The United States says two more government workers are confirmed victims in the unexplained Cuba attacks.

The State Department is increasing the official tally from 22 to 24. But State Department spokeswoman Heather Nauert says the new victims “do not reflect new attacks.” She says the additional victims were confirmed following medical evaluations of workers attacked earlier in the year.

Nauert says the most recent attack is still believed to have been near the end of August. A U.S. official told The Associated Press previously that attack occurred Aug. 21. The official wasn’t authorized to disclose the exact date and requested anonymity.

The State Department says it can’t rule out “additional new cases.”

The attacks started last year and affected American diplomats, intelligence officials and their spouses in Havana.

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