Of particular concern is a lack of information from leadership, including what some say has been a hands-off approach from Secretary of State Tony Blinken who has yet to meet with any of the State Department victims despite saying he would prioritize the incidents.
Fear of the mysterious illness is impacting diplomats' career decisions, sources say, with some foreign service officers deciding against taking jobs that they worry could make them targets of the unexplained phenomenon that has sickened hundreds of US officials over the past few years.
Two diplomats who spoke to CNN decided not to apply to jobs in Berlin and Vienna because they wanted to avoid cities where they had heard of incidents occurring.
Diplomats and intelligence sources who spoke to CNN said they want basic information such as the number of people affected and locations of the incidents -- data that the State Department used to release publicly in press briefings about the incidents in Cuba and China. The diplomats are also wondering what the department is doing to ensure that they and their families are not sent back into buildings or apartments where health incidents have been reported previously.
Some victims affected by the strange syndrome are also angry about the way the department has handled their cases.
"For the most part we don't know anything other than what is in the press," said one US diplomat. "It is difficult for people to make informed decisions about where to serve."
The cautious approach is even more pronounced for diplomats with children.
Striking the right balance
State Department officials told CNN they are aware of the frustration and fear among staffers and that they are currently considering ways to share more information with its workforce. Officials stressed they are working to strike the right balance: they want to share more details so that diplomats can make informed decisions particularly related to their security, but they also do not want to over-hype the threat.
The Department has established a team of medical experts to respond to reports of possible health incidents, and offered baseline medical screenings to diplomats in case they later report an incident.
But those who have not been impacted -- and fear the possibility -- still feel left in the dark. The lack of basic information has given rise to a whisper campaign that's spread among foreign service officers as they try to figure out if a job is vacant because the person who previously had it rotated out, or because the person had to take a medical leave.
"When you are going to a high threat post you know that diplomatic security will keep you informed as to what the threats are, and that they will take every possible step to mitigate those threats. In this situation the threat is not clear and mitigation isn't either," said a second diplomat.
Blinken's response stands in contrast to that of CIA Director Bill Burns, who sources say has been actively engaged on the issue and has met with intelligence officials impacted by the attacks. Blinken, who said he would prioritize these incidents when he became the nation's top diplomat, plans to meet soon with a cohort of the diplomats who have been impacted, State Department officials said.
Ambassador Pamela Spratlen, a career foreign service officer, is overseeing the task force -- the Health Incident Response Task Force -- which was created as a response to the spate of these incidents in Cuba and China in 2018. Spratlen was pulled out of retirement and put into this role by Blinken earlier this year, and she has met with some of diplomats who have been affected.
On the whole, US diplomats who spoke to CNN said they worry about the psychological impact the phenomenon has had, and whether it demonstrates that whoever is behind it has succeeded in its goals of sowing fear and confusion in a way that could eventually hinder the State Department's ability to do its work.
But other seasoned diplomats disagree, and balk at the idea of turning down a post over these incidents which are somewhat sparse and undefined. They also point out that there are plenty of US diplomats still willing to serve in European countries, which are coveted assignments for career diplomats.
Frustrated victims
In addition to the US diplomats who are concerned about defending against future threats, some victims have also expressed frustration with how the State Department has treated them throughout the process.
One victim of a series of incidents that took place in 2018 in Guangzhou, China, has claimed that the State Department retaliated against him for speaking up about his persistent symptoms. Mark Lenzi, a member of the diplomatic security services, has filed two whistleblower complaints, as well as a handful of formal discrimination complaints.
The impact of the health incidents and the frustration with the State Department's handling of them is not isolated to seasoned diplomats.
Lindsay Bryda, who worked as an intern at the US consulate in Guangzhou in 2018, told CNN she had the first and only seizure of her life days after her internship there ended in July 2018.
Byrda says she first became aware of the health incidents during the first week of her internship in May 2018, when consular officials called a meeting with all American staff to tell them about officers at the consulate who had been sickened with symptoms similar to those experienced by diplomatic staff in Havana beginning in 2016. Medical evacuations followed, and Bryda only learned later that the foreign service officer who had lived in her apartment immediately before her went on to receive treatment for symptoms consistent with Havana Syndrome, she told CNN.
Bryda says she was subsequently told by the consulate's chief management officer that her health could be impacted and that she should vacate the apartment, which was in the Edinburgh International Apartment complex in Guangzhou. She returned from a brief trip to Beijing to find a police line across her door, she recalled.
Bryda, whose experiences were corroborated by another intern who worked with her at the time, suffered the seizure shortly thereafter during a trip to Thailand and says she relayed the incident to the State Department. She was told her case was included in internal reports of the anomalous health incidents coming out of China. Despite repeatedly pressing the State Department Task Force for her medical records she has yet to hear back.
State Department task force
Since taking the reins at the department earlier this year, Spratlen has implemented a number of new efforts, alongside interagency partners, to support officials and more effectively probe the root cause of these incidents.
There is now an interagency tool which was built to assess reports of these incidents at different agencies in one place. This has been a particularly welcome development for investigators who are probing the case.
While it hasn't shared information publicly about the number of new incidents, the State Department did send out a memo earlier this year that directed employees and their family members to "immediately" report any new medical symptoms that fit the diverse pattern of "Havana Syndrome" symptoms.
"We have made clear that any employee who has reported a possible unexplained health incident, or UHI, has what she or he needs to seek immediate and appropriate attention and care. These health incidents have been a priority for Secretary Blinken since his day one," said State Department Spokesperson Ned Price during a press briefing.
Earlier this month Spratlen and Deputy Secretary of State for Management and Resources Brian McKoen convened a town hall with US diplomats in Vienna to hear directly from them and make clear that this challenge is high on the department's agenda, officials said.
But Spratlen doesn't directly report to Blinken -- something some sources say show that the department isn't prioritizing the issue as highly as it claims.
The department has been handling this unique situation for about five years and has faced criticism along the way.
A declassified 2018 State Department report obtained by the James Madison Project and posted on George Washington University's National Security Archive concluded that the department's initial investigation into the 'Havana syndrome' "was characterized by a lack of senior leadership, ineffective communications, and systemic disorganization."
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