said last month at a hearing of the House Foreign Affairs Committee that the symptoms of the first American employee in Guangzhou to report being ill “are very similar and entirely consistent with the medical indications that have taken place to Americans working in Cuba.”

There are roughly 170 American diplomats or employees in Guangzhou, as well as their family members, and a senior American official said a sizable number had undergone or would soon undergo testing by the State Department doctors who arrived on May 31.

The officials cautioned that no final determination had been made about what caused the illnesses.

The latest American employee evacuated from Guangzhou is Mark A. Lenzi, a security engineering officer at the consulate. He left Wednesday evening with his wife and two children after having suffered in recent months from what he described in an interview as neurological symptoms.

On Tuesday, Mr. Pompeo said in a statement that the symptoms in the first case discovered in Guangzhou were similar to the ones experienced by the 24 Americans who became ill in Havana. He said that the cause had not yet been established.

The injuries in Cuba, like those in China, followed disturbing sensations of sounds and vibrations that have been described variously as the noises made by cicadas, static, metal sheets waving or, in Mr. Lenzi’s case, marbles rolling around a metal funnel.

After the injuries were diagnosed in Cuba, the Trump administration expelled 15 Cuban diplomats, saying Cuban officials had failed to adequately protect American diplomats. The Cuban government denied any involvement and questioned whether any “attacks” had taken place. American officials suggested it was too soon to consider such a response in China, though they have raised it with the Chinese government.

On May 23, the State Department disclosed that an employee stationed in China had complained of “subtle and vague, but abnormal sensations of sound and pressure” over several months from late 2017 until April. That employee, who was evacuated, was not identified.

“We are not aware of any similar situations in China, either inside or outside of the diplomatic community,” the department said in the health alert. It advised others with “concerns about any symptoms or medical problems” to consult a doctor.

The disclosure caused anxiety and anger among American government employees in China. Others have since come forward to report similar experiences or symptoms.

In a statement on Wednesday evening, the State Department’s spokeswoman, Heather Nauert, said that “a number of individuals” had been sent to the United States for further testing and that the medical examinations continued in Guangzhou.

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transcript

How an Alleged Sonic Attack Shaped U.S. Policy on Cuba

In 2016, diplomats at the United States Embassy in Havana were mysteriously stricken. Was it an attack? There is no official explanation, but the episode has played a big role in America’s current political disengagement with Cuba.

“Imagine a CSI investigation — this famous TV program — where the investigators don’t have the murder weapon, don’t have the place, don’t have access to the victims. How the hell do you investigate that? It’s impossible!” Late 2016, Havana. “Dr. Rosenfarb, are you aware of any type of technology that would cause this?” “No, I’m not, sir.” American diplomats were complaining of crushing headaches, extreme fatigue. “Who would do this?” And, an intense sound. “Secretary Tillerson ordered the departure of non-emergency personnel.” The Cubans? They said they knew nothing about it. “Sporadic attacks continued until late April. But that sound is why this building is nearly empty at this important moment for Cuba. For the first time in 60 years, its leader will not be a Castro. “Two things we know for sure.” Here’s what the U.S. government has said about the sound: “People were hurt, and the Cuban government knows who did it. Whatever happened to these people happen as a result of some sophisticated technology that, quite frankly, is so sophisticated we don’t understand it. It leads you then …” In Washington, Senator Marco Rubio convened a hearing. “It was the early opinion of the security professionals who looked at it that it was likely a form of harassment.” “O.K. In late 2016, staff at the United States Embassy in Havana began complaining of strange noises, and among the descriptions that they complained of, high-pitched beam of sound or just intense pressure in one ear. There are 24 Americans, who during their time in Havana, have experienced symptoms that are consistent with what you would see in mild traumatic brain injury and/or concussion.” Doctors said that diplomats’ brain matter had actually changed. What started out as a mysterious nuisance — “We know it happened to 24 people” — — became a suspected instrument of attack. “Tillerson reacted as he would have reacted when he was an oil executive. He heard something happen in an oil rig. Get everybody out of there.” Secretary of State Rex Tillerson ordered his staff: “We are convinced these were targeted attacks. We don’t like our diplomats being targeted.” Depart your post, he said. Leave Cuba. And they did. Everyone from the people who discussed trade down to those who processed visas. The incident had become political. “This is entirely about the health, and the safety, and the well-being of Americans. We still have an investigation that’s underway. So I hope Cuba would focus instead on helping us with the investigation and be less concerned about claiming this is political.” [music] “So here the contrast, the contrast which is —” Carlos Alzugaray was a Cuban diplomat for decades. He’s a bit of an unofficial government spokesperson. “Why throw down the Embassy? The bad thing about it is that probably the guys who have been affected more are the regular Cubans, not the government.” By the time the diplomats left, the warming started by President Obama had undeniably chilled. The U.S. issued a travel advisory, and tourism dropped. On the streets of Havana, the idea that Cuba was involved in a sonic attack was met with skepticism. It wasn’t long after the incident became public that sound experts began downplaying the idea of a sonic attack. Sound can’t easily change brain matter, among other reasons. “You’ve got a long, long way to go before you even attribute this to sound. It’s not going to cause physical effects. If the sound goes through air before reaching you, it’s not going to cause that.” “It may have been a situation where people were drawn more closely together.” It wasn’t only the sound experts who struggled to explain what happened. “Infectious cause is what I would say.” Engineers also tried. “It could have just been a malfunctioning ultrasonic device, perhaps used for some other nefarious purpose.” And psychologists. “Well, these people were on an island. Fears can spread in a tight group. Things can get more intensified. Anything is possible.” A microwave expert. “If you direct a beam of microwave, the microwave would produce an acoustic wave.” This doctor said it could have just been a virus. ”An infection, of some type.” “So an ultrasonic weapon is not science fiction. I could build one. I could put it in the house of somebody I didn’t like, and I could annoy them. What its — really seems science-fiction is the idea that you could build an ultrasonic rifle that will shoot 100 meters and target somebody, and shoot through a wall and get just that one person.” Dr. Leighton is referring to this hotel, where some diplomats reported hearing the sound. Look up. It’s unlikely you could direct a weaponized sound wave across this street, 11 stories up through walls and windows, and hit individuals repeatedly without anyone noticing. The U.S. wouldn’t share any evidence of an attack with the Cubans. So they did their own investigation. For reference, 140 decibels is about the sound of a plane’s jet engine at takeoff. “You ask, what we think is that some people were ill, and that there was a psychogenic contagion. And other people started reporting that they were feeling ill. These are English-speaking communities that are relatively isolated from the Cuban population. They live among themselves. They exchange. And any kind of anxiety or stress —” Doctor Sosa is referring to mass hysteria, a psychological condition. There was no, quote unquote, attack. This theory is actually the current official Cuban standpoint. Today, the lights are on at the Embassy, but the doors remain locked. ”The administration’s reaction to all of this is so drastic, to make permanent the drawdown of the U.S. Embassy to ridiculously low, unnecessary levels, which has an element of spite to it.” Fulton Armstrong is a former C.I.A. analyst who covered Cuba. He made a career in searching for motives. “They were so desperate to make their case that it was sonic attacks. This is serious stuff. You’re accusing them of doing line-of-sight attacks with a weapon that no one knows exists. So, once the political people got stuck in their own internal contradictions, it was almost impossible, then, to get a real serious discussion of what was going on. The administration had already decided it was going to use it, the legitimate symptoms of U.S. government officials, for a political maneuver that looks like a lot of other political things that this administration has done. And that is, at any cost, undo what the predecessor did.” “There are a number of people in the administration, and some in Congress, who didn’t want to see normalization of relations. So, for those who didn’t like the policy changes by President Obama’s administration, it’s worked out pretty well.” “You have the State Department work, practically all the major executive jobs have not been covered. It’s the perfect situation for someone like Marco Rubio to hijack a policy and push.” “And so it leads you to conclude that the Cuban government either did this, or they know who did it. And they can’t say, because …” “Marco Rubio got his way. Sometimes, in U.S. politics, the strongest voice is the voice that predominates even when the bureaucracy isn’t with you.” “Whoever did this — did this …” “The bureaucracy has allowed the political voice to come in and dictate a lot, including analysis of the so-called sonic attacks issue.” “And then it leads you down the road of motivation. It makes you start to think, who would do this? Who would do this? Someone who doesn’t like our presence there, and someone who wants there to be this sort of friction between the U.S. So who would be motivated to create friction? Or who would not be in favor of an increased U.S. presence in Cuba? We don’t want to be in this position. We have no choice. We cannot send Americans into Foreign Service and their relatives to a country where their safety cannot be guaranteed.” Senator Rubio, a son of Cuban exiles, has been a longtime critic of the Castro government. He’s always been an opponent of reestablishing ties with Cuba. Now, I’m not under any fantasy that Cuba is going to transition from one day to the next and turn into Canada, but there has to be progress in that direction. And there’s never been a step in that direction to the extent that they’ve taken these steps, they’ve been largely cosmetic. And they’ve retreated from some of those positions. So who would be motivated to create friction? Or who would not be in favor of an increased U.S. presence? Maybe it was a third country. Which third country would want to disrupt the U.S. presence there? And the logical conclusion is Russia and Vladimir Putin.” “Has the State Department raised attacks against U.S. personnel in Cuba with the Russian government?” “That’s a very good question. I think it would be better to address that issue in a classified setting.” “Why would the fact or lack of existence of a communication to the Russian government be something that we can’t discuss in public?” “To give you the full reply would be required, and I believe that would be more appropriate in the classified setting.” “Has Raul Castro ever said to any U.S. diplomat, ‘I didn’t do it, but it’s possible that some of my guys did it without me knowing about it?’” “I do not believe that communication has ever occurred.” “You don’t want to discuss something that is not in a proper setting, or is that just you’re — you’ve just never heard?” “That is my recollection that I’ve never heard that.” “O.K. “The meeting is adjourned.” The U.S. has still not given an official explanation of the sound or its intent, if any. But its effect has been to play a big part in the current disengagement with Cuba. This is happening at a pivotal moment. Raul Castro is stepping down, and Miguel Díaz-Canel will likely be president. “The notion that we have just a skeletal staff at the Embassy — fewer people than we had during the time of isolation, is just unconscionable.” “Well, the transition is not — I mean, it’s a one-party transition. I mean the outcome’s not in doubt. You know, you would love to see a new generation of leadership that begins to move in the right direction, and I think those moves would be reciprocated by American policy makers. But it’s not going to happen because of a unilateral American opening. That was the flawed thinking behind an opening towards China, and China today is no more democratic and no more free than it was. And that was not the experience in the aftermath of the Obama opening. It did not lead to any changes in governance or on the economic condition of Cubans in the big picture.” “After more than five very difficult decades, the relationship between our governments will not be transformed overnight.” “What are we doing? We’re pulling out of the game. They would prefer to buy American rice and American chicken. They would prefer to have Americans come down and do travel in Cuba. They like us. But if we’re going to treat them in the way that we’re treating them, they will make their own future without us. They say they’ve been making their future for the last 60 years without us, and they’re prepared to do it, perhaps with some hyperbole, for another 60 years.” [music]

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In 2016, diplomats at the United States Embassy in Havana were mysteriously stricken. Was it an attack? There is no official explanation, but the episode has played a big role in America’s current political disengagement with Cuba.

Among those who reported symptoms was Mr. Lenzi. In an email sent to the entire staff of the consulate, he complained that the first employee was evacuated in April, but that no one was told of the health concerns until a month later — after doctors in the United States had found evidence of brain trauma. The initial health alert, he said in an interview, suggested it was an isolated case. “They knew full well it wasn’t,” he said.

The consulate, which opened in 2013, is a state-of-the-art building designed to withstand electronic eavesdropping and other security and intelligence threats.

In an interview before leaving China, Mr. Lenzi said that he had lived in the same apartment tower as the officer evacuated in April. It is one of several high-rise buildings in The Canton Place, a modern complex built around a plaza and bordered by restaurants, cafes and galleries. Another diplomat who reported symptoms was at a different upscale building near the consulate.

Mr. Lenzi said that over the past year he and his wife had experienced similar physical symptoms, including headaches, sleeplessness and nausea, and on three or four occasions they heard odd noises, though they did not put them together until the disclosures last month.

Even if people are evacuated for further tests, that does not necessarily mean that they have suffered injuries or illnesses, the officials emphasized. Only 25 percent of those evacuated from Cuba, for example, were later found to have health problems.

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The United States Consulate in Guangzhou, left. The building, which opened in 2013, is designed to withstand electronic eavesdropping and other threats.Credit...Lam Yik Fei for The New York Times

But the Chinese cases have raised alarms inside the State Department. Now led by Mr. Pompeo, the department appears eager to avoid the criticism it faced over what some called its handling of the Cuba cases.

In addition to the department’s medical team, William E. Todd, the acting director general of the Foreign Service, and Michael T. Evanoff, the assistant secretary of state for diplomatic security, flew to Guangzhou to assess the situation. Their visit was not announced in advance, and they were not made available to comment before departing on Wednesday.

In Tuesday’s statement, Mr. Pompeo said he had created a health care task force to examine “the unexplained health incidents that have affected a number of U.S. government personnel and family members stationed overseas.”

The statement left open the possibility that there have been similar events at other American embassies or consulates. One American official said that he was aware of reports of isolated episodes, but that there did not appear to be any discernible pattern.

Guangzhou is a major commercial hub of 14 million people on the Pearl River, about 75 miles north of Hong Kong. In addition to the embassy in Beijing and the consulates in Guangzhou and Hong Kong, the United States operates consulates in Chengdu, Shanghai, Shenyang and Wuhan.

Mr. Lenzi worked for the diplomatic security department, and he believes that his work could have made him a target. Before joining the Foreign Service in 2011, he worked with the International Republican Institute, funded by Congress, promoting democratic reforms in Ukraine and Georgia — two countries where Russia has denounced American involvement.

Steven Lee Myers reported from Guangzhou, and Jane Perlez from Beijing.

Follow Steven Lee Myers and Jane Perlez on Twitter: @stevenleemyers and @JanePerlez.

A version of this article appears in print on  , Section A, Page 1 of the New York edition with the headline: Cuba to China, Strange Illness Baffles the U.S.. Order Reprints | Today’s Paper | Subscribe

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