U.S. Marines race toward a vehicle that came under fire in Baghdad on April 8, 2003, during the Iraq war. / Laura Rauch, AP
WASHINGTON -- Veterans of the wars in Iraq and Afghanistan may be suffering from the 20-year-old set of symptoms known as Gulf War Illness, according to a new report released Wednesday by the federal Institute of Medicine.
"Preliminary data suggest that (chronic multisymptom illness) is occurring in veterans of the Iraq and Afghanistan wars as well," the report says.
This may be the first time that the symptoms suffered by veterans of the 1991 Gulf War have been linked to veterans of the current wars, which started in 2001 and 2003, said Paul Rieckhoff, CEO of Iraq and Afghanistan Veterans of America.
It also means the Department of Veterans Affairs' definition of who qualifies for Gulf War veterans' benefits should include those who served in Afghanistan, said Paul Sullivan, a 1991 Gulf War veteran and founder of Veterans for Common Sense.
Because Wednesday's report associates the symptoms with deployment, Sullivan said, the VA "should expand the geographical definition of the current Gulf War to include the ongoing conflicts in Iraq and Afghanistan."
The researchers investigated treatments for Gulf War illness, including any existing research, to see what worked for veterans. Their research included traumatic brain injury, which is caused by blunt force to the head or proximity to an explosion; post-traumatic stress disorder, which must involve exposure to trauma; respiratory problems, fibromyalgia and chronic pain.
Chronic multisymptom illness was formerly called Gulf War Syndrome, the Institute of Medicine report said. It includes symptoms in at least two of six categories: fatigue, mood and cognition issues, musculoskeletal problems, gastrointestinal problems, respiratory difficulties and neurologic issues that last for at least six months.
"We did redefine how we see the issue of chronic multisymptom illness," said committee chair Bernard M. Rosof, chairman of the board of directors at Huntington Hospital in Huntington, N.Y. He said the committee came out of the study with "no idea" what the cause might be, but that he expected data from veterans of the current wars to help. "We feel that the complaints will be the same."
Rosof said he believes the report will help veterans.
About one-third of Gulf War veterans -- or 175,000 to 250,000 people -- have Gulf War illness.
The symptoms are too broad for any one treatment, the report said.
"Based on the voluminous evidence we reviewed, our committee cannot recommend using one universal therapy to manage the health of veterans with chronic multisymptom illness, and we reject a 'one size fits all' treatment approach," Rosof, said. "Instead, we endorse individualized health care management plans as the best approach for treating this very real, highly diverse condition."
Researchers also said there may be no specific cause for the illness.
"Despite considerable efforts by researchers in the United States and elsewhere, there is no consensus among physicians, researchers and others as to the cause of CMI," the report states. "There is a growing belief that no specific causal factor or agent will be identified."
Anthony Hardie, a Gulf War veteran and advocate, disagreed. "They've lumped together so many ill people that it's impossible to come up with one treatment," Hardie said.
Other recent research has shown possible causes for some of the symptoms suffered by Gulf War illness.
A large-scale study done by Robert Haley, chief of epidemiology at the University of Texas Southwestern Medical Center in Dallas, showed veterans have damage to their autonomic nervous system caused by exposure to nerve agents after the U.S. Air Force bombed a chemical factory. Beatrice Golomb of the medical school at the University of California-San Diego tested the value of giving doses of the coenzyme Q10 to Gulf War veterans and found that "every single" veteran found improvement from 20 symptoms.
For current war veterans, scientists have connected chronic obstructive pulmonary disorder and bronchiolitis to exposures in Iraq and Afghanistan, including to garbage pits that burned as much as 240 tons of waste in an open pit a day, as well as to dust proved to be laden with bacteria and heavy metals.
The researchers also found that cognitive therapy and anti-depressants may provide relief. The committee recommended that VA conduct studies in biofeedback, acupuncture, St. John's wort, aerobic exercise, motivational interviewing and multimodal therapies.
Denise Nichols, also a Gulf War veteran and advocate, said she fears the report will add to Americans' belief that the symptoms are "all in our heads" -- even after numerous reports have come out saying the disease is physical and real.
"We need true treatment modalities," Nichols said, "that address the physical brain damage and other body organ damage from the exposures we endured."
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