Gulf War Syndrome or Gulf War Illness (GWI) has been used to describe a collection of chronic signs and symptoms reported by U.S., British, Canadian, Czech, Danish, Saudi, Egyptian, Australian and other Coalition Armed Forces that were deployed to Operation Desert Storm in 1991. Over 100,000 American veterans of Desert Storm /Desert Shield (approximately 15% of deployed U.S. Armed Forces) returned from the Persian Gulf and slowly (over 6-24 months or more) and presented with a variety of complex signs and symptoms characterized by disabling fatigue, intermittent fevers, night sweats, arthralgia, myalgia, impairments in short-term memory, headaches, skin rashes, intermittent diarrhea, abdominal bloating, chronic bronchitis, photophobia, confusion, transient visual scotomata, irritability and depression and other signs and symptoms that until recently have defied appropriate diagnoses. These symptoms are not localized to any one organ, and the signs and symptoms and routine laboratory test results are not consistent with a single, specific disease.
Unfortunately, when a veteran has symptoms suggestive of GWI, the type of care they get may depend on the type of doctor they see. A 2001 study shows that mental healthcare workers are more likely to believe that GWI is caused by a physical factor such as a contagious or toxic agent, while general internal medicine doctors are more likely to believe the syndrome is caused by mental illness. "It's particularly frustrating for patients when they are bounced back and forth between clinicians and psychologists", says lead author Dr. Ralph D. Richardson, co-director of the Gulf War Clinic in Portland, Oregon. [Archives of Internal Medicine, May 28th, 2001;161: pp.1289-94]
Although there is not yet a case definition for Gulf War Illness, the chronic signs and symptoms loosely fit the clinical criteria for Chronic Fatigue Syndrome and/or Fibromyalgia Syndrome. Some patients also have what appears to be neurotoxicity and brainstem dysfunction that can result in autonomic, cranial and peripheral nerve demyelination, possibly due to complex chemical exposures. Often these patients have been diagnosed with Multiple Chemical Sensitivity Syndrome (MCS) or Organophosphate-Induced Delayed Neurotoxicity (OPIDN). Chemically-exposed patients can be treated by removal of offending chemicals from the patient's environment, depletion of chemicals from the patient's system and treatment of the neurotoxic signs and symptoms caused by chemical exposure(s).
Scientists at The Institute for Molecular Medicine have found that slightly under one-half of the very sick Gulf War Illness patients in a pilot study with the signs and symptoms of Chronic Fatigue Syndrome or Fibromyalgia have chronic invasive infections involving certain uncommon mycoplasmas, such as Mycoplasma fermentans (incognitus strain). This has now been confirmed in a large Department of Defense – Department of Veterans' Affairs clinical trial.
Staff at The Institute for Molecular Medicine have recommended that these infections can be successfully treated with certain antibiotics, allowing the recovery of patients who have been long-term disabled. Similarly, in ongoing preliminary studies on Chronic Fatigue Syndrome and Fibomyalgia patients, we have found that a subset of patients have mycoplasmal infections that can be successfully treated with antibiotics, allowing patients to recover from their illnesses.