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The US embassy in China has sent its second alert in two weeks to its citizens over unexplained health issues that have prompted the evacuation of a number of US government employees working at a consulate in a southern city.
Friday's alert urged Americans to seek medical help in the event they suffered any "unusual, unexplained physical symptoms or events, auditory or sensory phenomena, or other health concerns".
The alert comes as a US medical team is screening more Americans who work at the Guangzhou consulate.
A previous case in Guangzhou, disclosed last month, prompted the tests.
The incidents have raised fears the unexplained issues that started in Cuba in 2016 have expanded to other countries.
State Department spokeswoman Heather Nauert said "a number of individuals" had been brought to the US but did not say how many were affected or evacuated.
Friday's alert called for people to be attentive of symptoms including "dizziness, headaches, tinnitus, fatigue, cognitive issues, visual problems, ear complaints and hearing loss, and difficulty sleeping". It urged them "not to attempt to locate the source of any unidentified auditory sensation. Instead, move to a different location".
The US government has deemed the Cuba incidents "specific attacks" on American workers, but has not publicly identified a cause or culprit. Most of the incidents were accompanied by bizarre, unexplained sounds that initially led US investigators to suspect a sonic attack.
Asked about the latest incidents, Chinese Foreign Ministry spokeswoman Hua Chunying said on Thursday that the US had not formally raised the matter with Beijing.
"If the US makes formal contact with us, China will continue necessary investigations in an earnest and responsible manner and maintain close communication and cooperation with the US," Hua said at a regularly scheduled news conference.
China earlier said it had looked into the case announced last month but came up with no clues about the cause of the symptoms.
The preliminary findings of the medical reports on the 24 personnel affected in Cuba showed they had sensory and memory problems similar to the brain dysfunction seen with concussions.
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In April, Canada also ordered families of diplomatic staff in Cuba to return home after mysterious health symptoms were detected in 10 Canadians stationed on the island. Canada said the 10 continued to show unexplained brain symptoms and that "medical information raised concerns for a new type of a possible acquired brain injury".
In testimony before the Senate Foreign Relations Committee last month about the first case in China, US Secretary of State Mike Pompeo said China had "said all the right things and have demonstrated their willingness to help us identify the vector which led to this medical incident".
The China incidents affect one of the most important of the seven US diplomatic outposts in the country. The Guangzhou consulate opened months after the establishment of diplomatic relations between Beijing and Washington in 1979 and moved to its new purpose-built facility in 2013.
It serves four southern provinces with a combined population of more than 204 million and processes more than one million visa applications of all types annually.
AP
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