Gulf War Syndrome ( GWS ), also known as Gulf War disease ( GWI ) and chronic multisymom disease ( CMI ), is a chronic and multisimtomatic disorder affecting military veterans and civilian workers from the 1990-91 Gulf War. Various acute and chronic symptoms have been associated with it, including fatigue, muscle aches, cognitive problems, rashes and diarrhea. About 250,000 of the 697,000 US veterans who served in the 1991 Gulf War suffered multi-symptom chronic disease, a condition with serious consequences. From 1995 to 2005, the health of war veterans worsened compared with unemployed veterans, with more recent chronic illness, functional impairment, repeated clinic visits and hospitalization, diseases such as chronic fatigue syndrome, post-traumatic stress disorder, and greater persistence. adverse health incidents. According to reports by Iraq and Afghanistan Veterans of America, Iraq and Afghanistan veterans may also suffer from the syndrome.
Recommended causes include reduced uranium, sarin gas, smoke from oil well burning, vaccination, combat stress and psychological factors.
The US Veterans Affairs Department (VA) described the Gulf War syndrome as a medically unexplained "Gulf War veteran" and referred to it as a chronic multi-symptom illness ( CMI ) and undiagnosed disease. The VA also explained that it does not use the term "Gulf War syndrome" when referring to medically unexplained symptoms reported by Gulf War veterans because the symptoms vary widely.
Video Gulf War syndrome
Classification
The medical illnesses associated with Gulf War syndrome have been recognized by the Department of Defense and the Department of Veterans Affairs. Because so little concrete information is known about this condition, the Veterans Health Administration (VHA) initially classifies individuals with related illnesses believed to be associated with their services in the Persian Gulf, the DX111 non-ICD-9 code, and ICD 9 code V65.5. There is no formal definition of the term "Gulf War syndrome" or "Gulf War disease".
Maps Gulf War syndrome
Signs and symptoms
According to a study sponsored by the Department of Veterans Affairs (VA) in April 2010 organized by the Institute of Medicine (IOM), part of the US National Academy of Sciences, 250,000 of 696,842 US soldiers and women in the 1991 Gulf War continue to suffer. from chronic multi-symptomatic disease, known as the "Gulf Bay Disease" or "Gulf War Syndrome." IOM found that chronic multi-symptom disease continued to affect these veterans almost 20 years after the war.
According to IOM, "It is clear that most of the troops deployed to the Gulf War have suffered from constellations that interfere with symptoms that are difficult to categorize," said committee chairman Stephen L. Hauser, professor and chair of the neurology department at the University of California, San Francisco (UCSF). "Unfortunately, symptoms that can not be quantified easily are sometimes negligible and are neglected and receive inadequate attention and funding by medical and scientific institutions.Veterans who continue to suffer from these symptoms are entitled to the best that modern science and medicine can offer to accelerate the development of effective treatments, healing, and - we hope - prevention.Our report points the way forward to achieving this goal, and we believe that through integrated national efforts and rigorous scientific input, answers can be found.
Questions still exist about why certain veterans show, and still show, symptoms that are not medically explained while others are not, why symptoms vary across multiple and specific to others, and why combat exposure is inconsistent with regard to having or not having symptoms. The lack of data on pre-deployment of veterans and post-immediate health status and the lack of measurement and monitoring of various substances that may have been exposed by veterans made it difficult - and in most cases impossible - to reconstruct what happened to service members during their placement of nearly 20 years after the fact, the committee noted. The report calls for a substantial commitment to improve the identification and treatment of multi-dimensional diseases in Gulf War veterans focusing on continuous monitoring of Gulf War veterans, better medical care, examination of genetic differences between symptomatic and asymptomatic groups and gene-environment interaction studies.
Various signs and symptoms have been associated with GWS:
Birth defects have been suggested as a consequence of the spread of the Gulf War. However, a 2006 review of some studies of veteran international coalition children found no compelling or consistent evidence of increased birth defects, found a modest increase in birth defects that fall within the general population range, in addition to excluding recall bias as an explanation for the results. A 2008 report states that "it is difficult to draw strong conclusions regarding birth defects and pregnancy outcomes in Gulf War veterans", observing that while there is a "significant but modest birth defect rate in children of Gulf War veterans," " the overall rate is still within the normal range found in the general population ". The same report calls for more research on this issue.
Cause
The United States Congress mandated the National Academy of Science Institute of Medicine to provide nine reports on Gulf War Syndrome since 1998. Aside from the many physical and psychological problems involving war zone deployments, Gulf War veterans are exposed to unique dangers not previously experienced during war. These include pyridostigmine bromide pills (administered to protect troops from the effects of nerve agents), depleted uranium ammunition, and anthrax and botulinum vaccines. The months of oil and smoke spewed out by hundreds of burned oil wells indicate the danger of other exposures previously unheard of in war zones. Military personnel must also cope with insect flocks, which require widespread use of pesticides. High-powered micro waves are used to disrupt Iraqi communication, and although it is unknown whether this may have contributed to the syndrome, recent research has shown that the safety limits for electromagnetic radiation are too soft.
Secretary of the United States Veterans Affairs Secretary Anthony Principi found that a pre-2005 study showed that veteran disease is neurologic and appears to be associated with exposure to neurotoxins, such as nerve gas sarin, pyridostigmine bromide anti-nerve gas drugs, and pesticides that affect the nervous system. The review committee concludes that "Research conducted since the war consistently shows that psychiatric illness, combat experience or other deployment-related stress does not explain the veterans of the Gulf War in the vast majority of sick veterans."
Pyridostigmine bromide nerve gas antidote
The US military issued a pyridostigmine bromide (PB) pill to protect against exposure to nerve gas agents such as sarin and soman. PB is used as prophylaxis against neurological agents; it's not a vaccine. Taken before exposure to nerve agents, PB is considered to increase the efficiency of antidote nerve agents. PB has been used since 1955 for patients suffering from myasthenia gravis with doses up to 1,500 mg per day, far more than 90 mg given to soldiers, and considered safe by the FDA at both levels for unlimited use and its use for exposure to pre- treat has recently been approved.
Given both the large body of epidemiological data in patients with myasthenia gravis and follow-up studies conducted on veterans it was concluded that while it is unlikely that the health effects reported today by Gulf War veterans are the result of exposure only to PB, the use of PB is causally related to disease. However, a later review by the Institute of Medicine concluded that the evidence was not strong enough to establish causal relationships.
Organophosphates
The organophosphate-induced delayed neuropathy (OPIDN, aka organophosphate-induced polyneuropathy) may contribute to an unexplained illusion of Gulf War veterans.
Organophosphate pesticides
The use of organophosphorous pesticides and insect repellents during the first Gulf War was credited with maintaining a low rate of pest disease. The use of pesticides is one of two exposures consistently identified by Gulf War epidemiologic studies to be significantly associated with Gulf War diseases. The profile of multisymptom disease similar to Gulf War disease has been associated with low levels of pesticide exposure in other human populations. In addition, Gulf War research has identified a dose-response effect, suggesting that greater use of pesticides is stronger associated with Gulf War disease than more limited use. The use of pesticides during the Gulf War has also been linked to neurocognitive deficits and neuroendocrine changes in Gulf War veterans in clinical studies conducted after the end of the war. The 2008 report concludes that "all available evidence sources combine to support a consistent and interesting case that pesticide use during the Gulf War is causally linked to Gulf War disease."
Sarin nerve agent
Many of the symptoms of Gulf War syndrome resemble the symptoms of organophosphates, mustard gas, and nerve gas poisoning. Gulf War veterans are exposed to a number of sources of these compounds, including nerve and pesticide gases.
Chemical detection units from Czechoslovakia, France, and England confirmed chemical agents. French detection unit detects chemical agents. Both Czech and French troops immediately report detection to US troops. US forces detect, confirm and report chemical agents; and US troops were awarded medals for detecting chemical agents. The Riegle report says that chemical alarms exploded 18,000 times during the Gulf War. After the air war began on January 16, 1991, coalition forces were chronically exposed to low and non-lethal levels of chemical and biological agents released mainly by direct Iraqi attacks through missiles, rockets, artillery, or aircraft ammunition and by the fall of the bombing Iraqi allies of the chemical warfare facility.
In 1997, the US Government released an unclassified report stating:
More than 125,000 US troops and 9,000 British soldiers were exposed to nerve gas and mustard gas when Iraqi depots in Khamisiyah were destroyed.
Recent studies have confirmed an earlier suspicion that sarin exposure, in combination with other contaminants such as pesticides and PB is linked to reports of veteran disease. Estimates range from 100,000 to 300,000 people exposed to nerve agents.
While low-level exposure to neural agents has been suggested as the cause of GWS, the RAC 2008 report (Research Advisory Committee on Gulf War Illnesses) states that "evidence is inconsistent or limited in important matters".
Chronic inflammation
The 2008 Report on Bay War and Gulf War Veterans Health Affairs suggests a possible link between GWS and chronic inflammation and is not specific to the central nervous system that causes pain, fatigue and memory problems, possibly due to pathology. Continuous improvement of cytokines and suggest further research is done on this issue.
Order
Some of the potential causes of GWS have been ruled out, including "uranium, anthrax vaccines, fuel, solvents, sand and particulates, infectious diseases, and depleted chemicals".
Oil well fires
During the war, many oil wells were burned in Kuwait by the retreating Iraqi army, and the smoke from the fire was inhaled by a large number of soldiers, many of whom suffered from acute lung and other chronic effects, including asthma and bronchitis. However, firefighters assigned to oil well fires and found smoke, but who did not take part in the battle, have not had symptoms of GWS. The 2008 RAC report states that "evidence [linking oil well fires with GWS] is inconsistent or limited in important matters".
Depleted Uuranium
Depleted uranium (DU) is widely used in penetrator kinetic energy tanks and autocannon rounds for the first time during the Gulf War and has been suggested as a possible cause of Gulf War syndrome. A 2008 review by the US Department of Veterans Affairs found no association between DU exposure and multi-symptomatic disease, concluding that "exposure to DU ammunition is unlikely to be a major cause of Gulf War disease". However, there are suggestions that long-term exposure to high-dose DU can lead to other health problems that are not associated with GWS.
In the Balkan war zone depleted uranium is also used; however, no symptoms or illnesses such as GWS have been identified. This is seen as evidence of the safety of DU munitions. While depleted uranium from shrapnel shrapnel has been shown to move into neurological tissue, it has not been associated with adverse effects and comparison between veterans with embedded and unconformed DU fragments. A group of veterans with high uranium levels in their urine from embedded particles have been monitored for any adverse health effects of dissolution of these particles, and no such effects have been identified.
The anthrax vaccine
Iraq has included anthrax, botulinum toxin, and aflatoxin into missiles and artillery shells to prepare for the Gulf War and ammunition is deployed to four locations in Iraq. During Operation Desert Storm, 41% of US combat troops and 75% of British combat troops were vaccinated against Anthrax. The reaction includes local skin irritation, some lasting for weeks or months. While the Food and Drug Administration (FDA) approved the vaccine, it never went through large-scale clinical trials.
While recent research has shown that vaccines are highly reactogenic, and cause motor neurone deaths in mice, there is no clear evidence or epidemiological studies on Gulf War veterans linking vaccines with Gulf War Syndrome. Combine this with the lack of symptoms of the current deployment of individuals who have received the lead vaccine Committee on Bay War Veterans Disease to conclude that the vaccine is unlikely to cause the Gulf War disease for most ill veterans. However, the committee's report shows that veterans who receive large numbers of different vaccines prior to deployment have shown higher rates of persistent symptoms since the war.
Fight stress
Research studies conducted since the war have consistently shown that psychiatric illness, combat experience or other deployment-related stresses do not explain the Gulf War veterans' disease in most ill veterans, according to the US Veterans Affairs Committee review committee.
A review of the Institute of Medicine in April 2010 found, "the excess of unexplained medical symptoms reported by Gulf war veterans deployed [1991] can not be relied upon to be derived from known psychiatric disorders", although they also conclude that "unstable constellations of symptoms unexplained associated with the Gulf War disease complexes could result from interactions between biological and psychological factors. "
Diagnosis
Multisymptom disease is more prevalent in Gulf War veterans than in previous conflict veterans, but similar comorbid patterns for active and non-deployed military personnel.
Treatment
The Institute of Medicine reviews evidence for treatment for symptoms associated with Gulf War syndrome and related conditions. They conclude that selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors and cognitive behavioral therapy are most likely to benefit patients.
Epidemiological research
Epidemiological studies have looked at many of the suspected causal factors for Gulf War syndrome as seen in the veteran population. Below is a summary of veteran epidemiological studies featuring multisimtomic disease and their exposure to the condition of the suspects from the 2008 US Veterans Administration report.
A more complete understanding of immune function in affected veterans of Gulf War is needed, especially in veterans' subgroups with different clinical characteristics and history of exposure. It is also important to determine the extent to which identified immune disorders may be associated with changes in neurologic and endocrine processes associated with immune regulation. Very limited cancer data have been reported for US Gulf War veterans in general, and no published studies have been published in cases that occurred after 1999. Due to the extended latency period associated with most cancers, it is important that cancer information is always updated and cancer levels are assessed at Gulf War veterans on an ongoing basis. In addition, cancer rates should be evaluated in relation to the identified exposure and subgroup location.
Other diseases
Gulf war veterans have been identified to have an increased risk of multiple sclerosis.
Controversy
Similar syndromes have been seen as an after-conflict effect - for example, 'shock shell' after World War I, and post-traumatic stress disorder (PTSD) after the Vietnam War. A review of the medical records of 15,000 American Civil War soldiers shows that "those who lose at least 5% of their companies have a 51% increased risk of developing heart disease, gastrointestinal or nervous diseases."
An article in 1996 in the New England Journal of Medicine found no difference in mortality rates, rates of hospitalization or self-reported symptoms between Persian veterans and non-Persian Gulf veterans. This article is a compilation of dozens of individual studies involving tens of thousands of veterans. The study found a statistically significant increase in the number of traffic accidents suffered by Gulf War veterans. An article in April 1998 in Emerging Infectious Diseases also found no improvement in overall rates of hospitalization and overall health for Persian Gulf War veterans compared with those living at home.
Despite this research, on November 17, 2008, a congressional designated committee called the Research Advisory Committee on Bay War Veterans Disease, administered by independent scientists and veterans designated by the Department of Veterans Affairs, announced that the syndrome is a different physical condition. The committee recommended that Congress increase funding for research on the health of Gulf War veterans at least up to $ 60 million per year. In January 2006, a study led by Melvin Blanchard and published by the Journal of Epidemiology, part of the "National Health Survey of the Veterans of the Gulf War of the Era and Their Families", stated that veterans were deployed in the Persian Gulf War has nearly twice the prevalence of chronic multisimtomatic disease, a group of symptoms similar to a series of conditions often called Gulf War Syndrome.
Louis Jones, Jr., the perpetrator of the 1995 Tracie McBride murder, declared that the Gulf War syndrome caused him to commit a crime and he sought forgiveness, hoping to avoid the death sentence given to him by the federal court. Jones was executed in 2003.
In March 2013, the hearing was held before the Subcommittee on the Supervision and Investigation of the Veterans Affairs Committee, the US House of Representatives, to determine not whether the Gulf War exists, but how it is identified, diagnosed and treated, and how the tools used to assist this effort have been used.
Related Act
On March 14, 2014, Representative Mike Coffman introduced the 2014 Gulf Healthcare Reform Health Research Act (H.R. 4261; 113th Congress) to the United States House of Representatives. The bill will change the relationship between the Gulf War Advisory Research Committee on Race and the Department of Veterans Affairs of the United States (VA). The bill would make RAC an independent organization within the VA, requiring a majority of RAC members to be appointed by Congress rather than VA, and declared that RAC could release its report without prior approval from the Secretary of Veterans Affairs. The RAC is responsible for investigating Gulf War syndrome, a chronic multisimtom disorder affecting military veterans and civilian workers from the Gulf War.
In the year preceding the consideration of this bill, VA and RAC contradict each other. VA replaced all but one of the RAC members, removing some of their oversight tasks, trying to influence the board to decide that stress, rather than biology was the cause of the Gulf War syndrome, and told RAC that it could not publish unauthorized reports. RAC was originally created in 1997, after Congress ruled that VA research into the problem was flawed, and focused on psychological causes, while most ignored the biological ones.
See also
- Delayed neuropathy induced by organophosphate
- Environmental issues with war
- Michael Donnelly (veteran), a prominent activist for Bay war crime sufferers
- Post-traumatic stress disorder
References
External links
- Gulf War syndrome in Curlie (based on DMOZ)
Source of the article : Wikipedia
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