AIDS, no increase in prevalence of M. fermentans was seen with later-stage AIDS (Cotton 1990; Hawkins et al. 1992). The authors speculated that mycoplasmas may survive as colonizers of mucosal surfaces for many years and that acquisition may be related to high-risk sexual behaviors associated with acquisition of HIV infection.

There have been no reports of cases of M. hominis infection in troops deployed to southwest and south-central Asia. There are no published reports of cases of M. pneumoniae infection; however, search results from a Department of Defense Gulf War hospitalization database identified 5 cases of this infection (see Chapter 4). Nicolson and Rosenberg-Nicolson have suggested that many of the symptoms of “Gulf War Illness” (GWI) could be explained by “aggressive pathogenic mycoplasma infections, such as Mycoplasma fermentans or Mycoplasma penetrans, and they should be treatable with multiple courses of antibiotics, such as doxycycline (100-200 mg/day) or macrolides” (Nicolson and Rosenberg-Nicolson 1995). Nicolson et al. (2003) hypothesized that the source of the infections may have been contamination of the multiple vaccines received by troops before and during deployment. They noted a study by Steele (2000) that found chronic symptoms consistent with GWI in 34.2% of Gulf War veterans who reported receiving vaccines during the war, 11.5% of Gulf War-era veterans (people in the military in 1990-1991 who did not serve in the Gulf War) who reported receiving vaccines, and 3.7% of Gulf War-era veterans who did not receive vaccines. Steele suggested that vaccines used during the war may have contributed to GWI.

Nicolson et al. (2003) noted anecdotally that 55 of 73 Gulf War veterans with whom they spoke “indicated that they had good responses to doxycycline and eventually returned to normal duty.” Nicolson et al. referred to an article by Lo et al. (1991), who discovered M. fermentans (incognitus strain), as evidence of the ability of the organism to cause chronic infections. Nicolson et al. further suggested that the presence of similar symptoms in family members supported the possibility of a transmissible agent. Nicolson and Nicolson (1996) reported a sampling of veterans with GWI and 21 healthy controls with a gene-tracking technique. The technique was designed by the authors to detect hybridization signals of M. fermentans DNA in nuclear fractions from the blood cells of subjects. Of 30 subjects, 14 had evidence of infection of leukocytes with this test method (65% were infected with M. fermentans only); 11 of the 14 responded to multiple cycles of antibiotics to which mycoplasmas are sensitive. Four of the successfully treated veterans were retested; results were negative for M. fermentans gene sequences. Further studies by Nicolson et al. (2002) using polymerase chain reaction (PCR) to detect mycoplasma found a 9-fold increase in mycoplasma infections and an 18-fold increase in M. fermentans compared with healthy control subjects. Other investigators have found similar rates of positivity in patients with chronic fatigue syndrome who had no exposure to multiple vaccinations or deployment to the Gulf War (Teixeira et al. 2006). Using their gene-tracking technique, Nicolson and Nicolson (1996) claim to have detected “highly unusual DNA sequences” that “included a portion of a retrovirus genome (the HIV-1 env gene), but not all of the genes that make up the virus.” They speculated further that “the presence of the viral envelope gene in the mycoplasma could be due to genetic manipulation, or much less likely natural causes,” and they went on to say that “the mycoplasmas that we have found in Gulf War veterans are not naturally occurring organisms, or to be more specific, they could have been genetically manipulated to be more invasive and pathogenic (potent biological weapons).”