Gulf War Illness: 10 Years Later

Ten years after the end of the 1991 war with Iraq, the physical health of veterans who served in the Persian Gulf was similar to that of veterans who served elsewhere, with several notable exceptions, a new study shows.

Gulf War veterans were more likely than veterans who served outside the Gulf to have chronic fatigue syndrome and fibromyalgia. The two conditions share many of the same symptoms with what has come to be known as Gulf War syndrome, including fatigue, joint and muscle pain, chronic headache, and memory problems.

But researcher Seth A. Eisen, MD, tells WebMD that the overall message of the U.S. Veterans Affairs Administration study is positive.

“In the vast majority of veterans who participated in this study, we did not identify any health differences between those who served in the Gulf and those who didn’t 10 years later,” he says.

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Illness Common After War

Approximately 700,000 U.S. servicemen and women served in the Persian Gulf during the 1991 war with Iraq. While combat casualties were low, reports of illness following the war’s end were common.

The scientific evidence in favor of a distinct medical syndrome associated with serving in the Gulf War has been mixed, however.

In this latest study, VA researchers examined the prevalence of 12 different medical conditions among 1,061 Gulf War veterans who served in the Persian Gulf and 1,128 veterans who served at the same time but were not deployed to the Gulf. The findings are published in the June 7 issue of the journal Annals of Internal Medicine.

Between 1999 and 2001, physicians and research nurses at 16 VA medical centers took detailed medical histories and performed physical examinations on all of the study participants. The average age of the veterans who participated in the study was 40 at examination; roughly one in five of them were women and four out of five were white.

Conditions such as high blood pressure, diabetes, hepatitis, and obstructive lung disease were no more common among the Gulf-deployed veterans than among those not deployed to the Gulf. But those who served in the Gulf were 40 times more likely to have a diagnosis of chronic fatigue syndrome, even though overall the rate of the disorder in both groups was small. Just over 1 percent of deployed veterans had chronic fatigue syndrome, compared with 0.1 percent of nondeployed veterans.

The deployed veterans were twice as likely as nondeployed veterans to have a diagnosis of fibromyalgia, almost twice as likely to experience frequent indigestion, and 40 percent more likely to have skin rashes.

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Obligation Isn’t Being Met

In an editorial accompanying the study, Harvard professor of medicine Anthony Komaroff, MD, wrote that it is now clear that veterans who served in the 1991 Gulf War have a higher incidence of chronic fatigue syndrome and fibromyalgia, but it is still not clear if the symptoms “constitute a unique syndrome.”

There are many theories about the potential cause or causes of Gulf War-related illness. Some say they are a reaction to the battery of immunizations given to service people before they were deployed. Others say that accidental exposure to some of Saddam Hussein’s stockpiles of nerve gas is to blame.

But Komaroff tells WebMD that the answer may never be known because little effort was made to track immunizations or chemical exposures during the war.

“A country that sends its young people to war has an obligation to study all illnesses that occur in the aftermath of war, not just traumatic injury,” he wrote in his editorial. “An illness like the Gulf War syndrome has been chronicled in every armed conflict since the Civil War, yet no systematic attempts have been made to understand it. Our armed forces deserve far better. Whatever the cause, the suffering is real.”

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By Salynn Boyles, reviewed by Brunilda Nazario, MD

SOURCES: Eisen, S.A., Annals of Internal Medicine, June 7, 2005; vol 142: pp 881-892. Seth A. Eisen, MD, St. Louis Veterans Affairs Medical Center. Anthony Komaroff, MD, professor of medicine, Harvard Medical School and Brigham and Women’s Hospital, Boston.