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Visitors wait at the entrance of Canada's embassy in Havana, Cuba, on April 17, 2018.Desmond Boylan/The Associated Press

Federal officials have announced that the number of Canadian diplomats and family members who have suffered mysterious brain injuries in Havana has grown to 13. But the injured officials said the government has still not assessed all the affected people in a consistent fashion, despite repeated requests from the diplomats.

The 13th Canadian diagnosis of “Havana syndrome” – which neurologists say is medically similar to a concussion, but without physical trauma, and which some U.S. researchers have speculated may have been the result of some sort of energy-weapon attack – emerged when a Canadian career diplomat, unknown to the other 12, began reporting symptoms including dizziness and nosebleeds this summer, government officials announced. The other 12 cases, including eight adults and four children, all showed symptoms starting in 2017, so this new case raises the possibility that the cause of the injury may still be present in Cuba.

Federal government officials said in a media briefing Thursday, in which they spoke without attribution, that they would be sending a team of senior officials to Havana next week and would consider all options, including withdrawing all staff or shutting down the Canadian embassy in Havana.

The embassy’s staffing level has already been reduced to 12 Canadians (down from 17 in 2017), and as of April, Canada has been posting only single staff to the mission, not allowing spouses or families.

Despite intensive study by scientific and medical researchers, national police, intelligence and defence agencies from Canada, the United States and Cuba, no explanation or plausible motive has yet been found for the attacks.

Officials from the foreign-affairs department, Global Affairs Canada (GAC), said repeatedly Thursday that they continue to investigate the case and their priority is the health, recovery and diagnosis of the affected staffers and family members.

But a group of the diplomats diagnosed with brain injuries, who spoke to The Globe and Mail on Thursday, said the government has repeatedly broken promises to have them all tested and diagnosed in specialized research programs devoted to the syndrome.

In April, after the diplomats had complained in months of correspondence about the lack of consistent testing or appropriate medical care, the government told the diplomats in a meeting and e-mail communications that they would all be sent to the University of Pennsylvania to be tested as part of a comprehensive evaluation of the “Havana syndrome” by neurological research specialists at the Perelman School of Medicine. Those researchers, led by neurosurgery specialist Douglas Smith, first identified the syndrome in a study published in the Journal of the American Medical Association in February.

But, in what one of the diplomats described as “a broken promise,” the government never sent the diplomats or their families to Pennsylvania, and did not respond clearly to their repeated requests (one was told by Ottawa that the UPenn researchers “had not returned our calls"). The diplomats were granted anonymity by The Globe because they are still full-time government employees and are not authorized to speak.

Only four of the affected Canadians – two adults and two children – ended up being tested at UPenn, and only because they had arranged and paid for the visit themselves. Shortly after they returned, and immediately after they submitted the university’s findings to Global Affairs Canada, the department made its promise to send the rest of the staff to participate in the study.

“We were told they would send others to be diagnosed at UPenn, but it has never materialized,” one diplomat said. “That is what we were requesting from GAC, and they refused.”

The diplomats consider the UPenn study crucial because it has included the much larger group of injured U.S. diplomats and intelligence agents, and makes use of new advanced scanning technology.

Government officials say they decided in August to fund a new study at the Brain Repair Centre of Dalhousie University in Halifax. As a result, it was only in September that all the diplomats received notice that they could be tested at Dalhousie. Because two of the diplomats are abroad, and have had to postpone, there remains no consistent research standard that has been applied to all the Canadian cases – unlike their U.S. counterparts, who were all systematically tested under the UPenn study.

“Dalhousie is an excellent Canadian alternative that should have materialized one year ago,” one of the diplomats said. “From a scientific perspective, we can only hope there will be comparable data and collaboration between Dal and UPenn … a bigger cohort leads to more solid findings.”

In response to these claims, Global Affairs officials said they have devoted considerable resources to medical treatment and diagnosis for the affected Canadians, as well as “baseline” testing for new Canadians posted to Cuba, and said all injured staff have been given the opportunity to be tested at Dalhousie, which the officials said was likely in touch with the UPenn team. University of Pennsylvania staff did not respond to a request for comment.