Health Consequences of Service During the Persian Gulf War Recommendations for Research and Information Systems (1996) / Chapter Skim
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Some Hypotheses Regarding Illnesses in Persian Gulf War Veterans
Some Hypotheses Regarding Illnesses in Persian Gulf War Veterans
Pages 117-127
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From page 117... ...
and the putative causal associations that we evaluated demonstrate the vexing nature of the medical problem presented by what some have referred to as a "Gulf War Syndrome" (GWS) , and we refer to as unexplained illnesses (UI)
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From page 118... ...
Fatigue, the main CFS symptom, is defined as "self-reported persistent or relapsing fatigue lasting six or more consecutive months," and all other possible medical and psychiatric causes are eliminated. The classification of chronic fatigue syndrome is made when the criteria for severity of fatigue are met and four or more of the following eight symptoms are concurrently present or recurring for 6 or more months of illness not predating fatigue: (1)
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From page 119... ...
MCS syndrome has become a diagnosis increasingly assigned to patients with a variety of commonly experienced symptoms attributed to exposure to various environmental chemicals at very low levels (Sparks et al., 1994~. Consequently, a working definition of MCS relies on the individual's subjective symptoms of distress, attributed to environmental exposure, rather than on measurable objective evidence.
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From page 120... ...
may be related to mercury toxicity occurring as a result of the installation of dental amalgams just prior to or immediately after service in the POW. This hypothesis asserts that installation of these amalgams resulted in clinically evident elemental mercury toxicity that continues as patients have ongoing exposure to mercury.
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From page 121... ...
The prevalence of this disorder in otherwise unexposed asymptomatic individuals is unexplored. 1\4YCOPLASMA AND CHRONIC FATIGUE Some investigators have hypothesized that a subset of soldiers with unexplained illnesses of a type considered similar to CFS have mycoplasma infections that can be diagnosed if appropriate laboratory tests are available.
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From page 122... ...
No source of mycoplasma infection has been documented, although mention has been made of the potential immunosuppressive effects of inhaled fine sand particulates present in the Gulf region. Nicolson has stated that the preliminary study of this hypothesis did not utilize "a scientific sample" (Nicolson, 1996)
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From page 123... ...
The authors suggest that the findings may serve as an initial sign that the patient is suffering multisystem effects of toxic exposure. As a biological model, Milner and colleagues (unpublished)
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From page 124... ...
An investigation of stool specimens collected in one case-control study of PGW veterans revealed no positive stool specimens. ORGANOPHOSPHATE-INDUCED DELAYED NEUROTOXICITY The multiplicity of symptoms involved in the PGW-related unexplained illnesses have led a group of investigators to survey the 24th Reserve Naval Seabee Battalion (Haley, 1995~.
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From page 125... ...
FIBROMYALGIA Unexplained illnesses that have been seen in veterans have been said to be strikingly similar to the condition known as fibromyalgia. The diagnosis of fibromyalgia is based on symptoms presented by the patient and one symptomrelated physical finding: namely, at any of multiple sites of the body, pinching or pressure by a probing finger induces unexpected withdrawal or exclamations of pain.
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From page 126... ...
SUMMARY The committee found these descriptions of ongoing work interesting for a variety of reasons. First, their diverse nature provides additional compelling evidence that no one disease entity will likely be adequate to resolve the understanding of all unexplained illnesses in PG veterans.
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From page 127... ...
The fact that work of the tentative nature summarized here continues 6 years after cessation of the POW underscores the importance of taking seriously the reports of ill health among active and returning troops. Those involved in future conflicts must anticipate the need to integrate into Defense Depa~l~ent and Department of Veterans Affairs planning at all stages high-quality research on the health consequences of combat and of deployments to hostile environments.
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