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Gulf War Illness

2020-09-13T07:03:36Z

Calirad:/* Cause of illness */

[[File:Operation Desert Storm.png|400px|thumb|right|Map of ground operations of Operation Desert Storm starting invasion February 24-28th 1991. Shows allied and Iraqi forces. Special arrows indicate the American 101st Airborne division moved by air and where the French 6th light division and American 3rd Armored Cavalry Regiment provided security]]
'''Gulf War Illness''' (GWI), also known as '''Gulf War Syndrome''' (GWS), is a term used for unexplained illnesses occurring in veterans of the 1991 [[wikipedia:Gulf_War|Gulf War]] in Southwest Asia. According to the [[Institute of Medicine]] in 2013, about one-third of US Gulf War veterans (250,000 of 700,000 personnel) suffer from “chronic multi-symptom illness (CMI): a series of symptoms that cannot be medically explained.”<ref>{{Cite web|url=http://www.hopkinsmedicine.org/healthlibrary/conditions/environmental_medicine/gulf_war_syndrome_85,P00487/|title=Gulf War Syndrome - Johns Hopkins Medicine Health Library|website=www.hopkinsmedicine.org|language=en|access-date=2018-08-24}}</ref><ref name=":7">{{Cite web|url=http://www8.nationalacademies.org/onpinews/newsitem.aspx?RecordID=12835|title=Gulf War Service Linked to Post-Traumatic Stress Disorder, Multisymptom Illness, Other Health Problems, But Causes Are Unclear|last=Stencel|first=Christine|date=Apr 9, 2010|website=|publisher=The National Academies of Science Engineering Medicine|language=en|archive-url=|archive-date=Apr 9, 2010|dead-url=|access-date=2018-08-26}}</ref> ''Science News'' summary of June 29, 2016, states: "Veterans of the Gulf War are more than twice as likely to have medically unexplained symptoms known as "multisymptom illness" (MSI), compared to Iraq/Afghanistan War veterans, according to an updated research."<ref>{{Cite news|url=https://www.sciencedaily.com/releases/2016/06/160629130628.htm|title=Gulf War veterans still have high rate of multisymptom illness|last=|first=|date=Jun 29, 2016|work=ScienceDaily|access-date=2018-08-24|archive-url=|archive-date=|dead-url=|publisher=Journal of Occupational and Environmental Medicine|language=en}}</ref>

== Symptoms ==
The [https://en.wikipedia.org/wiki/United_States_Department_of_Veterans_Affairs US Department of Veterans Affairs] has a list on [http://www.publichealth.va.gov/exposures/gulfwar/medically-unexplained-illness.asp Gulf War Veterans’ Medically Unexplained Illnesses].<ref name=":1" />
*[[ME/CFS|Myalgic Encephalomyelitis/Chronic fatigue syndrome]] ([[ME/CFS]]) with long-term severe [[fatigue]].
*[[Fibromyalgia]] characterized by widespread [[muscle pain]] and may include [[insomnia]], morning stiffness, [[headache]], and [[memory problems]].<ref name=":1">{{Cite web|url=https://www.publichealth.va.gov/exposures/gulfwar/medically-unexplained-illness.asp|title=Gulf War Veterans’ Medically Unexplained Illnesses - Public Health|last=Administration|first=US Department of Veterans Affairs, Veterans Health|website=www.publichealth.va.gov|language=en|access-date=2018-08-24}}</ref>

=== Functional gastrointestinal disorders ===
A group of conditions marked by chronic or recurrent symptoms related to any part of the [[Gastrointestinal system|gastrointestinal tract]]. Functional condition refers to an abnormal function of an organ, without a structural alteration in the tissues.
*functional [[abdominal pain]] syndrome
*functional dyspepsia (indigestion)
*[[irritable bowel syndrome]]<ref name=":1" />

=== Undiagnosed illnesses ===
These symptoms may be connected to undiagnosed illnesses.
*abnormal [[Weight loss|weight loss]]
*[[cardiovascular]] disease
*fatigue
*headache
*[[joint pain]]
*[[menstrual]] disorders
*muscle and [[joint pain]]
*[[Nervous system|neurological]] and psychological problems
*respiratory disorders
*skin conditions
*[[sleep dysfunction]]<ref name=":1" />

=== Other symptoms ===
* [[dizziness]]

* memory problems<ref name=":1" />

== Cause of illness ==
Causation include [[Vaccine|vaccination]]s; oil well fires; chemical and biological weapons; depleted uranium; noise; [https://www.publichealth.va.gov/exposures/carc-paint/index.asp CARC paint] used on military vehicles; occupational hazards; [[Mestinon|pyridostigmine]] bromide; pesticides or other [[Organophosphate|organophosphates]]; sand, dust, and particulates; toxic embedded fragments; infectious diseases; heat injuries; fuel; decontamination solutions; and the fluoroquinolone antibiotic ciprofloxacin.<ref>{{Cite web|url=https://www.militarytimes.com/2013/11/01/new-fda-warnings-on-cipro-may-tie-into-gulf-war-illness/|title=New FDA warnings on Cipro may tie into Gulf War illness|date=2017-08-08|website=Military Times|language=en-US|access-date=2020-09-13}}</ref><ref name=":8" /><ref>{{Cite web|url=http://www.ei-resource.org/illness-information/environmental-illnesses/gulf-war-syndrome/|title=Gulf War Syndrome - Overview, Symptoms & Possible Causes|last=Hogg|first=Matthew|date=Jun 8, 2017|website=www.ei-resource.org|language=en-gb|archive-url=|archive-date=|dead-url=|access-date=2018-08-26}}</ref><ref name=":2" />

=== Multisystem condition ===
In 2003, ''New Scientist''<nowiki/>'s March 29th print edition reported on Dr. [https://profiles.utsouthwestern.edu/profile/12888/robert-haley.html Robert Haley] and his team identifying three distinct syndromes in Gulf war veterans that involved [[brain]] damage.
* ''Syndrome 1'': Symptoms are [[Cognitive impairment|impaired cognition]], distractions, and [[insomnia]] from the exposure of pesticide with [[basal ganglia]] damage.

* ''Syndrome 2'': The symptoms are [[confusion]], disorientation, [[ataxia]], and [[vertigo]] due to exposure to sarin and pyridostigmine with damage to the [[brainstem]] and basal ganglia.

* ''Syndrome 3'': Symptoms are [[pain]], tingling, and [[numbness]] from exposure to [[wikipedia:DEET|DEET]] and pyridostigmine with damage to the brainstem.<ref name=":2">{{Cite news|url=https://www.newscientist.com/article/dn6609-us-in-u-turn-over-gulf-war-syndrome/|title=US in U-turn over Gulf war syndrome|last=MacKenzie|first=Deborah|date=Nov 3, 2004|work=New Scientist|access-date=2018-08-26|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>
175,000 of 700,000 US Gulf War personnel are affected by the brain damage syndromes categorized by Dr. Haley and 75,000 are ill due to other exposures; in total 250,000 are chronically ill with GWI. <ref name=":9">{{Cite web|url=https://youtu.be/OYKMMbPp_Do?t=546|title=Dr. Robert Haley, What Caused Gulf War Illness|last=Haley|first=Robert|date=May 6, 2013|website=YouTube|publisher=David Spencer|archive-url=|archive-date=|dead-url=|access-date=}}</ref><ref name=":2" /><ref name=":8">{{Cite web|url=https://www.publichealth.va.gov/exposures/gulfwar/sources/index.asp|title=Gulf War Exposures - Public Health|website=www.publichealth.va.gov|language=en|access-date=2018-08-26}}</ref>
=== Research conclusions ===
The ''Conclusions and Recommendations'' of the [https://www.va.gov/RAC-GWVI/RACReport2014Final.pdf Gulf War Illness and the Health of Gulf War Veterans: Research Update and Recommendations, 2009-2013]<ref name=":0">{{Cite web|url=https://www.va.gov/RAC-GWVI/RACReport2014Final.pdf|title=Gulf War Illness and the Health of Gulf War Veterans: Research Update and Recommendations, 2009-2013: Updated Scientific Findings and Recommendations|last=|first=|date=May 2014|website=va.gov|publisher=Research Advisory Committee on Gulf War Veterans’ llnesses|page=60|archive-url=|archive-date=|dead-url=|access-date=}}</ref> conclude "exposure to pesticides and pyridostigmine bromide are causally associated with Gulf War illness" as well as other hazardous exposures including gas agents sarin/cyclosarin. "Mixed exposures include not only mixtures of chemicals but also chemicals combined with heat, dehydration, infection and other environmental stressors."<ref name=":0" />

=== Vaccinations ===
Mass vaccinations "against infectious diseases including medical counter-measures against biological weapons" were given prior to military deployment.<ref name="Peakman, 2006">{{Citation|last1=Peakman|first1=Mark|authorlink1=|last2=Skowera|first2=Ania| authorlink2=|last3= Hotopf|first3=Matthew|authorlink3=Matthew Hotopf|title= Immunological dysfunction, vaccination and Gulf War illness|journal=Philosophical Transactions of the Royal Society B: Biological Sciences|volume=361|issue=1468|page= 681–687|date=2006|doi=10.1098/rstb.2006.1826}}</ref> Vaccination in the presence of elevated [[cortisol]] levels can drive [[cytokine]] expression toward [[Th2]] dominance.<ref>{{Cite journal|last=Bernton|first=E.|last2=Hoover|first2=D.|last3=Galloway|first3=R.|last4=Popp|first4=K.|date=1995-12-29|title=Adaptation to chronic stress in military trainees. Adrenal androgens, testosterone, glucocorticoids, IGF-1, and immune function|url=http://www.ncbi.nlm.nih.gov/pubmed/8597461|journal=Annals of the New York Academy of Sciences|volume=774|pages=217–231|issn=0077-8923|pmid=8597461}}</ref><ref>{{Cite journal|last=Ramírez|first=F.|last2=Fowell|first2=D.J.|last3=Puklavec|first3=M.|last4=Simmonds|first4=S.|last5=Mason|first5=D.|date=1996-04-01|title=Glucocorticoids promote a TH2 cytokine response by CD4+ T cells in vitro|url=http://www.ncbi.nlm.nih.gov/pubmed/8786298|journal=Journal of Immunology|volume=156|issue=7|pages=2406–2412|issn=0022-1767|pmid=8786298}}</ref>

== Notable studies ==
* Sep, 2017, Role of [[mitochondrial DNA]] damage and dysfunction in veterans with Gulf War Illness<ref>{{Cite web|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5599026/pdf/pone.0184832.pdf|title=Role of mitochondrial DNA damage and dysfunction in veterans with Gulf War Illness|last=Falvo|first=Michael|last2=Meyer|first2=Joel|date=Sep 2017|website=ncbi.nlm.nih.gov|type=PDF|archive-url=|archive-date=|dead-url=|access-date=|last3=Hill|first3=Helene Z.|last4=Lange|first4=Gudrun|last5=Condon|first5=Michael|last6=Klein|first6=Jacquelyn C.|last7=Ndirangu|first7=Duncan|last8=Falvo|first8=Michael J.}}</ref> - [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5599026/pdf/pone.0184832.pdf (Full Text)]
** [https://www.research.va.gov/currents/1017-Evidence-of-DNA-damage-in-Vets-with-Gulf-War-illness.cfm?platform=hootsuite Researchers find evidence of DNA damage in Vets with Gulf War illness]<ref>{{Cite web|url=https://www.research.va.gov/currents/1017-Evidence-of-DNA-damage-in-Vets-with-Gulf-War-illness.cfm?platform=hootsuite|title=Researchers find evidence of DNA damage in Vets with Gulf War illness|last=Richman|first=Mike|date=Oct 19, 2017|website=www.research.va.gov|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-08-26}}</ref>
* Nov, 2018, The Multiple Hit Hypothesis for Gulf War Illness: Self-Reported Chemical/Biological Weapons Exposure and Mild [[Traumatic Brain Injury]]<ref>{{Cite journal|last=Janulewicz|first=Patricia|last2=Krengel|first2=Maxine|last3=Quinn|first3=Emily|last4=Heeren|first4=Timothy|last5=Toomey|first5=Rosemary|last6=Killiany|first6=Ronald|last7=Zundel|first7=Clara|last8=Ajama|first8=Joy|last9=O’Callaghan|first9=James|date=Nov 2018|title=The Multiple Hit Hypothesis for Gulf War Illness: Self-Reported Chemical/Biological Weapons Exposure and Mild Traumatic Brain Injury|url=https://www.mdpi.com/2076-3425/8/11/198|journal=Brain Sciences|language=en|volume=8|issue=11|pages=198|doi=10.3390/brainsci8110198|pmc=|pmid=|quote=|author-link=|author-link2=|access-date=|author-link3=|author-link4=|author-link5=|author-link6=|via=}}</ref> - [https://www.mdpi.com/2076-3425/8/11/198/htm (Full Text)]
* Dec, 2018, Fatigue in Gulf War Illness is associated with tonically high activation in the executive control network<ref>{{Cite journal|last=|first=|author-link=Glenn Wylie|author-link2=Helen Genova|author-link3=Ekaterina Dobryakova|author-link4=John DeLuca|author-link5=Nancy Chiaravalloti|author-link6=Michael Falvo|author-link7=Dane Cook|date=2018-12-11|title=Fatigue in Gulf War Illness is associated with tonically high activation in the executive control network|url=https://www.sciencedirect.com/science/article/pii/S2213158218303899|journal=NeuroImage: Clinical|language=en|volume=|issue=|pages=101641|doi=10.1016/j.nicl.2018.101641|issn=2213-1582|quote=|via=}}</ref> - [https://www.sciencedirect.com/science/article/pii/S2213158218303899#%21 (Full Text)]
* Feb 21, 2019, [[Gastrointestinal system|Gastrointestinal]] [[Neuroimmune disease|neuroimmune]] disruption in a mouse model of Gulf War illness<ref>{{Cite journal|last=Hernandez|first=Siomara|last2=Fried|first2=David E.|last3=Grubišić|first3=Vladimir|last4=McClain|first4=Jonathon L.|last5=Gulbransen|first5=Brian D.|date=2019-02-21|title=Gastrointestinal neuroimmune disruption in a mouse model of Gulf War illness|url=https://www.fasebj.org/doi/10.1096/fj.201802572R|journal=The FASEB Journal|pages=fj.201802572R|doi=10.1096/fj.201802572R|issn=0892-6638}}</ref> - [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6463928/ (Full text)]
** [https://www.sciencedaily.com/releases/2019/02/190221141506.htm GI neuroimmune disruption contributes to Gulf War Illness]<ref name=":11">{{Cite web|url=https://www.sciencedaily.com/releases/2019/02/190221141506.htm|title=GI neuroimmune disruption contributes to Gulf War Illness: Mouse model points to gastrointestinal neuroimmune disruption as contributing mechanism of Gulf War Illness|last=|first=|authorlink=|last2=|first2=|authorlink2=|date=|website=ScienceDaily.com|publisher=|language=en|via=Science Daily for Federation of American Societies for Experimental Biology|archive-url=|archive-date=|dead-url=|access-date=2019-02-22}}</ref> <blockquote>Many Persian Gulf War veterans experience Gulf War Illness (GWI), a chronic condition with symptoms ranging from gastrointestinal to neurological. While exposure to the anti-nerve gas pyridostigmine bromide (PB) is linked to the development of GWI, the exact cause and mechanisms of the illness remain unclear. Recently, an animal study tested the hypothesis that exposure to PB contributes to the development of GWI by disrupting the neural and immune systems of the intestine.<ref name=":11" /></blockquote>
*May 2, 2020, In-vivo imaging of neuroinflammation in veterans with Gulf War illness<ref name="Loggia2020">{{Cite journal|last=Alshelh|first=Zeynab|author-link=|last2=Albrecht|first2=Daniel S.|author-link2=|last3=Bergan|first3=Courtney|author-link3=|last4=Akeju|first4=Oluwaseun|author-link4=|last5=Clauw|first5=Daniel J.|author-link5=Daniel Clauw|last6=Conboy|first6=Lisa|author-link6=|last7=Edwards|first7=Robert R.|last8=Kim|first8=Minhae|last9=Lee|first9=Yvonne C.|displayauthors=8|date=2020-02-04|title=In-vivo imaging of neuroinflammation in veterans with Gulf War illness|url=http://www.sciencedirect.com/science/article/pii/S0889159119313340|journal=Brain, Behavior, and Immunity|language=en|volume=|issue=|pages=|doi=10.1016/j.bbi.2020.01.020|issn=0889-1591|pmc=|pmid=|access-date=|quote=|via=|last10=Protsenko|first10=Ekaterina|last11=Napadow|first11=Vitaly|last12=Sullivan|first12=Kimberly|author-link12=Kimberly Sullivan|author-link13=Marco Loggia|last13=Loggia|first13=Marco F.}}</ref> - [https://www.sciencedirect.com/science/article/pii/S0889159119313340 (Full text)]
*August 10, 2020, Exercise alters brain activation in Gulf War Illness and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome<ref name="Washington2020">{{Cite journal|last=Washington|first=Stuart D.|author-link=|last2=Rayhan|first2=Rakib U.|author-link2=Rakib Rayhan|last3=Garner|first3=Richard|author-link3=|last4=Provenzano|first4=Destie|author-link4=|last5=Zajur|first5=Kristina|author-link5=|last6=Addiego|first6=Florencia Martinez|author-link6=|last7=VanMeter|first7=John W.|last8=Baraniuk|first8=James N.|author-link8=James Baraniuk|date=2020-07-01|title=Exercise alters brain activation in Gulf War Illness and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome|url=https://academic.oup.com/braincomms/article/2/2/fcaa070/5885074|journal=Brain Communications|language=en|volume=2|issue=2|pages=|doi=10.1093/braincomms/fcaa070|pmc=|pmid=|access-date=|quote=|via=}}</ref> - [https://academic.oup.com/braincomms/article/2/2/fcaa070/5885074 (Full text)]

== Risk of developing other conditions ==
The US Department of Veteran's Affairs found that "1990-1991 Gulf War deployment is associated with an increased risk for ME/CFS, fibromyalgia, skin conditions, and dyspepsia."<ref>{{Cite web|url=https://www.publichealth.va.gov/exposures/gulfwar/chronic-fatigue-syndrome.asp|title=Myalgic Encephalomyelitis/Chronic Fatigue Syndrome in Gulf War Veterans - Public Health|last=Administration|first=US Department of Veterans Affairs, Veterans Health|website=www.publichealth.va.gov|language=en|access-date=2018-08-24}}</ref>

== Controversy ==

=== US Department of Veterans Affairs' cover-up of GWI ===
* Aug 28, 1997, [http://gulfwarvets.com/arison/gws.htm The Cover-up of Gulf War Syndrome -- A Question of Natinal Integrity]<ref>{{Cite web|url=http://gulfwarvets.com/arison/gws.htm|title=The Cover-Up of Gulf War Syndrome -- A Question of National Integrity|last=Harrison III|first=H. Lindsey|date=Aug 28, 1997|website=gulfwarvets.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-26}}</ref>
* Mar 13, 2013, [http://gulfwarvets.com/va_cover_up_data.htm Whistleblower: Veterans Affairs Covered Up Data on Mental Health, Gulf War Syndrome]<ref>{{Cite web|url=http://gulfwarvets.com/va_cover_up_data.htm|title=Whistleblower: Veterans Affairs Covered Up Data on Mental Health, Gulf War Syndrome|last=Reno|first=Jamie|date=Mar 13, 2013|website=gulfwarvets.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-26}}</ref>
* Mar 13, 2013, [https://www.usatoday.com/story/news/nation/2013/03/13/whistleblower-alleges-veterans-affairs-cover-up/1979839/ Researcher says officials covered up vets' health data]<ref name=":6">{{Cite news|url=https://www.usatoday.com/story/news/nation/2013/03/13/whistleblower-alleges-veterans-affairs-cover-up/1979839/|title=Researcher says officials covered up vets' health data|last=Kennedy|first=Kelly|date=Mar 13, 2013|work=USA TODAY|access-date=2018-08-26|archive-url=|archive-date=|dead-url=|language=en}}</ref>
<blockquote>WASHINGTON — [[wikipedia:United_States_Department_of_Veterans_Affairs|Department of Veterans Affairs]] officials purposely manipulate or hide data that would support the claims of veterans from Iraq and Afghanistan to prevent paying costly benefits, a former VA researcher told a House subcommittee Wednesday.</blockquote><blockquote>"If the studies produce results that do not support the office of public health's unwritten policy, they do not release them," said [[wikipedia:Steven_S._Coughlin|Steven Coughlin]], a former epidemiologist in the VA's public health department.</blockquote><blockquote>"This applies to data regarding adverse health consequences of environmental exposures, such as burn pits in Iraq and Afghanistan, and toxic exposures in the Gulf War," Coughlin said. "On the rare occasions when embarrassing study results are released, data are manipulated to make them unintelligible."<ref name=":6" /></blockquote>
* Apr 12, 2013, [https://www.youtube.com/watch?v=OYKMMbPp_Do&feature=youtu.be&t=546 Dr. Robert Haley, What Caused Gulf War Illness]<ref name=":9" /> (Video) Dr. Haley speaks about the United States Department of Veterans Affairs' cover-up of US Gulf War troop illness being due to environmental exposure.

* Mar 14, 2014, [https://www.forbes.com/sites/rebeccaruiz/2014/03/24/congress-confronts-va-over-gulf-war-illness-research/#7648eec961fb Congress Confronts VA Over Gulf War Illness Research]<ref>{{Cite news|url=https://www.forbes.com/sites/rebeccaruiz/2014/03/24/congress-confronts-va-over-gulf-war-illness-research/#7648eec961fb|title=Congress Confronts VA Over Gulf War Illness Research|last=Ruiz|first=Rebecca|date=Mar 24, 2014|work=Forbes|access-date=2018-08-26|archive-url=|archive-date=|dead-url=|language=en}}</ref>
* Mar 30, 2015, [https://www.disabledveterans.org/2015/03/30/former-va-chief-of-staff-linked-to-gulf-war-scandal/ Former VA Chief Of Staff Linked To Gulf War Scandal]<ref>{{Cite news|url=https://www.disabledveterans.org/2015/03/30/former-va-chief-of-staff-linked-to-gulf-war-scandal/|title=Former VA Chief Of Staff Linked To Gulf War Scandal|last=Krause|first=Benjamin|date=2015-03-30|work=DisabledVeterans.Org|access-date=2018-08-26|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

===Simon Wessely's past stress related beliefs in GWI ===
Professor [[Simon Wessely]], psychiatric paradigm researcher of [[chronic fatigue syndrome]], believed that [[stress]] was the common denominator of GWI.
* 2004, Interview with ''New Scientist'', [https://www.newscientist.com/article/dn6609-us-in-u-turn-over-gulf-war-syndrome/ US in U-turn over Gulf war syndrome]<ref name=":2" />
<blockquote>Wessely told ''New Scientist'': “There is not one single cause for the ill health,” adding that he believes we may never fully know what happened to the people who became ill.</blockquote><blockquote>Wessely asked both Gulf and non-Gulf veterans about 50 standard symptoms. “Gulf veterans reported every symptom twice as often,” he told the Lloyd inquiry. If there were a unique Gulf syndrome, some would be relatively more frequent in the Gulf group. “But they are just experiencing more ill health. There is no unique syndrome here.”</blockquote><blockquote>Wessely favours psychological explanations for Gulf war illnesses. The only thing that could have affected so many different people, he says, was stress, especially anxiety about chemical weapons, misinformation about Gulf war syndrome afterwards, and the many vaccinations Gulf troops received. His team found the more vaccine Gulf, but not non-Gulf veterans, received the more likely they are to be ill.</blockquote><blockquote>Haley says the questions in Wessely’s study were too vague to distinguish between a real syndrome and people who have, say, occasional dizziness or joint pain. He says this will confound efforts to uncover a meaningful pattern behind the veterans’ symptoms.<ref name=":2" /></blockquote>
* 2006, A study published in [[The Lancet|''The Lancet'']] that Wessely was involved with, [https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(06)68662-5/fulltext The health of UK military personnel who deployed to the 2003 Iraq war: a cohort study]<ref name=":3">{{Cite journal|last=Hotopf|first=Matthew|last2=Hull|first2=Lisa|last3=Fear|first3=NicolaT|last4=Browne|first4=Tess|last5=Horn|first5=Oded|last6=Iversen|first6=Amy|last7=Jones|first7=Margaret|last8=Murphy|first8=Dominic|last9=Bland|first9=Duncan|date=2006|others=Earnshaw, Mark; Greenberg, Neil; Hacker Hughes, Jamie; Tate, Rosemary; Dandeker, Christopher; Rona, Robert; Wessely, Simon|title=The health of UK military personnel who deployed to the 2003 Iraq war: a cohort study|url=https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(06)68662-5/fulltext|journal=The Lancet|language=English|volume=367|issue=9524|pages=1731–1741|doi=10.1016/S0140-6736(06)68662-5|issn=0140-6736|via=}}</ref> interpretation:
<blockquote>For regular personnel in the UK armed forces, deployment to the Iraq war has not, so far, been associated with significantly worse health outcomes, apart from a modest effect on multiple physical symptoms. There is evidence of a clinically and statistically significant effect on health in reservists.<ref name=":3" /></blockquote>
* 2006, [http://www.gresham.ac.uk/lectures-and-events/something-old-something-new-something-borrowed-something-blue-the-true-story-of Something old, something new, something borrowed, something blue: The true story of Gulf War Syndrome]<ref name=":10">{{Cite web|url=http://www.gresham.ac.uk/lectures-and-events/something-old-something-new-something-borrowed-something-blue-the-true-story-of|title=Something old, something new, something borrowed, something blue: The true story of Gulf War Syndrome|website=www.gresham.ac.uk|access-date=2018-08-29}}</ref>
<blockquote>So my story then: something old, we have seen some of these before; something new, there was a definite hazard with some of the precautions that were taken to protect Gulf veterans; something borrowed, soldiers can also be civilians and the things that concern us also can concern them; something blue, the psychiatry of Gulf War is the psychiatry more of [[depression]] than it is of [[Post-traumatic stress disorder|PTSD]].<ref name=":10" /></blockquote>
* 2010, A second study [https://www.kcl.ac.uk/kcmhr/publications/assetfiles/iraqafghan/Fear2010-consequencesofdeployment.pdf What are the consequences of deployment to Iraq and Afghanistan on the mental health of the UK armed forces? A cohort study]<ref name=":4">{{Cite web|url=https://www.kcl.ac.uk/kcmhr/publications/assetfiles/iraqafghan/Fear2010-consequencesofdeployment.pdf|title=What are the consequences of deployment to Iraq and Afghanistan on the mental health of the UK armed forces?: A cohort study|last=Fear|first=Nicola T|last2=Jones|first2=Margaret|date=2010|website=kcl.ac.uk|others=Jones, Norman; Greenberg, Neil; Landau, Sabine; Dandeker, Christopher; Rona, Roberta J; Hotopf, Mathew; Wessely, Simon|archive-url=|archive-date=|dead-url=|access-date=|last3=Murphy|first3=Dominic|last4=Hull|first4=Lisa|last5=Civerson|first5=Amy|last6=Coker|first6=Bolaji|last7=Machell|first7=Louise|last8=Sundin|first8=Josefin|last9=Woodhead|first9=Charlotte|type=PDF}}</ref> interpretation:
<blockquote>Symptoms of common mental disorders and alcohol misuse remain the most frequently reported mental disorders in UK armed forces personnel, whereas the prevalence of probable [[post-traumatic stress disorder]] was low. These findings show the importance of continued health surveillance of UK military personnel.<ref name=":4" /></blockquote>
* 2011, A ''BBC'' report [https://www.bbc.com/news/uk-12195884 Two decades on, battle goes on over 'Gulf War Syndrome']<ref name=":5">{{Cite news|url=https://www.bbc.com/news/uk-12195884|title=Battle continues over Gulf War Syndrome|last=Hughes|first=Caroline Hawley and Stuart|date=2011|work=BBC News|access-date=2018-08-26|language=en-GB}}</ref>
<blockquote>Professor [[Simon Wessely]] is director of the King's Centre for Military Health Research in London and an adviser to the Ministry of Defence. He does not believe Gulf War Syndrome exists as a distinct illness.</blockquote><blockquote>Even so, he has no doubt that a significant number of Gulf veterans became ill as a direct result of their military service.</blockquote><blockquote>"The evidence is incontrovertible that there is a Gulf War health effect," he says.</blockquote><blockquote>"Something to do with the Gulf has affected health and no-one serious has ever disputed that.</blockquote><blockquote>"Is there a problem? Yes there is. Is it Gulf War Syndrome or isn't it? I think that's a statistical and technical question that's of minor interest."</blockquote><blockquote>The Ministry of Defence echoes Professor Wessely's view.<ref name=":5" /></blockquote>

==See also==
* [[Vaccine]]

==Learn more==
* 2004, ''Independent Public Inquiry on Gulf War Illnesses'' (The Lloyd Inquiry) ([https://web.archive.org/web/20041120030227/http://www.lloyd-gwii.com:80/admin/ManagedFiles/4/ReportResume.doc Report Resume])<ref>{{Cite web|url=https://web.archive.org/web/20041120030227/http://www.lloyd-gwii.com:80/admin/ManagedFiles/4/ReportResume.doc|title=Independent Public Inquiry on Gulf War Illnesses REPORT RÉSUMÉ|date=2004-11-20|access-date=2018-08-26|website=web.archive.org|last=Lloyd|first=Anthony|archive-url=|archive-date=|dead-url=|via=Wayback Machine|last2=Jones|first2=Norman|last3=Davies|first3=Michael|type=WORD}}</ref> - ([https://web.archive.org/web/20050119184010/http://www.lloyd-gwii.com:80/admin/ManagedFiles/4/LloydReport.pdf Full Testimony])<ref>{{Cite web|url=https://web.archive.org/web/20050119184010/http://www.lloyd-gwii.com:80/admin/ManagedFiles/4/LloydReport.pdf|title=Independent Public Inquiry on Gulf War Illnesses|date=2005-01-19|access-date=2018-08-26|website=web.archive.org|last=Lloyd|first=Anthony|archive-url=|archive-date=|dead-url=|last2=Jones|first2=Norman|last3=Davies|first3=Michael|publisher=Way Back Machine|type=PDF}}</ref>

* 2008, [https://www.va.gov/RAC-GWVI/docs/Committee_Documents/GWIandHealthofGWVeterans_RAC-GWVIReport_2008.pdf Gulf War Illness and the Health of Gulf War Veterans Scientific Findings and Recommendations]<ref>{{Cite web|url=https://www.va.gov/RAC-GWVI/docs/Committee_Documents/GWIandHealthofGWVeterans_RAC-GWVIReport_2008.pdf|title=Gulf War Illness and the Health of Gulf War Veterans Scientific Findings and Recommendations|last=|first=|date=Nov 2008|website=va.gov|publisher=Research Advisory Committee on Gulf War Veterans’ llnesses|type=Microsoft WORD|archive-url=|archive-date=|dead-url=|access-date=}}</ref>
* 2014, [http://www.usmedicine.com/agencies/department-of-veterans-affairs/advisory-group-exposures-not-stress-caused-gulf-war-illness/ Advisory Group: Exposures, Not Stress Caused Gulf War Illness]<ref>{{Cite news|url=http://www.usmedicine.com/agencies/department-of-veterans-affairs/advisory-group-exposures-not-stress-caused-gulf-war-illness/|title=Advisory Group: Exposures, Not Stress Caused Gulf War Illness - U.S. Medicine|last=usmedicine.com|date=2014-06-06|work=U.S. Medicine|access-date=2018-08-26|language=en-US}}</ref>
* 2015, [http://www.research.va.gov/pubs/docs/GWResearch-StrategicPlan.pdf GULF WAR RESEARCH STRATEGIC PLAN 2013-2017]<ref>{{Cite web|url=https://www.research.va.gov/pubs/docs/GWResearch-StrategicPlan.pdf|title=GULF WAR RESEARCH STRATEGIC PLAN 2013-2017 - 2015 Update|last=|first=|date=2015|website=va.gov|archive-url=|archive-date=|dead-url=|access-date=}}</ref>

*2016, [https://www.youtube.com/watch?v=KuyKkIaoMgw&feature=youtu.be Testing nine potential treatments for Gulf War Illness pain and fatigue]<ref>{{Cite web|url=https://www.youtube.com/watch?v=KuyKkIaoMgw&feature=youtu.be|title=Testing nine potential treatments for Gulf War Illness pain and fatigue|last=Younger|first=Jared|date=Apr 13, 2016|website=YouTube|publisher=Younger Lab|archive-url=|archive-date=|dead-url=|access-date=}}</ref>
*2019, [https://gumc.georgetown.edu/news-release/veterans-study-suggests-two-subtypes-of-gulf-war-illness/# Veterans Study Suggests Two Subtypes of Gulf War Illness]<ref>{{Cite web|url=https://gumc.georgetown.edu/news-release/veterans-study-suggests-two-subtypes-of-gulf-war-illness/|title=Veterans Study Suggests Two Subtypes of Gulf War Illness|date=2019-12-12|website=Georgetown University Medical Center|language=en-US|access-date=2019-12-13}}</ref>
*2019, [https://medicalxpress.com/news/2019-10-brain-chronic-fatigue-syndrome-gulf.html Brain studies show chronic fatigue syndrome and Gulf War illness are distinct conditions]<ref>{{Cite web|url=https://medicalxpress.com/news/2019-10-brain-chronic-fatigue-syndrome-gulf.html|title=Brain studies show chronic fatigue syndrome and Gulf War illness are distinct conditions|website=medicalxpress.com|language=en-us|access-date=2019-12-13}}</ref>
*[[wikipedia:Gulf_War_syndrome#CITEREFRAC-GWVI_Minutes2005|Wikipedia article on GWI]]

== References ==
{{reflist}}

[[Category:Diagnoses]]

Gulf War Illness

2020-09-13T06:54:20Z

Calirad:/* Cause of illness */

[[File:Operation Desert Storm.png|400px|thumb|right|Map of ground operations of Operation Desert Storm starting invasion February 24-28th 1991. Shows allied and Iraqi forces. Special arrows indicate the American 101st Airborne division moved by air and where the French 6th light division and American 3rd Armored Cavalry Regiment provided security]]
'''Gulf War Illness''' (GWI), also known as '''Gulf War Syndrome''' (GWS), is a term used for unexplained illnesses occurring in veterans of the 1991 [[wikipedia:Gulf_War|Gulf War]] in Southwest Asia. According to the [[Institute of Medicine]] in 2013, about one-third of US Gulf War veterans (250,000 of 700,000 personnel) suffer from “chronic multi-symptom illness (CMI): a series of symptoms that cannot be medically explained.”<ref>{{Cite web|url=http://www.hopkinsmedicine.org/healthlibrary/conditions/environmental_medicine/gulf_war_syndrome_85,P00487/|title=Gulf War Syndrome - Johns Hopkins Medicine Health Library|website=www.hopkinsmedicine.org|language=en|access-date=2018-08-24}}</ref><ref name=":7">{{Cite web|url=http://www8.nationalacademies.org/onpinews/newsitem.aspx?RecordID=12835|title=Gulf War Service Linked to Post-Traumatic Stress Disorder, Multisymptom Illness, Other Health Problems, But Causes Are Unclear|last=Stencel|first=Christine|date=Apr 9, 2010|website=|publisher=The National Academies of Science Engineering Medicine|language=en|archive-url=|archive-date=Apr 9, 2010|dead-url=|access-date=2018-08-26}}</ref> ''Science News'' summary of June 29, 2016, states: "Veterans of the Gulf War are more than twice as likely to have medically unexplained symptoms known as "multisymptom illness" (MSI), compared to Iraq/Afghanistan War veterans, according to an updated research."<ref>{{Cite news|url=https://www.sciencedaily.com/releases/2016/06/160629130628.htm|title=Gulf War veterans still have high rate of multisymptom illness|last=|first=|date=Jun 29, 2016|work=ScienceDaily|access-date=2018-08-24|archive-url=|archive-date=|dead-url=|publisher=Journal of Occupational and Environmental Medicine|language=en}}</ref>

== Symptoms ==
The [https://en.wikipedia.org/wiki/United_States_Department_of_Veterans_Affairs US Department of Veterans Affairs] has a list on [http://www.publichealth.va.gov/exposures/gulfwar/medically-unexplained-illness.asp Gulf War Veterans’ Medically Unexplained Illnesses].<ref name=":1" />
*[[ME/CFS|Myalgic Encephalomyelitis/Chronic fatigue syndrome]] ([[ME/CFS]]) with long-term severe [[fatigue]].
*[[Fibromyalgia]] characterized by widespread [[muscle pain]] and may include [[insomnia]], morning stiffness, [[headache]], and [[memory problems]].<ref name=":1">{{Cite web|url=https://www.publichealth.va.gov/exposures/gulfwar/medically-unexplained-illness.asp|title=Gulf War Veterans’ Medically Unexplained Illnesses - Public Health|last=Administration|first=US Department of Veterans Affairs, Veterans Health|website=www.publichealth.va.gov|language=en|access-date=2018-08-24}}</ref>

=== Functional gastrointestinal disorders ===
A group of conditions marked by chronic or recurrent symptoms related to any part of the [[Gastrointestinal system|gastrointestinal tract]]. Functional condition refers to an abnormal function of an organ, without a structural alteration in the tissues.
*functional [[abdominal pain]] syndrome
*functional dyspepsia (indigestion)
*[[irritable bowel syndrome]]<ref name=":1" />

=== Undiagnosed illnesses ===
These symptoms may be connected to undiagnosed illnesses.
*abnormal [[Weight loss|weight loss]]
*[[cardiovascular]] disease
*fatigue
*headache
*[[joint pain]]
*[[menstrual]] disorders
*muscle and [[joint pain]]
*[[Nervous system|neurological]] and psychological problems
*respiratory disorders
*skin conditions
*[[sleep dysfunction]]<ref name=":1" />

=== Other symptoms ===
* [[dizziness]]

* memory problems<ref name=":1" />

== Cause of illness ==
Causation include [[Vaccine|vaccination]]s; oil well fires; chemical and biological weapons; depleted uranium; noise; [https://www.publichealth.va.gov/exposures/carc-paint/index.asp CARC paint] used on military vehicles; occupational hazards; [[Mestinon|pyridostigmine]] bromide; pesticides or other [[Organophosphate|organophosphates]]; sand, dust, and particulates; toxic embedded fragments; infectious diseases; heat injuries; fuel; decontamination solutions; and the fluoroquinolone antibiotic ciprofloxacin<ref>{{Cite web|url=https://www.militarytimes.com/2013/11/01/new-fda-warnings-on-cipro-may-tie-into-gulf-war-illness/|title=New FDA warnings on Cipro may tie into Gulf War illness|date=2017-08-08|website=Military Times|language=en-US|access-date=2020-09-13}}</ref>.<ref name=":8" /><ref>{{Cite web|url=http://www.ei-resource.org/illness-information/environmental-illnesses/gulf-war-syndrome/|title=Gulf War Syndrome - Overview, Symptoms & Possible Causes|last=Hogg|first=Matthew|date=Jun 8, 2017|website=www.ei-resource.org|language=en-gb|archive-url=|archive-date=|dead-url=|access-date=2018-08-26}}</ref><ref name=":2" />

=== Multisystem condition ===
In 2003, ''New Scientist''<nowiki/>'s March 29th print edition reported on Dr. [https://profiles.utsouthwestern.edu/profile/12888/robert-haley.html Robert Haley] and his team identifying three distinct syndromes in Gulf war veterans that involved [[brain]] damage.
* ''Syndrome 1'': Symptoms are [[Cognitive impairment|impaired cognition]], distractions, and [[insomnia]] from the exposure of pesticide with [[basal ganglia]] damage.

* ''Syndrome 2'': The symptoms are [[confusion]], disorientation, [[ataxia]], and [[vertigo]] due to exposure to sarin and pyridostigmine with damage to the [[brainstem]] and basal ganglia.

* ''Syndrome 3'': Symptoms are [[pain]], tingling, and [[numbness]] from exposure to [[wikipedia:DEET|DEET]] and pyridostigmine with damage to the brainstem.<ref name=":2">{{Cite news|url=https://www.newscientist.com/article/dn6609-us-in-u-turn-over-gulf-war-syndrome/|title=US in U-turn over Gulf war syndrome|last=MacKenzie|first=Deborah|date=Nov 3, 2004|work=New Scientist|access-date=2018-08-26|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>
175,000 of 700,000 US Gulf War personnel are affected by the brain damage syndromes categorized by Dr. Haley and 75,000 are ill due to other exposures; in total 250,000 are chronically ill with GWI. <ref name=":9">{{Cite web|url=https://youtu.be/OYKMMbPp_Do?t=546|title=Dr. Robert Haley, What Caused Gulf War Illness|last=Haley|first=Robert|date=May 6, 2013|website=YouTube|publisher=David Spencer|archive-url=|archive-date=|dead-url=|access-date=}}</ref><ref name=":2" /><ref name=":8">{{Cite web|url=https://www.publichealth.va.gov/exposures/gulfwar/sources/index.asp|title=Gulf War Exposures - Public Health|website=www.publichealth.va.gov|language=en|access-date=2018-08-26}}</ref>
=== Research conclusions ===
The ''Conclusions and Recommendations'' of the [https://www.va.gov/RAC-GWVI/RACReport2014Final.pdf Gulf War Illness and the Health of Gulf War Veterans: Research Update and Recommendations, 2009-2013]<ref name=":0">{{Cite web|url=https://www.va.gov/RAC-GWVI/RACReport2014Final.pdf|title=Gulf War Illness and the Health of Gulf War Veterans: Research Update and Recommendations, 2009-2013: Updated Scientific Findings and Recommendations|last=|first=|date=May 2014|website=va.gov|publisher=Research Advisory Committee on Gulf War Veterans’ llnesses|page=60|archive-url=|archive-date=|dead-url=|access-date=}}</ref> conclude "exposure to pesticides and pyridostigmine bromide are causally associated with Gulf War illness" as well as other hazardous exposures including gas agents sarin/cyclosarin. "Mixed exposures include not only mixtures of chemicals but also chemicals combined with heat, dehydration, infection and other environmental stressors."<ref name=":0" />

=== Vaccinations ===
Mass vaccinations "against infectious diseases including medical counter-measures against biological weapons" were given prior to military deployment.<ref name="Peakman, 2006">{{Citation|last1=Peakman|first1=Mark|authorlink1=|last2=Skowera|first2=Ania| authorlink2=|last3= Hotopf|first3=Matthew|authorlink3=Matthew Hotopf|title= Immunological dysfunction, vaccination and Gulf War illness|journal=Philosophical Transactions of the Royal Society B: Biological Sciences|volume=361|issue=1468|page= 681–687|date=2006|doi=10.1098/rstb.2006.1826}}</ref> Vaccination in the presence of elevated [[cortisol]] levels can drive [[cytokine]] expression toward [[Th2]] dominance.<ref>{{Cite journal|last=Bernton|first=E.|last2=Hoover|first2=D.|last3=Galloway|first3=R.|last4=Popp|first4=K.|date=1995-12-29|title=Adaptation to chronic stress in military trainees. Adrenal androgens, testosterone, glucocorticoids, IGF-1, and immune function|url=http://www.ncbi.nlm.nih.gov/pubmed/8597461|journal=Annals of the New York Academy of Sciences|volume=774|pages=217–231|issn=0077-8923|pmid=8597461}}</ref><ref>{{Cite journal|last=Ramírez|first=F.|last2=Fowell|first2=D.J.|last3=Puklavec|first3=M.|last4=Simmonds|first4=S.|last5=Mason|first5=D.|date=1996-04-01|title=Glucocorticoids promote a TH2 cytokine response by CD4+ T cells in vitro|url=http://www.ncbi.nlm.nih.gov/pubmed/8786298|journal=Journal of Immunology|volume=156|issue=7|pages=2406–2412|issn=0022-1767|pmid=8786298}}</ref>

== Notable studies ==
* Sep, 2017, Role of [[mitochondrial DNA]] damage and dysfunction in veterans with Gulf War Illness<ref>{{Cite web|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5599026/pdf/pone.0184832.pdf|title=Role of mitochondrial DNA damage and dysfunction in veterans with Gulf War Illness|last=Falvo|first=Michael|last2=Meyer|first2=Joel|date=Sep 2017|website=ncbi.nlm.nih.gov|type=PDF|archive-url=|archive-date=|dead-url=|access-date=|last3=Hill|first3=Helene Z.|last4=Lange|first4=Gudrun|last5=Condon|first5=Michael|last6=Klein|first6=Jacquelyn C.|last7=Ndirangu|first7=Duncan|last8=Falvo|first8=Michael J.}}</ref> - [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5599026/pdf/pone.0184832.pdf (Full Text)]
** [https://www.research.va.gov/currents/1017-Evidence-of-DNA-damage-in-Vets-with-Gulf-War-illness.cfm?platform=hootsuite Researchers find evidence of DNA damage in Vets with Gulf War illness]<ref>{{Cite web|url=https://www.research.va.gov/currents/1017-Evidence-of-DNA-damage-in-Vets-with-Gulf-War-illness.cfm?platform=hootsuite|title=Researchers find evidence of DNA damage in Vets with Gulf War illness|last=Richman|first=Mike|date=Oct 19, 2017|website=www.research.va.gov|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-08-26}}</ref>
* Nov, 2018, The Multiple Hit Hypothesis for Gulf War Illness: Self-Reported Chemical/Biological Weapons Exposure and Mild [[Traumatic Brain Injury]]<ref>{{Cite journal|last=Janulewicz|first=Patricia|last2=Krengel|first2=Maxine|last3=Quinn|first3=Emily|last4=Heeren|first4=Timothy|last5=Toomey|first5=Rosemary|last6=Killiany|first6=Ronald|last7=Zundel|first7=Clara|last8=Ajama|first8=Joy|last9=O’Callaghan|first9=James|date=Nov 2018|title=The Multiple Hit Hypothesis for Gulf War Illness: Self-Reported Chemical/Biological Weapons Exposure and Mild Traumatic Brain Injury|url=https://www.mdpi.com/2076-3425/8/11/198|journal=Brain Sciences|language=en|volume=8|issue=11|pages=198|doi=10.3390/brainsci8110198|pmc=|pmid=|quote=|author-link=|author-link2=|access-date=|author-link3=|author-link4=|author-link5=|author-link6=|via=}}</ref> - [https://www.mdpi.com/2076-3425/8/11/198/htm (Full Text)]
* Dec, 2018, Fatigue in Gulf War Illness is associated with tonically high activation in the executive control network<ref>{{Cite journal|last=|first=|author-link=Glenn Wylie|author-link2=Helen Genova|author-link3=Ekaterina Dobryakova|author-link4=John DeLuca|author-link5=Nancy Chiaravalloti|author-link6=Michael Falvo|author-link7=Dane Cook|date=2018-12-11|title=Fatigue in Gulf War Illness is associated with tonically high activation in the executive control network|url=https://www.sciencedirect.com/science/article/pii/S2213158218303899|journal=NeuroImage: Clinical|language=en|volume=|issue=|pages=101641|doi=10.1016/j.nicl.2018.101641|issn=2213-1582|quote=|via=}}</ref> - [https://www.sciencedirect.com/science/article/pii/S2213158218303899#%21 (Full Text)]
* Feb 21, 2019, [[Gastrointestinal system|Gastrointestinal]] [[Neuroimmune disease|neuroimmune]] disruption in a mouse model of Gulf War illness<ref>{{Cite journal|last=Hernandez|first=Siomara|last2=Fried|first2=David E.|last3=Grubišić|first3=Vladimir|last4=McClain|first4=Jonathon L.|last5=Gulbransen|first5=Brian D.|date=2019-02-21|title=Gastrointestinal neuroimmune disruption in a mouse model of Gulf War illness|url=https://www.fasebj.org/doi/10.1096/fj.201802572R|journal=The FASEB Journal|pages=fj.201802572R|doi=10.1096/fj.201802572R|issn=0892-6638}}</ref> - [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6463928/ (Full text)]
** [https://www.sciencedaily.com/releases/2019/02/190221141506.htm GI neuroimmune disruption contributes to Gulf War Illness]<ref name=":11">{{Cite web|url=https://www.sciencedaily.com/releases/2019/02/190221141506.htm|title=GI neuroimmune disruption contributes to Gulf War Illness: Mouse model points to gastrointestinal neuroimmune disruption as contributing mechanism of Gulf War Illness|last=|first=|authorlink=|last2=|first2=|authorlink2=|date=|website=ScienceDaily.com|publisher=|language=en|via=Science Daily for Federation of American Societies for Experimental Biology|archive-url=|archive-date=|dead-url=|access-date=2019-02-22}}</ref> <blockquote>Many Persian Gulf War veterans experience Gulf War Illness (GWI), a chronic condition with symptoms ranging from gastrointestinal to neurological. While exposure to the anti-nerve gas pyridostigmine bromide (PB) is linked to the development of GWI, the exact cause and mechanisms of the illness remain unclear. Recently, an animal study tested the hypothesis that exposure to PB contributes to the development of GWI by disrupting the neural and immune systems of the intestine.<ref name=":11" /></blockquote>
*May 2, 2020, In-vivo imaging of neuroinflammation in veterans with Gulf War illness<ref name="Loggia2020">{{Cite journal|last=Alshelh|first=Zeynab|author-link=|last2=Albrecht|first2=Daniel S.|author-link2=|last3=Bergan|first3=Courtney|author-link3=|last4=Akeju|first4=Oluwaseun|author-link4=|last5=Clauw|first5=Daniel J.|author-link5=Daniel Clauw|last6=Conboy|first6=Lisa|author-link6=|last7=Edwards|first7=Robert R.|last8=Kim|first8=Minhae|last9=Lee|first9=Yvonne C.|displayauthors=8|date=2020-02-04|title=In-vivo imaging of neuroinflammation in veterans with Gulf War illness|url=http://www.sciencedirect.com/science/article/pii/S0889159119313340|journal=Brain, Behavior, and Immunity|language=en|volume=|issue=|pages=|doi=10.1016/j.bbi.2020.01.020|issn=0889-1591|pmc=|pmid=|access-date=|quote=|via=|last10=Protsenko|first10=Ekaterina|last11=Napadow|first11=Vitaly|last12=Sullivan|first12=Kimberly|author-link12=Kimberly Sullivan|author-link13=Marco Loggia|last13=Loggia|first13=Marco F.}}</ref> - [https://www.sciencedirect.com/science/article/pii/S0889159119313340 (Full text)]
*August 10, 2020, Exercise alters brain activation in Gulf War Illness and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome<ref name="Washington2020">{{Cite journal|last=Washington|first=Stuart D.|author-link=|last2=Rayhan|first2=Rakib U.|author-link2=Rakib Rayhan|last3=Garner|first3=Richard|author-link3=|last4=Provenzano|first4=Destie|author-link4=|last5=Zajur|first5=Kristina|author-link5=|last6=Addiego|first6=Florencia Martinez|author-link6=|last7=VanMeter|first7=John W.|last8=Baraniuk|first8=James N.|author-link8=James Baraniuk|date=2020-07-01|title=Exercise alters brain activation in Gulf War Illness and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome|url=https://academic.oup.com/braincomms/article/2/2/fcaa070/5885074|journal=Brain Communications|language=en|volume=2|issue=2|pages=|doi=10.1093/braincomms/fcaa070|pmc=|pmid=|access-date=|quote=|via=}}</ref> - [https://academic.oup.com/braincomms/article/2/2/fcaa070/5885074 (Full text)]

== Risk of developing other conditions ==
The US Department of Veteran's Affairs found that "1990-1991 Gulf War deployment is associated with an increased risk for ME/CFS, fibromyalgia, skin conditions, and dyspepsia."<ref>{{Cite web|url=https://www.publichealth.va.gov/exposures/gulfwar/chronic-fatigue-syndrome.asp|title=Myalgic Encephalomyelitis/Chronic Fatigue Syndrome in Gulf War Veterans - Public Health|last=Administration|first=US Department of Veterans Affairs, Veterans Health|website=www.publichealth.va.gov|language=en|access-date=2018-08-24}}</ref>

== Controversy ==

=== US Department of Veterans Affairs' cover-up of GWI ===
* Aug 28, 1997, [http://gulfwarvets.com/arison/gws.htm The Cover-up of Gulf War Syndrome -- A Question of Natinal Integrity]<ref>{{Cite web|url=http://gulfwarvets.com/arison/gws.htm|title=The Cover-Up of Gulf War Syndrome -- A Question of National Integrity|last=Harrison III|first=H. Lindsey|date=Aug 28, 1997|website=gulfwarvets.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-26}}</ref>
* Mar 13, 2013, [http://gulfwarvets.com/va_cover_up_data.htm Whistleblower: Veterans Affairs Covered Up Data on Mental Health, Gulf War Syndrome]<ref>{{Cite web|url=http://gulfwarvets.com/va_cover_up_data.htm|title=Whistleblower: Veterans Affairs Covered Up Data on Mental Health, Gulf War Syndrome|last=Reno|first=Jamie|date=Mar 13, 2013|website=gulfwarvets.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-26}}</ref>
* Mar 13, 2013, [https://www.usatoday.com/story/news/nation/2013/03/13/whistleblower-alleges-veterans-affairs-cover-up/1979839/ Researcher says officials covered up vets' health data]<ref name=":6">{{Cite news|url=https://www.usatoday.com/story/news/nation/2013/03/13/whistleblower-alleges-veterans-affairs-cover-up/1979839/|title=Researcher says officials covered up vets' health data|last=Kennedy|first=Kelly|date=Mar 13, 2013|work=USA TODAY|access-date=2018-08-26|archive-url=|archive-date=|dead-url=|language=en}}</ref>
<blockquote>WASHINGTON — [[wikipedia:United_States_Department_of_Veterans_Affairs|Department of Veterans Affairs]] officials purposely manipulate or hide data that would support the claims of veterans from Iraq and Afghanistan to prevent paying costly benefits, a former VA researcher told a House subcommittee Wednesday.</blockquote><blockquote>"If the studies produce results that do not support the office of public health's unwritten policy, they do not release them," said [[wikipedia:Steven_S._Coughlin|Steven Coughlin]], a former epidemiologist in the VA's public health department.</blockquote><blockquote>"This applies to data regarding adverse health consequences of environmental exposures, such as burn pits in Iraq and Afghanistan, and toxic exposures in the Gulf War," Coughlin said. "On the rare occasions when embarrassing study results are released, data are manipulated to make them unintelligible."<ref name=":6" /></blockquote>
* Apr 12, 2013, [https://www.youtube.com/watch?v=OYKMMbPp_Do&feature=youtu.be&t=546 Dr. Robert Haley, What Caused Gulf War Illness]<ref name=":9" /> (Video) Dr. Haley speaks about the United States Department of Veterans Affairs' cover-up of US Gulf War troop illness being due to environmental exposure.

* Mar 14, 2014, [https://www.forbes.com/sites/rebeccaruiz/2014/03/24/congress-confronts-va-over-gulf-war-illness-research/#7648eec961fb Congress Confronts VA Over Gulf War Illness Research]<ref>{{Cite news|url=https://www.forbes.com/sites/rebeccaruiz/2014/03/24/congress-confronts-va-over-gulf-war-illness-research/#7648eec961fb|title=Congress Confronts VA Over Gulf War Illness Research|last=Ruiz|first=Rebecca|date=Mar 24, 2014|work=Forbes|access-date=2018-08-26|archive-url=|archive-date=|dead-url=|language=en}}</ref>
* Mar 30, 2015, [https://www.disabledveterans.org/2015/03/30/former-va-chief-of-staff-linked-to-gulf-war-scandal/ Former VA Chief Of Staff Linked To Gulf War Scandal]<ref>{{Cite news|url=https://www.disabledveterans.org/2015/03/30/former-va-chief-of-staff-linked-to-gulf-war-scandal/|title=Former VA Chief Of Staff Linked To Gulf War Scandal|last=Krause|first=Benjamin|date=2015-03-30|work=DisabledVeterans.Org|access-date=2018-08-26|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

===Simon Wessely's past stress related beliefs in GWI ===
Professor [[Simon Wessely]], psychiatric paradigm researcher of [[chronic fatigue syndrome]], believed that [[stress]] was the common denominator of GWI.
* 2004, Interview with ''New Scientist'', [https://www.newscientist.com/article/dn6609-us-in-u-turn-over-gulf-war-syndrome/ US in U-turn over Gulf war syndrome]<ref name=":2" />
<blockquote>Wessely told ''New Scientist'': “There is not one single cause for the ill health,” adding that he believes we may never fully know what happened to the people who became ill.</blockquote><blockquote>Wessely asked both Gulf and non-Gulf veterans about 50 standard symptoms. “Gulf veterans reported every symptom twice as often,” he told the Lloyd inquiry. If there were a unique Gulf syndrome, some would be relatively more frequent in the Gulf group. “But they are just experiencing more ill health. There is no unique syndrome here.”</blockquote><blockquote>Wessely favours psychological explanations for Gulf war illnesses. The only thing that could have affected so many different people, he says, was stress, especially anxiety about chemical weapons, misinformation about Gulf war syndrome afterwards, and the many vaccinations Gulf troops received. His team found the more vaccine Gulf, but not non-Gulf veterans, received the more likely they are to be ill.</blockquote><blockquote>Haley says the questions in Wessely’s study were too vague to distinguish between a real syndrome and people who have, say, occasional dizziness or joint pain. He says this will confound efforts to uncover a meaningful pattern behind the veterans’ symptoms.<ref name=":2" /></blockquote>
* 2006, A study published in [[The Lancet|''The Lancet'']] that Wessely was involved with, [https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(06)68662-5/fulltext The health of UK military personnel who deployed to the 2003 Iraq war: a cohort study]<ref name=":3">{{Cite journal|last=Hotopf|first=Matthew|last2=Hull|first2=Lisa|last3=Fear|first3=NicolaT|last4=Browne|first4=Tess|last5=Horn|first5=Oded|last6=Iversen|first6=Amy|last7=Jones|first7=Margaret|last8=Murphy|first8=Dominic|last9=Bland|first9=Duncan|date=2006|others=Earnshaw, Mark; Greenberg, Neil; Hacker Hughes, Jamie; Tate, Rosemary; Dandeker, Christopher; Rona, Robert; Wessely, Simon|title=The health of UK military personnel who deployed to the 2003 Iraq war: a cohort study|url=https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(06)68662-5/fulltext|journal=The Lancet|language=English|volume=367|issue=9524|pages=1731–1741|doi=10.1016/S0140-6736(06)68662-5|issn=0140-6736|via=}}</ref> interpretation:
<blockquote>For regular personnel in the UK armed forces, deployment to the Iraq war has not, so far, been associated with significantly worse health outcomes, apart from a modest effect on multiple physical symptoms. There is evidence of a clinically and statistically significant effect on health in reservists.<ref name=":3" /></blockquote>
* 2006, [http://www.gresham.ac.uk/lectures-and-events/something-old-something-new-something-borrowed-something-blue-the-true-story-of Something old, something new, something borrowed, something blue: The true story of Gulf War Syndrome]<ref name=":10">{{Cite web|url=http://www.gresham.ac.uk/lectures-and-events/something-old-something-new-something-borrowed-something-blue-the-true-story-of|title=Something old, something new, something borrowed, something blue: The true story of Gulf War Syndrome|website=www.gresham.ac.uk|access-date=2018-08-29}}</ref>
<blockquote>So my story then: something old, we have seen some of these before; something new, there was a definite hazard with some of the precautions that were taken to protect Gulf veterans; something borrowed, soldiers can also be civilians and the things that concern us also can concern them; something blue, the psychiatry of Gulf War is the psychiatry more of [[depression]] than it is of [[Post-traumatic stress disorder|PTSD]].<ref name=":10" /></blockquote>
* 2010, A second study [https://www.kcl.ac.uk/kcmhr/publications/assetfiles/iraqafghan/Fear2010-consequencesofdeployment.pdf What are the consequences of deployment to Iraq and Afghanistan on the mental health of the UK armed forces? A cohort study]<ref name=":4">{{Cite web|url=https://www.kcl.ac.uk/kcmhr/publications/assetfiles/iraqafghan/Fear2010-consequencesofdeployment.pdf|title=What are the consequences of deployment to Iraq and Afghanistan on the mental health of the UK armed forces?: A cohort study|last=Fear|first=Nicola T|last2=Jones|first2=Margaret|date=2010|website=kcl.ac.uk|others=Jones, Norman; Greenberg, Neil; Landau, Sabine; Dandeker, Christopher; Rona, Roberta J; Hotopf, Mathew; Wessely, Simon|archive-url=|archive-date=|dead-url=|access-date=|last3=Murphy|first3=Dominic|last4=Hull|first4=Lisa|last5=Civerson|first5=Amy|last6=Coker|first6=Bolaji|last7=Machell|first7=Louise|last8=Sundin|first8=Josefin|last9=Woodhead|first9=Charlotte|type=PDF}}</ref> interpretation:
<blockquote>Symptoms of common mental disorders and alcohol misuse remain the most frequently reported mental disorders in UK armed forces personnel, whereas the prevalence of probable [[post-traumatic stress disorder]] was low. These findings show the importance of continued health surveillance of UK military personnel.<ref name=":4" /></blockquote>
* 2011, A ''BBC'' report [https://www.bbc.com/news/uk-12195884 Two decades on, battle goes on over 'Gulf War Syndrome']<ref name=":5">{{Cite news|url=https://www.bbc.com/news/uk-12195884|title=Battle continues over Gulf War Syndrome|last=Hughes|first=Caroline Hawley and Stuart|date=2011|work=BBC News|access-date=2018-08-26|language=en-GB}}</ref>
<blockquote>Professor [[Simon Wessely]] is director of the King's Centre for Military Health Research in London and an adviser to the Ministry of Defence. He does not believe Gulf War Syndrome exists as a distinct illness.</blockquote><blockquote>Even so, he has no doubt that a significant number of Gulf veterans became ill as a direct result of their military service.</blockquote><blockquote>"The evidence is incontrovertible that there is a Gulf War health effect," he says.</blockquote><blockquote>"Something to do with the Gulf has affected health and no-one serious has ever disputed that.</blockquote><blockquote>"Is there a problem? Yes there is. Is it Gulf War Syndrome or isn't it? I think that's a statistical and technical question that's of minor interest."</blockquote><blockquote>The Ministry of Defence echoes Professor Wessely's view.<ref name=":5" /></blockquote>

==See also==
* [[Vaccine]]

==Learn more==
* 2004, ''Independent Public Inquiry on Gulf War Illnesses'' (The Lloyd Inquiry) ([https://web.archive.org/web/20041120030227/http://www.lloyd-gwii.com:80/admin/ManagedFiles/4/ReportResume.doc Report Resume])<ref>{{Cite web|url=https://web.archive.org/web/20041120030227/http://www.lloyd-gwii.com:80/admin/ManagedFiles/4/ReportResume.doc|title=Independent Public Inquiry on Gulf War Illnesses REPORT RÉSUMÉ|date=2004-11-20|access-date=2018-08-26|website=web.archive.org|last=Lloyd|first=Anthony|archive-url=|archive-date=|dead-url=|via=Wayback Machine|last2=Jones|first2=Norman|last3=Davies|first3=Michael|type=WORD}}</ref> - ([https://web.archive.org/web/20050119184010/http://www.lloyd-gwii.com:80/admin/ManagedFiles/4/LloydReport.pdf Full Testimony])<ref>{{Cite web|url=https://web.archive.org/web/20050119184010/http://www.lloyd-gwii.com:80/admin/ManagedFiles/4/LloydReport.pdf|title=Independent Public Inquiry on Gulf War Illnesses|date=2005-01-19|access-date=2018-08-26|website=web.archive.org|last=Lloyd|first=Anthony|archive-url=|archive-date=|dead-url=|last2=Jones|first2=Norman|last3=Davies|first3=Michael|publisher=Way Back Machine|type=PDF}}</ref>

* 2008, [https://www.va.gov/RAC-GWVI/docs/Committee_Documents/GWIandHealthofGWVeterans_RAC-GWVIReport_2008.pdf Gulf War Illness and the Health of Gulf War Veterans Scientific Findings and Recommendations]<ref>{{Cite web|url=https://www.va.gov/RAC-GWVI/docs/Committee_Documents/GWIandHealthofGWVeterans_RAC-GWVIReport_2008.pdf|title=Gulf War Illness and the Health of Gulf War Veterans Scientific Findings and Recommendations|last=|first=|date=Nov 2008|website=va.gov|publisher=Research Advisory Committee on Gulf War Veterans’ llnesses|type=Microsoft WORD|archive-url=|archive-date=|dead-url=|access-date=}}</ref>
* 2014, [http://www.usmedicine.com/agencies/department-of-veterans-affairs/advisory-group-exposures-not-stress-caused-gulf-war-illness/ Advisory Group: Exposures, Not Stress Caused Gulf War Illness]<ref>{{Cite news|url=http://www.usmedicine.com/agencies/department-of-veterans-affairs/advisory-group-exposures-not-stress-caused-gulf-war-illness/|title=Advisory Group: Exposures, Not Stress Caused Gulf War Illness - U.S. Medicine|last=usmedicine.com|date=2014-06-06|work=U.S. Medicine|access-date=2018-08-26|language=en-US}}</ref>
* 2015, [http://www.research.va.gov/pubs/docs/GWResearch-StrategicPlan.pdf GULF WAR RESEARCH STRATEGIC PLAN 2013-2017]<ref>{{Cite web|url=https://www.research.va.gov/pubs/docs/GWResearch-StrategicPlan.pdf|title=GULF WAR RESEARCH STRATEGIC PLAN 2013-2017 - 2015 Update|last=|first=|date=2015|website=va.gov|archive-url=|archive-date=|dead-url=|access-date=}}</ref>

*2016, [https://www.youtube.com/watch?v=KuyKkIaoMgw&feature=youtu.be Testing nine potential treatments for Gulf War Illness pain and fatigue]<ref>{{Cite web|url=https://www.youtube.com/watch?v=KuyKkIaoMgw&feature=youtu.be|title=Testing nine potential treatments for Gulf War Illness pain and fatigue|last=Younger|first=Jared|date=Apr 13, 2016|website=YouTube|publisher=Younger Lab|archive-url=|archive-date=|dead-url=|access-date=}}</ref>
*2019, [https://gumc.georgetown.edu/news-release/veterans-study-suggests-two-subtypes-of-gulf-war-illness/# Veterans Study Suggests Two Subtypes of Gulf War Illness]<ref>{{Cite web|url=https://gumc.georgetown.edu/news-release/veterans-study-suggests-two-subtypes-of-gulf-war-illness/|title=Veterans Study Suggests Two Subtypes of Gulf War Illness|date=2019-12-12|website=Georgetown University Medical Center|language=en-US|access-date=2019-12-13}}</ref>
*2019, [https://medicalxpress.com/news/2019-10-brain-chronic-fatigue-syndrome-gulf.html Brain studies show chronic fatigue syndrome and Gulf War illness are distinct conditions]<ref>{{Cite web|url=https://medicalxpress.com/news/2019-10-brain-chronic-fatigue-syndrome-gulf.html|title=Brain studies show chronic fatigue syndrome and Gulf War illness are distinct conditions|website=medicalxpress.com|language=en-us|access-date=2019-12-13}}</ref>
*[[wikipedia:Gulf_War_syndrome#CITEREFRAC-GWVI_Minutes2005|Wikipedia article on GWI]]

== References ==
{{reflist}}

[[Category:Diagnoses]]

Gulf War Illness

2020-09-13T06:34:32Z

Calirad:/* Cause of illness */

[[File:Operation Desert Storm.png|400px|thumb|right|Map of ground operations of Operation Desert Storm starting invasion February 24-28th 1991. Shows allied and Iraqi forces. Special arrows indicate the American 101st Airborne division moved by air and where the French 6th light division and American 3rd Armored Cavalry Regiment provided security]]
'''Gulf War Illness''' (GWI), also known as '''Gulf War Syndrome''' (GWS), is a term used for unexplained illnesses occurring in veterans of the 1991 [[wikipedia:Gulf_War|Gulf War]] in Southwest Asia. According to the [[Institute of Medicine]] in 2013, about one-third of US Gulf War veterans (250,000 of 700,000 personnel) suffer from “chronic multi-symptom illness (CMI): a series of symptoms that cannot be medically explained.”<ref>{{Cite web|url=http://www.hopkinsmedicine.org/healthlibrary/conditions/environmental_medicine/gulf_war_syndrome_85,P00487/|title=Gulf War Syndrome - Johns Hopkins Medicine Health Library|website=www.hopkinsmedicine.org|language=en|access-date=2018-08-24}}</ref><ref name=":7">{{Cite web|url=http://www8.nationalacademies.org/onpinews/newsitem.aspx?RecordID=12835|title=Gulf War Service Linked to Post-Traumatic Stress Disorder, Multisymptom Illness, Other Health Problems, But Causes Are Unclear|last=Stencel|first=Christine|date=Apr 9, 2010|website=|publisher=The National Academies of Science Engineering Medicine|language=en|archive-url=|archive-date=Apr 9, 2010|dead-url=|access-date=2018-08-26}}</ref> ''Science News'' summary of June 29, 2016, states: "Veterans of the Gulf War are more than twice as likely to have medically unexplained symptoms known as "multisymptom illness" (MSI), compared to Iraq/Afghanistan War veterans, according to an updated research."<ref>{{Cite news|url=https://www.sciencedaily.com/releases/2016/06/160629130628.htm|title=Gulf War veterans still have high rate of multisymptom illness|last=|first=|date=Jun 29, 2016|work=ScienceDaily|access-date=2018-08-24|archive-url=|archive-date=|dead-url=|publisher=Journal of Occupational and Environmental Medicine|language=en}}</ref>

== Symptoms ==
The [https://en.wikipedia.org/wiki/United_States_Department_of_Veterans_Affairs US Department of Veterans Affairs] has a list on [http://www.publichealth.va.gov/exposures/gulfwar/medically-unexplained-illness.asp Gulf War Veterans’ Medically Unexplained Illnesses].<ref name=":1" />
*[[ME/CFS|Myalgic Encephalomyelitis/Chronic fatigue syndrome]] ([[ME/CFS]]) with long-term severe [[fatigue]].
*[[Fibromyalgia]] characterized by widespread [[muscle pain]] and may include [[insomnia]], morning stiffness, [[headache]], and [[memory problems]].<ref name=":1">{{Cite web|url=https://www.publichealth.va.gov/exposures/gulfwar/medically-unexplained-illness.asp|title=Gulf War Veterans’ Medically Unexplained Illnesses - Public Health|last=Administration|first=US Department of Veterans Affairs, Veterans Health|website=www.publichealth.va.gov|language=en|access-date=2018-08-24}}</ref>

=== Functional gastrointestinal disorders ===
A group of conditions marked by chronic or recurrent symptoms related to any part of the [[Gastrointestinal system|gastrointestinal tract]]. Functional condition refers to an abnormal function of an organ, without a structural alteration in the tissues.
*functional [[abdominal pain]] syndrome
*functional dyspepsia (indigestion)
*[[irritable bowel syndrome]]<ref name=":1" />

=== Undiagnosed illnesses ===
These symptoms may be connected to undiagnosed illnesses.
*abnormal [[Weight loss|weight loss]]
*[[cardiovascular]] disease
*fatigue
*headache
*[[joint pain]]
*[[menstrual]] disorders
*muscle and [[joint pain]]
*[[Nervous system|neurological]] and psychological problems
*respiratory disorders
*skin conditions
*[[sleep dysfunction]]<ref name=":1" />

=== Other symptoms ===
* [[dizziness]]

* memory problems<ref name=":1" />

== Cause of illness ==
Causation include [[Vaccine|vaccination]]s; oil well fires; chemical and biological weapons; depleted uranium; noise; [https://www.publichealth.va.gov/exposures/carc-paint/index.asp CARC paint] used on military vehicles; occupational hazards; [[Mestinon|pyridostigmine]] bromide; pesticides or other [[Organophosphate|organophosphates]]; sand, dust, and particulates; toxic embedded fragments; infectious diseases; heat injuries; fuel; decontamination solutions; and the antibiotic ciprofloxacin.<ref name=":8" /><ref>{{Cite web|url=http://www.ei-resource.org/illness-information/environmental-illnesses/gulf-war-syndrome/|title=Gulf War Syndrome - Overview, Symptoms & Possible Causes|last=Hogg|first=Matthew|date=Jun 8, 2017|website=www.ei-resource.org|language=en-gb|archive-url=|archive-date=|dead-url=|access-date=2018-08-26}}</ref><ref name=":2" />

=== Multisystem condition ===
In 2003, ''New Scientist''<nowiki/>'s March 29th print edition reported on Dr. [https://profiles.utsouthwestern.edu/profile/12888/robert-haley.html Robert Haley] and his team identifying three distinct syndromes in Gulf war veterans that involved [[brain]] damage.
* ''Syndrome 1'': Symptoms are [[Cognitive impairment|impaired cognition]], distractions, and [[insomnia]] from the exposure of pesticide with [[basal ganglia]] damage.

* ''Syndrome 2'': The symptoms are [[confusion]], disorientation, [[ataxia]], and [[vertigo]] due to exposure to sarin and pyridostigmine with damage to the [[brainstem]] and basal ganglia.

* ''Syndrome 3'': Symptoms are [[pain]], tingling, and [[numbness]] from exposure to [[wikipedia:DEET|DEET]] and pyridostigmine with damage to the brainstem.<ref name=":2">{{Cite news|url=https://www.newscientist.com/article/dn6609-us-in-u-turn-over-gulf-war-syndrome/|title=US in U-turn over Gulf war syndrome|last=MacKenzie|first=Deborah|date=Nov 3, 2004|work=New Scientist|access-date=2018-08-26|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>
175,000 of 700,000 US Gulf War personnel are affected by the brain damage syndromes categorized by Dr. Haley and 75,000 are ill due to other exposures; in total 250,000 are chronically ill with GWI. <ref name=":9">{{Cite web|url=https://youtu.be/OYKMMbPp_Do?t=546|title=Dr. Robert Haley, What Caused Gulf War Illness|last=Haley|first=Robert|date=May 6, 2013|website=YouTube|publisher=David Spencer|archive-url=|archive-date=|dead-url=|access-date=}}</ref><ref name=":2" /><ref name=":8">{{Cite web|url=https://www.publichealth.va.gov/exposures/gulfwar/sources/index.asp|title=Gulf War Exposures - Public Health|website=www.publichealth.va.gov|language=en|access-date=2018-08-26}}</ref>
=== Research conclusions ===
The ''Conclusions and Recommendations'' of the [https://www.va.gov/RAC-GWVI/RACReport2014Final.pdf Gulf War Illness and the Health of Gulf War Veterans: Research Update and Recommendations, 2009-2013]<ref name=":0">{{Cite web|url=https://www.va.gov/RAC-GWVI/RACReport2014Final.pdf|title=Gulf War Illness and the Health of Gulf War Veterans: Research Update and Recommendations, 2009-2013: Updated Scientific Findings and Recommendations|last=|first=|date=May 2014|website=va.gov|publisher=Research Advisory Committee on Gulf War Veterans’ llnesses|page=60|archive-url=|archive-date=|dead-url=|access-date=}}</ref> conclude "exposure to pesticides and pyridostigmine bromide are causally associated with Gulf War illness" as well as other hazardous exposures including gas agents sarin/cyclosarin. "Mixed exposures include not only mixtures of chemicals but also chemicals combined with heat, dehydration, infection and other environmental stressors."<ref name=":0" />

=== Vaccinations ===
Mass vaccinations "against infectious diseases including medical counter-measures against biological weapons" were given prior to military deployment.<ref name="Peakman, 2006">{{Citation|last1=Peakman|first1=Mark|authorlink1=|last2=Skowera|first2=Ania| authorlink2=|last3= Hotopf|first3=Matthew|authorlink3=Matthew Hotopf|title= Immunological dysfunction, vaccination and Gulf War illness|journal=Philosophical Transactions of the Royal Society B: Biological Sciences|volume=361|issue=1468|page= 681–687|date=2006|doi=10.1098/rstb.2006.1826}}</ref> Vaccination in the presence of elevated [[cortisol]] levels can drive [[cytokine]] expression toward [[Th2]] dominance.<ref>{{Cite journal|last=Bernton|first=E.|last2=Hoover|first2=D.|last3=Galloway|first3=R.|last4=Popp|first4=K.|date=1995-12-29|title=Adaptation to chronic stress in military trainees. Adrenal androgens, testosterone, glucocorticoids, IGF-1, and immune function|url=http://www.ncbi.nlm.nih.gov/pubmed/8597461|journal=Annals of the New York Academy of Sciences|volume=774|pages=217–231|issn=0077-8923|pmid=8597461}}</ref><ref>{{Cite journal|last=Ramírez|first=F.|last2=Fowell|first2=D.J.|last3=Puklavec|first3=M.|last4=Simmonds|first4=S.|last5=Mason|first5=D.|date=1996-04-01|title=Glucocorticoids promote a TH2 cytokine response by CD4+ T cells in vitro|url=http://www.ncbi.nlm.nih.gov/pubmed/8786298|journal=Journal of Immunology|volume=156|issue=7|pages=2406–2412|issn=0022-1767|pmid=8786298}}</ref>

== Notable studies ==
* Sep, 2017, Role of [[mitochondrial DNA]] damage and dysfunction in veterans with Gulf War Illness<ref>{{Cite web|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5599026/pdf/pone.0184832.pdf|title=Role of mitochondrial DNA damage and dysfunction in veterans with Gulf War Illness|last=Falvo|first=Michael|last2=Meyer|first2=Joel|date=Sep 2017|website=ncbi.nlm.nih.gov|type=PDF|archive-url=|archive-date=|dead-url=|access-date=|last3=Hill|first3=Helene Z.|last4=Lange|first4=Gudrun|last5=Condon|first5=Michael|last6=Klein|first6=Jacquelyn C.|last7=Ndirangu|first7=Duncan|last8=Falvo|first8=Michael J.}}</ref> - [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5599026/pdf/pone.0184832.pdf (Full Text)]
** [https://www.research.va.gov/currents/1017-Evidence-of-DNA-damage-in-Vets-with-Gulf-War-illness.cfm?platform=hootsuite Researchers find evidence of DNA damage in Vets with Gulf War illness]<ref>{{Cite web|url=https://www.research.va.gov/currents/1017-Evidence-of-DNA-damage-in-Vets-with-Gulf-War-illness.cfm?platform=hootsuite|title=Researchers find evidence of DNA damage in Vets with Gulf War illness|last=Richman|first=Mike|date=Oct 19, 2017|website=www.research.va.gov|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-08-26}}</ref>
* Nov, 2018, The Multiple Hit Hypothesis for Gulf War Illness: Self-Reported Chemical/Biological Weapons Exposure and Mild [[Traumatic Brain Injury]]<ref>{{Cite journal|last=Janulewicz|first=Patricia|last2=Krengel|first2=Maxine|last3=Quinn|first3=Emily|last4=Heeren|first4=Timothy|last5=Toomey|first5=Rosemary|last6=Killiany|first6=Ronald|last7=Zundel|first7=Clara|last8=Ajama|first8=Joy|last9=O’Callaghan|first9=James|date=Nov 2018|title=The Multiple Hit Hypothesis for Gulf War Illness: Self-Reported Chemical/Biological Weapons Exposure and Mild Traumatic Brain Injury|url=https://www.mdpi.com/2076-3425/8/11/198|journal=Brain Sciences|language=en|volume=8|issue=11|pages=198|doi=10.3390/brainsci8110198|pmc=|pmid=|quote=|author-link=|author-link2=|access-date=|author-link3=|author-link4=|author-link5=|author-link6=|via=}}</ref> - [https://www.mdpi.com/2076-3425/8/11/198/htm (Full Text)]
* Dec, 2018, Fatigue in Gulf War Illness is associated with tonically high activation in the executive control network<ref>{{Cite journal|last=|first=|author-link=Glenn Wylie|author-link2=Helen Genova|author-link3=Ekaterina Dobryakova|author-link4=John DeLuca|author-link5=Nancy Chiaravalloti|author-link6=Michael Falvo|author-link7=Dane Cook|date=2018-12-11|title=Fatigue in Gulf War Illness is associated with tonically high activation in the executive control network|url=https://www.sciencedirect.com/science/article/pii/S2213158218303899|journal=NeuroImage: Clinical|language=en|volume=|issue=|pages=101641|doi=10.1016/j.nicl.2018.101641|issn=2213-1582|quote=|via=}}</ref> - [https://www.sciencedirect.com/science/article/pii/S2213158218303899#%21 (Full Text)]
* Feb 21, 2019, [[Gastrointestinal system|Gastrointestinal]] [[Neuroimmune disease|neuroimmune]] disruption in a mouse model of Gulf War illness<ref>{{Cite journal|last=Hernandez|first=Siomara|last2=Fried|first2=David E.|last3=Grubišić|first3=Vladimir|last4=McClain|first4=Jonathon L.|last5=Gulbransen|first5=Brian D.|date=2019-02-21|title=Gastrointestinal neuroimmune disruption in a mouse model of Gulf War illness|url=https://www.fasebj.org/doi/10.1096/fj.201802572R|journal=The FASEB Journal|pages=fj.201802572R|doi=10.1096/fj.201802572R|issn=0892-6638}}</ref> - [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6463928/ (Full text)]
** [https://www.sciencedaily.com/releases/2019/02/190221141506.htm GI neuroimmune disruption contributes to Gulf War Illness]<ref name=":11">{{Cite web|url=https://www.sciencedaily.com/releases/2019/02/190221141506.htm|title=GI neuroimmune disruption contributes to Gulf War Illness: Mouse model points to gastrointestinal neuroimmune disruption as contributing mechanism of Gulf War Illness|last=|first=|authorlink=|last2=|first2=|authorlink2=|date=|website=ScienceDaily.com|publisher=|language=en|via=Science Daily for Federation of American Societies for Experimental Biology|archive-url=|archive-date=|dead-url=|access-date=2019-02-22}}</ref> <blockquote>Many Persian Gulf War veterans experience Gulf War Illness (GWI), a chronic condition with symptoms ranging from gastrointestinal to neurological. While exposure to the anti-nerve gas pyridostigmine bromide (PB) is linked to the development of GWI, the exact cause and mechanisms of the illness remain unclear. Recently, an animal study tested the hypothesis that exposure to PB contributes to the development of GWI by disrupting the neural and immune systems of the intestine.<ref name=":11" /></blockquote>
*May 2, 2020, In-vivo imaging of neuroinflammation in veterans with Gulf War illness<ref name="Loggia2020">{{Cite journal|last=Alshelh|first=Zeynab|author-link=|last2=Albrecht|first2=Daniel S.|author-link2=|last3=Bergan|first3=Courtney|author-link3=|last4=Akeju|first4=Oluwaseun|author-link4=|last5=Clauw|first5=Daniel J.|author-link5=Daniel Clauw|last6=Conboy|first6=Lisa|author-link6=|last7=Edwards|first7=Robert R.|last8=Kim|first8=Minhae|last9=Lee|first9=Yvonne C.|displayauthors=8|date=2020-02-04|title=In-vivo imaging of neuroinflammation in veterans with Gulf War illness|url=http://www.sciencedirect.com/science/article/pii/S0889159119313340|journal=Brain, Behavior, and Immunity|language=en|volume=|issue=|pages=|doi=10.1016/j.bbi.2020.01.020|issn=0889-1591|pmc=|pmid=|access-date=|quote=|via=|last10=Protsenko|first10=Ekaterina|last11=Napadow|first11=Vitaly|last12=Sullivan|first12=Kimberly|author-link12=Kimberly Sullivan|author-link13=Marco Loggia|last13=Loggia|first13=Marco F.}}</ref> - [https://www.sciencedirect.com/science/article/pii/S0889159119313340 (Full text)]
*August 10, 2020, Exercise alters brain activation in Gulf War Illness and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome<ref name="Washington2020">{{Cite journal|last=Washington|first=Stuart D.|author-link=|last2=Rayhan|first2=Rakib U.|author-link2=Rakib Rayhan|last3=Garner|first3=Richard|author-link3=|last4=Provenzano|first4=Destie|author-link4=|last5=Zajur|first5=Kristina|author-link5=|last6=Addiego|first6=Florencia Martinez|author-link6=|last7=VanMeter|first7=John W.|last8=Baraniuk|first8=James N.|author-link8=James Baraniuk|date=2020-07-01|title=Exercise alters brain activation in Gulf War Illness and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome|url=https://academic.oup.com/braincomms/article/2/2/fcaa070/5885074|journal=Brain Communications|language=en|volume=2|issue=2|pages=|doi=10.1093/braincomms/fcaa070|pmc=|pmid=|access-date=|quote=|via=}}</ref> - [https://academic.oup.com/braincomms/article/2/2/fcaa070/5885074 (Full text)]

== Risk of developing other conditions ==
The US Department of Veteran's Affairs found that "1990-1991 Gulf War deployment is associated with an increased risk for ME/CFS, fibromyalgia, skin conditions, and dyspepsia."<ref>{{Cite web|url=https://www.publichealth.va.gov/exposures/gulfwar/chronic-fatigue-syndrome.asp|title=Myalgic Encephalomyelitis/Chronic Fatigue Syndrome in Gulf War Veterans - Public Health|last=Administration|first=US Department of Veterans Affairs, Veterans Health|website=www.publichealth.va.gov|language=en|access-date=2018-08-24}}</ref>

== Controversy ==

=== US Department of Veterans Affairs' cover-up of GWI ===
* Aug 28, 1997, [http://gulfwarvets.com/arison/gws.htm The Cover-up of Gulf War Syndrome -- A Question of Natinal Integrity]<ref>{{Cite web|url=http://gulfwarvets.com/arison/gws.htm|title=The Cover-Up of Gulf War Syndrome -- A Question of National Integrity|last=Harrison III|first=H. Lindsey|date=Aug 28, 1997|website=gulfwarvets.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-26}}</ref>
* Mar 13, 2013, [http://gulfwarvets.com/va_cover_up_data.htm Whistleblower: Veterans Affairs Covered Up Data on Mental Health, Gulf War Syndrome]<ref>{{Cite web|url=http://gulfwarvets.com/va_cover_up_data.htm|title=Whistleblower: Veterans Affairs Covered Up Data on Mental Health, Gulf War Syndrome|last=Reno|first=Jamie|date=Mar 13, 2013|website=gulfwarvets.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-26}}</ref>
* Mar 13, 2013, [https://www.usatoday.com/story/news/nation/2013/03/13/whistleblower-alleges-veterans-affairs-cover-up/1979839/ Researcher says officials covered up vets' health data]<ref name=":6">{{Cite news|url=https://www.usatoday.com/story/news/nation/2013/03/13/whistleblower-alleges-veterans-affairs-cover-up/1979839/|title=Researcher says officials covered up vets' health data|last=Kennedy|first=Kelly|date=Mar 13, 2013|work=USA TODAY|access-date=2018-08-26|archive-url=|archive-date=|dead-url=|language=en}}</ref>
<blockquote>WASHINGTON — [[wikipedia:United_States_Department_of_Veterans_Affairs|Department of Veterans Affairs]] officials purposely manipulate or hide data that would support the claims of veterans from Iraq and Afghanistan to prevent paying costly benefits, a former VA researcher told a House subcommittee Wednesday.</blockquote><blockquote>"If the studies produce results that do not support the office of public health's unwritten policy, they do not release them," said [[wikipedia:Steven_S._Coughlin|Steven Coughlin]], a former epidemiologist in the VA's public health department.</blockquote><blockquote>"This applies to data regarding adverse health consequences of environmental exposures, such as burn pits in Iraq and Afghanistan, and toxic exposures in the Gulf War," Coughlin said. "On the rare occasions when embarrassing study results are released, data are manipulated to make them unintelligible."<ref name=":6" /></blockquote>
* Apr 12, 2013, [https://www.youtube.com/watch?v=OYKMMbPp_Do&feature=youtu.be&t=546 Dr. Robert Haley, What Caused Gulf War Illness]<ref name=":9" /> (Video) Dr. Haley speaks about the United States Department of Veterans Affairs' cover-up of US Gulf War troop illness being due to environmental exposure.

* Mar 14, 2014, [https://www.forbes.com/sites/rebeccaruiz/2014/03/24/congress-confronts-va-over-gulf-war-illness-research/#7648eec961fb Congress Confronts VA Over Gulf War Illness Research]<ref>{{Cite news|url=https://www.forbes.com/sites/rebeccaruiz/2014/03/24/congress-confronts-va-over-gulf-war-illness-research/#7648eec961fb|title=Congress Confronts VA Over Gulf War Illness Research|last=Ruiz|first=Rebecca|date=Mar 24, 2014|work=Forbes|access-date=2018-08-26|archive-url=|archive-date=|dead-url=|language=en}}</ref>
* Mar 30, 2015, [https://www.disabledveterans.org/2015/03/30/former-va-chief-of-staff-linked-to-gulf-war-scandal/ Former VA Chief Of Staff Linked To Gulf War Scandal]<ref>{{Cite news|url=https://www.disabledveterans.org/2015/03/30/former-va-chief-of-staff-linked-to-gulf-war-scandal/|title=Former VA Chief Of Staff Linked To Gulf War Scandal|last=Krause|first=Benjamin|date=2015-03-30|work=DisabledVeterans.Org|access-date=2018-08-26|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

===Simon Wessely's past stress related beliefs in GWI ===
Professor [[Simon Wessely]], psychiatric paradigm researcher of [[chronic fatigue syndrome]], believed that [[stress]] was the common denominator of GWI.
* 2004, Interview with ''New Scientist'', [https://www.newscientist.com/article/dn6609-us-in-u-turn-over-gulf-war-syndrome/ US in U-turn over Gulf war syndrome]<ref name=":2" />
<blockquote>Wessely told ''New Scientist'': “There is not one single cause for the ill health,” adding that he believes we may never fully know what happened to the people who became ill.</blockquote><blockquote>Wessely asked both Gulf and non-Gulf veterans about 50 standard symptoms. “Gulf veterans reported every symptom twice as often,” he told the Lloyd inquiry. If there were a unique Gulf syndrome, some would be relatively more frequent in the Gulf group. “But they are just experiencing more ill health. There is no unique syndrome here.”</blockquote><blockquote>Wessely favours psychological explanations for Gulf war illnesses. The only thing that could have affected so many different people, he says, was stress, especially anxiety about chemical weapons, misinformation about Gulf war syndrome afterwards, and the many vaccinations Gulf troops received. His team found the more vaccine Gulf, but not non-Gulf veterans, received the more likely they are to be ill.</blockquote><blockquote>Haley says the questions in Wessely’s study were too vague to distinguish between a real syndrome and people who have, say, occasional dizziness or joint pain. He says this will confound efforts to uncover a meaningful pattern behind the veterans’ symptoms.<ref name=":2" /></blockquote>
* 2006, A study published in [[The Lancet|''The Lancet'']] that Wessely was involved with, [https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(06)68662-5/fulltext The health of UK military personnel who deployed to the 2003 Iraq war: a cohort study]<ref name=":3">{{Cite journal|last=Hotopf|first=Matthew|last2=Hull|first2=Lisa|last3=Fear|first3=NicolaT|last4=Browne|first4=Tess|last5=Horn|first5=Oded|last6=Iversen|first6=Amy|last7=Jones|first7=Margaret|last8=Murphy|first8=Dominic|last9=Bland|first9=Duncan|date=2006|others=Earnshaw, Mark; Greenberg, Neil; Hacker Hughes, Jamie; Tate, Rosemary; Dandeker, Christopher; Rona, Robert; Wessely, Simon|title=The health of UK military personnel who deployed to the 2003 Iraq war: a cohort study|url=https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(06)68662-5/fulltext|journal=The Lancet|language=English|volume=367|issue=9524|pages=1731–1741|doi=10.1016/S0140-6736(06)68662-5|issn=0140-6736|via=}}</ref> interpretation:
<blockquote>For regular personnel in the UK armed forces, deployment to the Iraq war has not, so far, been associated with significantly worse health outcomes, apart from a modest effect on multiple physical symptoms. There is evidence of a clinically and statistically significant effect on health in reservists.<ref name=":3" /></blockquote>
* 2006, [http://www.gresham.ac.uk/lectures-and-events/something-old-something-new-something-borrowed-something-blue-the-true-story-of Something old, something new, something borrowed, something blue: The true story of Gulf War Syndrome]<ref name=":10">{{Cite web|url=http://www.gresham.ac.uk/lectures-and-events/something-old-something-new-something-borrowed-something-blue-the-true-story-of|title=Something old, something new, something borrowed, something blue: The true story of Gulf War Syndrome|website=www.gresham.ac.uk|access-date=2018-08-29}}</ref>
<blockquote>So my story then: something old, we have seen some of these before; something new, there was a definite hazard with some of the precautions that were taken to protect Gulf veterans; something borrowed, soldiers can also be civilians and the things that concern us also can concern them; something blue, the psychiatry of Gulf War is the psychiatry more of [[depression]] than it is of [[Post-traumatic stress disorder|PTSD]].<ref name=":10" /></blockquote>
* 2010, A second study [https://www.kcl.ac.uk/kcmhr/publications/assetfiles/iraqafghan/Fear2010-consequencesofdeployment.pdf What are the consequences of deployment to Iraq and Afghanistan on the mental health of the UK armed forces? A cohort study]<ref name=":4">{{Cite web|url=https://www.kcl.ac.uk/kcmhr/publications/assetfiles/iraqafghan/Fear2010-consequencesofdeployment.pdf|title=What are the consequences of deployment to Iraq and Afghanistan on the mental health of the UK armed forces?: A cohort study|last=Fear|first=Nicola T|last2=Jones|first2=Margaret|date=2010|website=kcl.ac.uk|others=Jones, Norman; Greenberg, Neil; Landau, Sabine; Dandeker, Christopher; Rona, Roberta J; Hotopf, Mathew; Wessely, Simon|archive-url=|archive-date=|dead-url=|access-date=|last3=Murphy|first3=Dominic|last4=Hull|first4=Lisa|last5=Civerson|first5=Amy|last6=Coker|first6=Bolaji|last7=Machell|first7=Louise|last8=Sundin|first8=Josefin|last9=Woodhead|first9=Charlotte|type=PDF}}</ref> interpretation:
<blockquote>Symptoms of common mental disorders and alcohol misuse remain the most frequently reported mental disorders in UK armed forces personnel, whereas the prevalence of probable [[post-traumatic stress disorder]] was low. These findings show the importance of continued health surveillance of UK military personnel.<ref name=":4" /></blockquote>
* 2011, A ''BBC'' report [https://www.bbc.com/news/uk-12195884 Two decades on, battle goes on over 'Gulf War Syndrome']<ref name=":5">{{Cite news|url=https://www.bbc.com/news/uk-12195884|title=Battle continues over Gulf War Syndrome|last=Hughes|first=Caroline Hawley and Stuart|date=2011|work=BBC News|access-date=2018-08-26|language=en-GB}}</ref>
<blockquote>Professor [[Simon Wessely]] is director of the King's Centre for Military Health Research in London and an adviser to the Ministry of Defence. He does not believe Gulf War Syndrome exists as a distinct illness.</blockquote><blockquote>Even so, he has no doubt that a significant number of Gulf veterans became ill as a direct result of their military service.</blockquote><blockquote>"The evidence is incontrovertible that there is a Gulf War health effect," he says.</blockquote><blockquote>"Something to do with the Gulf has affected health and no-one serious has ever disputed that.</blockquote><blockquote>"Is there a problem? Yes there is. Is it Gulf War Syndrome or isn't it? I think that's a statistical and technical question that's of minor interest."</blockquote><blockquote>The Ministry of Defence echoes Professor Wessely's view.<ref name=":5" /></blockquote>

==See also==
* [[Vaccine]]

==Learn more==
* 2004, ''Independent Public Inquiry on Gulf War Illnesses'' (The Lloyd Inquiry) ([https://web.archive.org/web/20041120030227/http://www.lloyd-gwii.com:80/admin/ManagedFiles/4/ReportResume.doc Report Resume])<ref>{{Cite web|url=https://web.archive.org/web/20041120030227/http://www.lloyd-gwii.com:80/admin/ManagedFiles/4/ReportResume.doc|title=Independent Public Inquiry on Gulf War Illnesses REPORT RÉSUMÉ|date=2004-11-20|access-date=2018-08-26|website=web.archive.org|last=Lloyd|first=Anthony|archive-url=|archive-date=|dead-url=|via=Wayback Machine|last2=Jones|first2=Norman|last3=Davies|first3=Michael|type=WORD}}</ref> - ([https://web.archive.org/web/20050119184010/http://www.lloyd-gwii.com:80/admin/ManagedFiles/4/LloydReport.pdf Full Testimony])<ref>{{Cite web|url=https://web.archive.org/web/20050119184010/http://www.lloyd-gwii.com:80/admin/ManagedFiles/4/LloydReport.pdf|title=Independent Public Inquiry on Gulf War Illnesses|date=2005-01-19|access-date=2018-08-26|website=web.archive.org|last=Lloyd|first=Anthony|archive-url=|archive-date=|dead-url=|last2=Jones|first2=Norman|last3=Davies|first3=Michael|publisher=Way Back Machine|type=PDF}}</ref>

* 2008, [https://www.va.gov/RAC-GWVI/docs/Committee_Documents/GWIandHealthofGWVeterans_RAC-GWVIReport_2008.pdf Gulf War Illness and the Health of Gulf War Veterans Scientific Findings and Recommendations]<ref>{{Cite web|url=https://www.va.gov/RAC-GWVI/docs/Committee_Documents/GWIandHealthofGWVeterans_RAC-GWVIReport_2008.pdf|title=Gulf War Illness and the Health of Gulf War Veterans Scientific Findings and Recommendations|last=|first=|date=Nov 2008|website=va.gov|publisher=Research Advisory Committee on Gulf War Veterans’ llnesses|type=Microsoft WORD|archive-url=|archive-date=|dead-url=|access-date=}}</ref>
* 2014, [http://www.usmedicine.com/agencies/department-of-veterans-affairs/advisory-group-exposures-not-stress-caused-gulf-war-illness/ Advisory Group: Exposures, Not Stress Caused Gulf War Illness]<ref>{{Cite news|url=http://www.usmedicine.com/agencies/department-of-veterans-affairs/advisory-group-exposures-not-stress-caused-gulf-war-illness/|title=Advisory Group: Exposures, Not Stress Caused Gulf War Illness - U.S. Medicine|last=usmedicine.com|date=2014-06-06|work=U.S. Medicine|access-date=2018-08-26|language=en-US}}</ref>
* 2015, [http://www.research.va.gov/pubs/docs/GWResearch-StrategicPlan.pdf GULF WAR RESEARCH STRATEGIC PLAN 2013-2017]<ref>{{Cite web|url=https://www.research.va.gov/pubs/docs/GWResearch-StrategicPlan.pdf|title=GULF WAR RESEARCH STRATEGIC PLAN 2013-2017 - 2015 Update|last=|first=|date=2015|website=va.gov|archive-url=|archive-date=|dead-url=|access-date=}}</ref>

*2016, [https://www.youtube.com/watch?v=KuyKkIaoMgw&feature=youtu.be Testing nine potential treatments for Gulf War Illness pain and fatigue]<ref>{{Cite web|url=https://www.youtube.com/watch?v=KuyKkIaoMgw&feature=youtu.be|title=Testing nine potential treatments for Gulf War Illness pain and fatigue|last=Younger|first=Jared|date=Apr 13, 2016|website=YouTube|publisher=Younger Lab|archive-url=|archive-date=|dead-url=|access-date=}}</ref>
*2019, [https://gumc.georgetown.edu/news-release/veterans-study-suggests-two-subtypes-of-gulf-war-illness/# Veterans Study Suggests Two Subtypes of Gulf War Illness]<ref>{{Cite web|url=https://gumc.georgetown.edu/news-release/veterans-study-suggests-two-subtypes-of-gulf-war-illness/|title=Veterans Study Suggests Two Subtypes of Gulf War Illness|date=2019-12-12|website=Georgetown University Medical Center|language=en-US|access-date=2019-12-13}}</ref>
*2019, [https://medicalxpress.com/news/2019-10-brain-chronic-fatigue-syndrome-gulf.html Brain studies show chronic fatigue syndrome and Gulf War illness are distinct conditions]<ref>{{Cite web|url=https://medicalxpress.com/news/2019-10-brain-chronic-fatigue-syndrome-gulf.html|title=Brain studies show chronic fatigue syndrome and Gulf War illness are distinct conditions|website=medicalxpress.com|language=en-us|access-date=2019-12-13}}</ref>
*[[wikipedia:Gulf_War_syndrome#CITEREFRAC-GWVI_Minutes2005|Wikipedia article on GWI]]

== References ==
{{reflist}}

[[Category:Diagnoses]]

Gulf War Illness

2020-09-13T06:32:39Z

Calirad:/* Cause of illness */

[[File:Operation Desert Storm.png|400px|thumb|right|Map of ground operations of Operation Desert Storm starting invasion February 24-28th 1991. Shows allied and Iraqi forces. Special arrows indicate the American 101st Airborne division moved by air and where the French 6th light division and American 3rd Armored Cavalry Regiment provided security]]
'''Gulf War Illness''' (GWI), also known as '''Gulf War Syndrome''' (GWS), is a term used for unexplained illnesses occurring in veterans of the 1991 [[wikipedia:Gulf_War|Gulf War]] in Southwest Asia. According to the [[Institute of Medicine]] in 2013, about one-third of US Gulf War veterans (250,000 of 700,000 personnel) suffer from “chronic multi-symptom illness (CMI): a series of symptoms that cannot be medically explained.”<ref>{{Cite web|url=http://www.hopkinsmedicine.org/healthlibrary/conditions/environmental_medicine/gulf_war_syndrome_85,P00487/|title=Gulf War Syndrome - Johns Hopkins Medicine Health Library|website=www.hopkinsmedicine.org|language=en|access-date=2018-08-24}}</ref><ref name=":7">{{Cite web|url=http://www8.nationalacademies.org/onpinews/newsitem.aspx?RecordID=12835|title=Gulf War Service Linked to Post-Traumatic Stress Disorder, Multisymptom Illness, Other Health Problems, But Causes Are Unclear|last=Stencel|first=Christine|date=Apr 9, 2010|website=|publisher=The National Academies of Science Engineering Medicine|language=en|archive-url=|archive-date=Apr 9, 2010|dead-url=|access-date=2018-08-26}}</ref> ''Science News'' summary of June 29, 2016, states: "Veterans of the Gulf War are more than twice as likely to have medically unexplained symptoms known as "multisymptom illness" (MSI), compared to Iraq/Afghanistan War veterans, according to an updated research."<ref>{{Cite news|url=https://www.sciencedaily.com/releases/2016/06/160629130628.htm|title=Gulf War veterans still have high rate of multisymptom illness|last=|first=|date=Jun 29, 2016|work=ScienceDaily|access-date=2018-08-24|archive-url=|archive-date=|dead-url=|publisher=Journal of Occupational and Environmental Medicine|language=en}}</ref>

== Symptoms ==
The [https://en.wikipedia.org/wiki/United_States_Department_of_Veterans_Affairs US Department of Veterans Affairs] has a list on [http://www.publichealth.va.gov/exposures/gulfwar/medically-unexplained-illness.asp Gulf War Veterans’ Medically Unexplained Illnesses].<ref name=":1" />
*[[ME/CFS|Myalgic Encephalomyelitis/Chronic fatigue syndrome]] ([[ME/CFS]]) with long-term severe [[fatigue]].
*[[Fibromyalgia]] characterized by widespread [[muscle pain]] and may include [[insomnia]], morning stiffness, [[headache]], and [[memory problems]].<ref name=":1">{{Cite web|url=https://www.publichealth.va.gov/exposures/gulfwar/medically-unexplained-illness.asp|title=Gulf War Veterans’ Medically Unexplained Illnesses - Public Health|last=Administration|first=US Department of Veterans Affairs, Veterans Health|website=www.publichealth.va.gov|language=en|access-date=2018-08-24}}</ref>

=== Functional gastrointestinal disorders ===
A group of conditions marked by chronic or recurrent symptoms related to any part of the [[Gastrointestinal system|gastrointestinal tract]]. Functional condition refers to an abnormal function of an organ, without a structural alteration in the tissues.
*functional [[abdominal pain]] syndrome
*functional dyspepsia (indigestion)
*[[irritable bowel syndrome]]<ref name=":1" />

=== Undiagnosed illnesses ===
These symptoms may be connected to undiagnosed illnesses.
*abnormal [[Weight loss|weight loss]]
*[[cardiovascular]] disease
*fatigue
*headache
*[[joint pain]]
*[[menstrual]] disorders
*muscle and [[joint pain]]
*[[Nervous system|neurological]] and psychological problems
*respiratory disorders
*skin conditions
*[[sleep dysfunction]]<ref name=":1" />

=== Other symptoms ===
* [[dizziness]]

* memory problems<ref name=":1" />

== Cause of illness ==
Causation include [[Vaccine|vaccination]]s; oil well fires; chemical and biological weapons; depleted uranium; noise; [https://www.publichealth.va.gov/exposures/carc-paint/index.asp CARC paint] used on military vehicles; occupational hazards; [[Mestinon|pyridostigmine]] bromide; pesticides or other [[Organophosphate|organophosphates]]; sand, dust, and particulates; toxic embedded fragments; infectious diseases; heat injuries; fuel; decontamination solutions; and doses of the antibiotic ciprofloxacin.<ref name=":8" /><ref>{{Cite web|url=http://www.ei-resource.org/illness-information/environmental-illnesses/gulf-war-syndrome/|title=Gulf War Syndrome - Overview, Symptoms & Possible Causes|last=Hogg|first=Matthew|date=Jun 8, 2017|website=www.ei-resource.org|language=en-gb|archive-url=|archive-date=|dead-url=|access-date=2018-08-26}}</ref><ref name=":2" />

=== Multisystem condition ===
In 2003, ''New Scientist''<nowiki/>'s March 29th print edition reported on Dr. [https://profiles.utsouthwestern.edu/profile/12888/robert-haley.html Robert Haley] and his team identifying three distinct syndromes in Gulf war veterans that involved [[brain]] damage.
* ''Syndrome 1'': Symptoms are [[Cognitive impairment|impaired cognition]], distractions, and [[insomnia]] from the exposure of pesticide with [[basal ganglia]] damage.

* ''Syndrome 2'': The symptoms are [[confusion]], disorientation, [[ataxia]], and [[vertigo]] due to exposure to sarin and pyridostigmine with damage to the [[brainstem]] and basal ganglia.

* ''Syndrome 3'': Symptoms are [[pain]], tingling, and [[numbness]] from exposure to [[wikipedia:DEET|DEET]] and pyridostigmine with damage to the brainstem.<ref name=":2">{{Cite news|url=https://www.newscientist.com/article/dn6609-us-in-u-turn-over-gulf-war-syndrome/|title=US in U-turn over Gulf war syndrome|last=MacKenzie|first=Deborah|date=Nov 3, 2004|work=New Scientist|access-date=2018-08-26|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>
175,000 of 700,000 US Gulf War personnel are affected by the brain damage syndromes categorized by Dr. Haley and 75,000 are ill due to other exposures; in total 250,000 are chronically ill with GWI. <ref name=":9">{{Cite web|url=https://youtu.be/OYKMMbPp_Do?t=546|title=Dr. Robert Haley, What Caused Gulf War Illness|last=Haley|first=Robert|date=May 6, 2013|website=YouTube|publisher=David Spencer|archive-url=|archive-date=|dead-url=|access-date=}}</ref><ref name=":2" /><ref name=":8">{{Cite web|url=https://www.publichealth.va.gov/exposures/gulfwar/sources/index.asp|title=Gulf War Exposures - Public Health|website=www.publichealth.va.gov|language=en|access-date=2018-08-26}}</ref>
=== Research conclusions ===
The ''Conclusions and Recommendations'' of the [https://www.va.gov/RAC-GWVI/RACReport2014Final.pdf Gulf War Illness and the Health of Gulf War Veterans: Research Update and Recommendations, 2009-2013]<ref name=":0">{{Cite web|url=https://www.va.gov/RAC-GWVI/RACReport2014Final.pdf|title=Gulf War Illness and the Health of Gulf War Veterans: Research Update and Recommendations, 2009-2013: Updated Scientific Findings and Recommendations|last=|first=|date=May 2014|website=va.gov|publisher=Research Advisory Committee on Gulf War Veterans’ llnesses|page=60|archive-url=|archive-date=|dead-url=|access-date=}}</ref> conclude "exposure to pesticides and pyridostigmine bromide are causally associated with Gulf War illness" as well as other hazardous exposures including gas agents sarin/cyclosarin. "Mixed exposures include not only mixtures of chemicals but also chemicals combined with heat, dehydration, infection and other environmental stressors."<ref name=":0" />

=== Vaccinations ===
Mass vaccinations "against infectious diseases including medical counter-measures against biological weapons" were given prior to military deployment.<ref name="Peakman, 2006">{{Citation|last1=Peakman|first1=Mark|authorlink1=|last2=Skowera|first2=Ania| authorlink2=|last3= Hotopf|first3=Matthew|authorlink3=Matthew Hotopf|title= Immunological dysfunction, vaccination and Gulf War illness|journal=Philosophical Transactions of the Royal Society B: Biological Sciences|volume=361|issue=1468|page= 681–687|date=2006|doi=10.1098/rstb.2006.1826}}</ref> Vaccination in the presence of elevated [[cortisol]] levels can drive [[cytokine]] expression toward [[Th2]] dominance.<ref>{{Cite journal|last=Bernton|first=E.|last2=Hoover|first2=D.|last3=Galloway|first3=R.|last4=Popp|first4=K.|date=1995-12-29|title=Adaptation to chronic stress in military trainees. Adrenal androgens, testosterone, glucocorticoids, IGF-1, and immune function|url=http://www.ncbi.nlm.nih.gov/pubmed/8597461|journal=Annals of the New York Academy of Sciences|volume=774|pages=217–231|issn=0077-8923|pmid=8597461}}</ref><ref>{{Cite journal|last=Ramírez|first=F.|last2=Fowell|first2=D.J.|last3=Puklavec|first3=M.|last4=Simmonds|first4=S.|last5=Mason|first5=D.|date=1996-04-01|title=Glucocorticoids promote a TH2 cytokine response by CD4+ T cells in vitro|url=http://www.ncbi.nlm.nih.gov/pubmed/8786298|journal=Journal of Immunology|volume=156|issue=7|pages=2406–2412|issn=0022-1767|pmid=8786298}}</ref>

== Notable studies ==
* Sep, 2017, Role of [[mitochondrial DNA]] damage and dysfunction in veterans with Gulf War Illness<ref>{{Cite web|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5599026/pdf/pone.0184832.pdf|title=Role of mitochondrial DNA damage and dysfunction in veterans with Gulf War Illness|last=Falvo|first=Michael|last2=Meyer|first2=Joel|date=Sep 2017|website=ncbi.nlm.nih.gov|type=PDF|archive-url=|archive-date=|dead-url=|access-date=|last3=Hill|first3=Helene Z.|last4=Lange|first4=Gudrun|last5=Condon|first5=Michael|last6=Klein|first6=Jacquelyn C.|last7=Ndirangu|first7=Duncan|last8=Falvo|first8=Michael J.}}</ref> - [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5599026/pdf/pone.0184832.pdf (Full Text)]
** [https://www.research.va.gov/currents/1017-Evidence-of-DNA-damage-in-Vets-with-Gulf-War-illness.cfm?platform=hootsuite Researchers find evidence of DNA damage in Vets with Gulf War illness]<ref>{{Cite web|url=https://www.research.va.gov/currents/1017-Evidence-of-DNA-damage-in-Vets-with-Gulf-War-illness.cfm?platform=hootsuite|title=Researchers find evidence of DNA damage in Vets with Gulf War illness|last=Richman|first=Mike|date=Oct 19, 2017|website=www.research.va.gov|language=en|archive-url=|archive-date=|dead-url=|access-date=2018-08-26}}</ref>
* Nov, 2018, The Multiple Hit Hypothesis for Gulf War Illness: Self-Reported Chemical/Biological Weapons Exposure and Mild [[Traumatic Brain Injury]]<ref>{{Cite journal|last=Janulewicz|first=Patricia|last2=Krengel|first2=Maxine|last3=Quinn|first3=Emily|last4=Heeren|first4=Timothy|last5=Toomey|first5=Rosemary|last6=Killiany|first6=Ronald|last7=Zundel|first7=Clara|last8=Ajama|first8=Joy|last9=O’Callaghan|first9=James|date=Nov 2018|title=The Multiple Hit Hypothesis for Gulf War Illness: Self-Reported Chemical/Biological Weapons Exposure and Mild Traumatic Brain Injury|url=https://www.mdpi.com/2076-3425/8/11/198|journal=Brain Sciences|language=en|volume=8|issue=11|pages=198|doi=10.3390/brainsci8110198|pmc=|pmid=|quote=|author-link=|author-link2=|access-date=|author-link3=|author-link4=|author-link5=|author-link6=|via=}}</ref> - [https://www.mdpi.com/2076-3425/8/11/198/htm (Full Text)]
* Dec, 2018, Fatigue in Gulf War Illness is associated with tonically high activation in the executive control network<ref>{{Cite journal|last=|first=|author-link=Glenn Wylie|author-link2=Helen Genova|author-link3=Ekaterina Dobryakova|author-link4=John DeLuca|author-link5=Nancy Chiaravalloti|author-link6=Michael Falvo|author-link7=Dane Cook|date=2018-12-11|title=Fatigue in Gulf War Illness is associated with tonically high activation in the executive control network|url=https://www.sciencedirect.com/science/article/pii/S2213158218303899|journal=NeuroImage: Clinical|language=en|volume=|issue=|pages=101641|doi=10.1016/j.nicl.2018.101641|issn=2213-1582|quote=|via=}}</ref> - [https://www.sciencedirect.com/science/article/pii/S2213158218303899#%21 (Full Text)]
* Feb 21, 2019, [[Gastrointestinal system|Gastrointestinal]] [[Neuroimmune disease|neuroimmune]] disruption in a mouse model of Gulf War illness<ref>{{Cite journal|last=Hernandez|first=Siomara|last2=Fried|first2=David E.|last3=Grubišić|first3=Vladimir|last4=McClain|first4=Jonathon L.|last5=Gulbransen|first5=Brian D.|date=2019-02-21|title=Gastrointestinal neuroimmune disruption in a mouse model of Gulf War illness|url=https://www.fasebj.org/doi/10.1096/fj.201802572R|journal=The FASEB Journal|pages=fj.201802572R|doi=10.1096/fj.201802572R|issn=0892-6638}}</ref> - [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6463928/ (Full text)]
** [https://www.sciencedaily.com/releases/2019/02/190221141506.htm GI neuroimmune disruption contributes to Gulf War Illness]<ref name=":11">{{Cite web|url=https://www.sciencedaily.com/releases/2019/02/190221141506.htm|title=GI neuroimmune disruption contributes to Gulf War Illness: Mouse model points to gastrointestinal neuroimmune disruption as contributing mechanism of Gulf War Illness|last=|first=|authorlink=|last2=|first2=|authorlink2=|date=|website=ScienceDaily.com|publisher=|language=en|via=Science Daily for Federation of American Societies for Experimental Biology|archive-url=|archive-date=|dead-url=|access-date=2019-02-22}}</ref> <blockquote>Many Persian Gulf War veterans experience Gulf War Illness (GWI), a chronic condition with symptoms ranging from gastrointestinal to neurological. While exposure to the anti-nerve gas pyridostigmine bromide (PB) is linked to the development of GWI, the exact cause and mechanisms of the illness remain unclear. Recently, an animal study tested the hypothesis that exposure to PB contributes to the development of GWI by disrupting the neural and immune systems of the intestine.<ref name=":11" /></blockquote>
*May 2, 2020, In-vivo imaging of neuroinflammation in veterans with Gulf War illness<ref name="Loggia2020">{{Cite journal|last=Alshelh|first=Zeynab|author-link=|last2=Albrecht|first2=Daniel S.|author-link2=|last3=Bergan|first3=Courtney|author-link3=|last4=Akeju|first4=Oluwaseun|author-link4=|last5=Clauw|first5=Daniel J.|author-link5=Daniel Clauw|last6=Conboy|first6=Lisa|author-link6=|last7=Edwards|first7=Robert R.|last8=Kim|first8=Minhae|last9=Lee|first9=Yvonne C.|displayauthors=8|date=2020-02-04|title=In-vivo imaging of neuroinflammation in veterans with Gulf War illness|url=http://www.sciencedirect.com/science/article/pii/S0889159119313340|journal=Brain, Behavior, and Immunity|language=en|volume=|issue=|pages=|doi=10.1016/j.bbi.2020.01.020|issn=0889-1591|pmc=|pmid=|access-date=|quote=|via=|last10=Protsenko|first10=Ekaterina|last11=Napadow|first11=Vitaly|last12=Sullivan|first12=Kimberly|author-link12=Kimberly Sullivan|author-link13=Marco Loggia|last13=Loggia|first13=Marco F.}}</ref> - [https://www.sciencedirect.com/science/article/pii/S0889159119313340 (Full text)]
*August 10, 2020, Exercise alters brain activation in Gulf War Illness and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome<ref name="Washington2020">{{Cite journal|last=Washington|first=Stuart D.|author-link=|last2=Rayhan|first2=Rakib U.|author-link2=Rakib Rayhan|last3=Garner|first3=Richard|author-link3=|last4=Provenzano|first4=Destie|author-link4=|last5=Zajur|first5=Kristina|author-link5=|last6=Addiego|first6=Florencia Martinez|author-link6=|last7=VanMeter|first7=John W.|last8=Baraniuk|first8=James N.|author-link8=James Baraniuk|date=2020-07-01|title=Exercise alters brain activation in Gulf War Illness and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome|url=https://academic.oup.com/braincomms/article/2/2/fcaa070/5885074|journal=Brain Communications|language=en|volume=2|issue=2|pages=|doi=10.1093/braincomms/fcaa070|pmc=|pmid=|access-date=|quote=|via=}}</ref> - [https://academic.oup.com/braincomms/article/2/2/fcaa070/5885074 (Full text)]

== Risk of developing other conditions ==
The US Department of Veteran's Affairs found that "1990-1991 Gulf War deployment is associated with an increased risk for ME/CFS, fibromyalgia, skin conditions, and dyspepsia."<ref>{{Cite web|url=https://www.publichealth.va.gov/exposures/gulfwar/chronic-fatigue-syndrome.asp|title=Myalgic Encephalomyelitis/Chronic Fatigue Syndrome in Gulf War Veterans - Public Health|last=Administration|first=US Department of Veterans Affairs, Veterans Health|website=www.publichealth.va.gov|language=en|access-date=2018-08-24}}</ref>

== Controversy ==

=== US Department of Veterans Affairs' cover-up of GWI ===
* Aug 28, 1997, [http://gulfwarvets.com/arison/gws.htm The Cover-up of Gulf War Syndrome -- A Question of Natinal Integrity]<ref>{{Cite web|url=http://gulfwarvets.com/arison/gws.htm|title=The Cover-Up of Gulf War Syndrome -- A Question of National Integrity|last=Harrison III|first=H. Lindsey|date=Aug 28, 1997|website=gulfwarvets.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-26}}</ref>
* Mar 13, 2013, [http://gulfwarvets.com/va_cover_up_data.htm Whistleblower: Veterans Affairs Covered Up Data on Mental Health, Gulf War Syndrome]<ref>{{Cite web|url=http://gulfwarvets.com/va_cover_up_data.htm|title=Whistleblower: Veterans Affairs Covered Up Data on Mental Health, Gulf War Syndrome|last=Reno|first=Jamie|date=Mar 13, 2013|website=gulfwarvets.com|archive-url=|archive-date=|dead-url=|access-date=2018-08-26}}</ref>
* Mar 13, 2013, [https://www.usatoday.com/story/news/nation/2013/03/13/whistleblower-alleges-veterans-affairs-cover-up/1979839/ Researcher says officials covered up vets' health data]<ref name=":6">{{Cite news|url=https://www.usatoday.com/story/news/nation/2013/03/13/whistleblower-alleges-veterans-affairs-cover-up/1979839/|title=Researcher says officials covered up vets' health data|last=Kennedy|first=Kelly|date=Mar 13, 2013|work=USA TODAY|access-date=2018-08-26|archive-url=|archive-date=|dead-url=|language=en}}</ref>
<blockquote>WASHINGTON — [[wikipedia:United_States_Department_of_Veterans_Affairs|Department of Veterans Affairs]] officials purposely manipulate or hide data that would support the claims of veterans from Iraq and Afghanistan to prevent paying costly benefits, a former VA researcher told a House subcommittee Wednesday.</blockquote><blockquote>"If the studies produce results that do not support the office of public health's unwritten policy, they do not release them," said [[wikipedia:Steven_S._Coughlin|Steven Coughlin]], a former epidemiologist in the VA's public health department.</blockquote><blockquote>"This applies to data regarding adverse health consequences of environmental exposures, such as burn pits in Iraq and Afghanistan, and toxic exposures in the Gulf War," Coughlin said. "On the rare occasions when embarrassing study results are released, data are manipulated to make them unintelligible."<ref name=":6" /></blockquote>
* Apr 12, 2013, [https://www.youtube.com/watch?v=OYKMMbPp_Do&feature=youtu.be&t=546 Dr. Robert Haley, What Caused Gulf War Illness]<ref name=":9" /> (Video) Dr. Haley speaks about the United States Department of Veterans Affairs' cover-up of US Gulf War troop illness being due to environmental exposure.

* Mar 14, 2014, [https://www.forbes.com/sites/rebeccaruiz/2014/03/24/congress-confronts-va-over-gulf-war-illness-research/#7648eec961fb Congress Confronts VA Over Gulf War Illness Research]<ref>{{Cite news|url=https://www.forbes.com/sites/rebeccaruiz/2014/03/24/congress-confronts-va-over-gulf-war-illness-research/#7648eec961fb|title=Congress Confronts VA Over Gulf War Illness Research|last=Ruiz|first=Rebecca|date=Mar 24, 2014|work=Forbes|access-date=2018-08-26|archive-url=|archive-date=|dead-url=|language=en}}</ref>
* Mar 30, 2015, [https://www.disabledveterans.org/2015/03/30/former-va-chief-of-staff-linked-to-gulf-war-scandal/ Former VA Chief Of Staff Linked To Gulf War Scandal]<ref>{{Cite news|url=https://www.disabledveterans.org/2015/03/30/former-va-chief-of-staff-linked-to-gulf-war-scandal/|title=Former VA Chief Of Staff Linked To Gulf War Scandal|last=Krause|first=Benjamin|date=2015-03-30|work=DisabledVeterans.Org|access-date=2018-08-26|archive-url=|archive-date=|dead-url=|language=en-US}}</ref>

===Simon Wessely's past stress related beliefs in GWI ===
Professor [[Simon Wessely]], psychiatric paradigm researcher of [[chronic fatigue syndrome]], believed that [[stress]] was the common denominator of GWI.
* 2004, Interview with ''New Scientist'', [https://www.newscientist.com/article/dn6609-us-in-u-turn-over-gulf-war-syndrome/ US in U-turn over Gulf war syndrome]<ref name=":2" />
<blockquote>Wessely told ''New Scientist'': “There is not one single cause for the ill health,” adding that he believes we may never fully know what happened to the people who became ill.</blockquote><blockquote>Wessely asked both Gulf and non-Gulf veterans about 50 standard symptoms. “Gulf veterans reported every symptom twice as often,” he told the Lloyd inquiry. If there were a unique Gulf syndrome, some would be relatively more frequent in the Gulf group. “But they are just experiencing more ill health. There is no unique syndrome here.”</blockquote><blockquote>Wessely favours psychological explanations for Gulf war illnesses. The only thing that could have affected so many different people, he says, was stress, especially anxiety about chemical weapons, misinformation about Gulf war syndrome afterwards, and the many vaccinations Gulf troops received. His team found the more vaccine Gulf, but not non-Gulf veterans, received the more likely they are to be ill.</blockquote><blockquote>Haley says the questions in Wessely’s study were too vague to distinguish between a real syndrome and people who have, say, occasional dizziness or joint pain. He says this will confound efforts to uncover a meaningful pattern behind the veterans’ symptoms.<ref name=":2" /></blockquote>
* 2006, A study published in [[The Lancet|''The Lancet'']] that Wessely was involved with, [https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(06)68662-5/fulltext The health of UK military personnel who deployed to the 2003 Iraq war: a cohort study]<ref name=":3">{{Cite journal|last=Hotopf|first=Matthew|last2=Hull|first2=Lisa|last3=Fear|first3=NicolaT|last4=Browne|first4=Tess|last5=Horn|first5=Oded|last6=Iversen|first6=Amy|last7=Jones|first7=Margaret|last8=Murphy|first8=Dominic|last9=Bland|first9=Duncan|date=2006|others=Earnshaw, Mark; Greenberg, Neil; Hacker Hughes, Jamie; Tate, Rosemary; Dandeker, Christopher; Rona, Robert; Wessely, Simon|title=The health of UK military personnel who deployed to the 2003 Iraq war: a cohort study|url=https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(06)68662-5/fulltext|journal=The Lancet|language=English|volume=367|issue=9524|pages=1731–1741|doi=10.1016/S0140-6736(06)68662-5|issn=0140-6736|via=}}</ref> interpretation:
<blockquote>For regular personnel in the UK armed forces, deployment to the Iraq war has not, so far, been associated with significantly worse health outcomes, apart from a modest effect on multiple physical symptoms. There is evidence of a clinically and statistically significant effect on health in reservists.<ref name=":3" /></blockquote>
* 2006, [http://www.gresham.ac.uk/lectures-and-events/something-old-something-new-something-borrowed-something-blue-the-true-story-of Something old, something new, something borrowed, something blue: The true story of Gulf War Syndrome]<ref name=":10">{{Cite web|url=http://www.gresham.ac.uk/lectures-and-events/something-old-something-new-something-borrowed-something-blue-the-true-story-of|title=Something old, something new, something borrowed, something blue: The true story of Gulf War Syndrome|website=www.gresham.ac.uk|access-date=2018-08-29}}</ref>
<blockquote>So my story then: something old, we have seen some of these before; something new, there was a definite hazard with some of the precautions that were taken to protect Gulf veterans; something borrowed, soldiers can also be civilians and the things that concern us also can concern them; something blue, the psychiatry of Gulf War is the psychiatry more of [[depression]] than it is of [[Post-traumatic stress disorder|PTSD]].<ref name=":10" /></blockquote>
* 2010, A second study [https://www.kcl.ac.uk/kcmhr/publications/assetfiles/iraqafghan/Fear2010-consequencesofdeployment.pdf What are the consequences of deployment to Iraq and Afghanistan on the mental health of the UK armed forces? A cohort study]<ref name=":4">{{Cite web|url=https://www.kcl.ac.uk/kcmhr/publications/assetfiles/iraqafghan/Fear2010-consequencesofdeployment.pdf|title=What are the consequences of deployment to Iraq and Afghanistan on the mental health of the UK armed forces?: A cohort study|last=Fear|first=Nicola T|last2=Jones|first2=Margaret|date=2010|website=kcl.ac.uk|others=Jones, Norman; Greenberg, Neil; Landau, Sabine; Dandeker, Christopher; Rona, Roberta J; Hotopf, Mathew; Wessely, Simon|archive-url=|archive-date=|dead-url=|access-date=|last3=Murphy|first3=Dominic|last4=Hull|first4=Lisa|last5=Civerson|first5=Amy|last6=Coker|first6=Bolaji|last7=Machell|first7=Louise|last8=Sundin|first8=Josefin|last9=Woodhead|first9=Charlotte|type=PDF}}</ref> interpretation:
<blockquote>Symptoms of common mental disorders and alcohol misuse remain the most frequently reported mental disorders in UK armed forces personnel, whereas the prevalence of probable [[post-traumatic stress disorder]] was low. These findings show the importance of continued health surveillance of UK military personnel.<ref name=":4" /></blockquote>
* 2011, A ''BBC'' report [https://www.bbc.com/news/uk-12195884 Two decades on, battle goes on over 'Gulf War Syndrome']<ref name=":5">{{Cite news|url=https://www.bbc.com/news/uk-12195884|title=Battle continues over Gulf War Syndrome|last=Hughes|first=Caroline Hawley and Stuart|date=2011|work=BBC News|access-date=2018-08-26|language=en-GB}}</ref>
<blockquote>Professor [[Simon Wessely]] is director of the King's Centre for Military Health Research in London and an adviser to the Ministry of Defence. He does not believe Gulf War Syndrome exists as a distinct illness.</blockquote><blockquote>Even so, he has no doubt that a significant number of Gulf veterans became ill as a direct result of their military service.</blockquote><blockquote>"The evidence is incontrovertible that there is a Gulf War health effect," he says.</blockquote><blockquote>"Something to do with the Gulf has affected health and no-one serious has ever disputed that.</blockquote><blockquote>"Is there a problem? Yes there is. Is it Gulf War Syndrome or isn't it? I think that's a statistical and technical question that's of minor interest."</blockquote><blockquote>The Ministry of Defence echoes Professor Wessely's view.<ref name=":5" /></blockquote>

==See also==
* [[Vaccine]]

==Learn more==
* 2004, ''Independent Public Inquiry on Gulf War Illnesses'' (The Lloyd Inquiry) ([https://web.archive.org/web/20041120030227/http://www.lloyd-gwii.com:80/admin/ManagedFiles/4/ReportResume.doc Report Resume])<ref>{{Cite web|url=https://web.archive.org/web/20041120030227/http://www.lloyd-gwii.com:80/admin/ManagedFiles/4/ReportResume.doc|title=Independent Public Inquiry on Gulf War Illnesses REPORT RÉSUMÉ|date=2004-11-20|access-date=2018-08-26|website=web.archive.org|last=Lloyd|first=Anthony|archive-url=|archive-date=|dead-url=|via=Wayback Machine|last2=Jones|first2=Norman|last3=Davies|first3=Michael|type=WORD}}</ref> - ([https://web.archive.org/web/20050119184010/http://www.lloyd-gwii.com:80/admin/ManagedFiles/4/LloydReport.pdf Full Testimony])<ref>{{Cite web|url=https://web.archive.org/web/20050119184010/http://www.lloyd-gwii.com:80/admin/ManagedFiles/4/LloydReport.pdf|title=Independent Public Inquiry on Gulf War Illnesses|date=2005-01-19|access-date=2018-08-26|website=web.archive.org|last=Lloyd|first=Anthony|archive-url=|archive-date=|dead-url=|last2=Jones|first2=Norman|last3=Davies|first3=Michael|publisher=Way Back Machine|type=PDF}}</ref>

* 2008, [https://www.va.gov/RAC-GWVI/docs/Committee_Documents/GWIandHealthofGWVeterans_RAC-GWVIReport_2008.pdf Gulf War Illness and the Health of Gulf War Veterans Scientific Findings and Recommendations]<ref>{{Cite web|url=https://www.va.gov/RAC-GWVI/docs/Committee_Documents/GWIandHealthofGWVeterans_RAC-GWVIReport_2008.pdf|title=Gulf War Illness and the Health of Gulf War Veterans Scientific Findings and Recommendations|last=|first=|date=Nov 2008|website=va.gov|publisher=Research Advisory Committee on Gulf War Veterans’ llnesses|type=Microsoft WORD|archive-url=|archive-date=|dead-url=|access-date=}}</ref>
* 2014, [http://www.usmedicine.com/agencies/department-of-veterans-affairs/advisory-group-exposures-not-stress-caused-gulf-war-illness/ Advisory Group: Exposures, Not Stress Caused Gulf War Illness]<ref>{{Cite news|url=http://www.usmedicine.com/agencies/department-of-veterans-affairs/advisory-group-exposures-not-stress-caused-gulf-war-illness/|title=Advisory Group: Exposures, Not Stress Caused Gulf War Illness - U.S. Medicine|last=usmedicine.com|date=2014-06-06|work=U.S. Medicine|access-date=2018-08-26|language=en-US}}</ref>
* 2015, [http://www.research.va.gov/pubs/docs/GWResearch-StrategicPlan.pdf GULF WAR RESEARCH STRATEGIC PLAN 2013-2017]<ref>{{Cite web|url=https://www.research.va.gov/pubs/docs/GWResearch-StrategicPlan.pdf|title=GULF WAR RESEARCH STRATEGIC PLAN 2013-2017 - 2015 Update|last=|first=|date=2015|website=va.gov|archive-url=|archive-date=|dead-url=|access-date=}}</ref>

*2016, [https://www.youtube.com/watch?v=KuyKkIaoMgw&feature=youtu.be Testing nine potential treatments for Gulf War Illness pain and fatigue]<ref>{{Cite web|url=https://www.youtube.com/watch?v=KuyKkIaoMgw&feature=youtu.be|title=Testing nine potential treatments for Gulf War Illness pain and fatigue|last=Younger|first=Jared|date=Apr 13, 2016|website=YouTube|publisher=Younger Lab|archive-url=|archive-date=|dead-url=|access-date=}}</ref>
*2019, [https://gumc.georgetown.edu/news-release/veterans-study-suggests-two-subtypes-of-gulf-war-illness/# Veterans Study Suggests Two Subtypes of Gulf War Illness]<ref>{{Cite web|url=https://gumc.georgetown.edu/news-release/veterans-study-suggests-two-subtypes-of-gulf-war-illness/|title=Veterans Study Suggests Two Subtypes of Gulf War Illness|date=2019-12-12|website=Georgetown University Medical Center|language=en-US|access-date=2019-12-13}}</ref>
*2019, [https://medicalxpress.com/news/2019-10-brain-chronic-fatigue-syndrome-gulf.html Brain studies show chronic fatigue syndrome and Gulf War illness are distinct conditions]<ref>{{Cite web|url=https://medicalxpress.com/news/2019-10-brain-chronic-fatigue-syndrome-gulf.html|title=Brain studies show chronic fatigue syndrome and Gulf War illness are distinct conditions|website=medicalxpress.com|language=en-us|access-date=2019-12-13}}</ref>
*[[wikipedia:Gulf_War_syndrome#CITEREFRAC-GWVI_Minutes2005|Wikipedia article on GWI]]

== References ==
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[[Category:Diagnoses]]