Q. Are 1990-1991 Gulf War veterans illnesses contagious?
A. A few veterans' illnesses are known to be contagious,
but there is little reason to believe that most veterans' illnesses can
be spread to other persons. Of all the veterans (33,542) who have completed
the detailed medical evaluations at the DoD clinics and hospitals, about
3% were found to have an infection as their main diagnosis. A small number
of these veterans had infections well known to medical science which could
be passed on to other persons (viral hepatitis, herpes simplex infections,
HIV infection, and tuberculosis). Otherwise, the vast majority of the
infections were either brief, one-time illnesses, easily treated and cured
illnesses, or infections that are not contagious from person to person.
Other than the specific infections of malaria and leishmaniasis (which
are not spread from person to person), none of the veterans' infections
can be specifically linked to service in the Persian Gulf. The infectious
diseases among veterans resemble the range of illnesses common in the
population at large. Despite the above, however, DoD and the VA continue
to pursue research studies of the questions of contagion and of previously
unrecognized causes of infection.
Q. What are mycoplasmas?
A. Mycroplasmas are the smallest, free-living infectious
agents. They are distinct from viruses because of their ability to grow
in cell-free media and from bacteria because they lack a cell wall and
the ability to synthesize cell wall precursors. A variety of plant and
animal diseases are caused by the mycoplasmas. However, only certain types
have been clearly shown to cause disease in humans.
Q. What research is being conducted to determine if any
of the 1990-1991 Gulf War illnesses are contagious?
A. An ongoing study at Walter Reed Army Medical Center
is looking at the possibility that veterans are infected with a bacterium
called Mycoplasma fermentans. This study is a collaboration with Garth
Nicolson, Ph.D. who has reported that a gene tracking test which he developed
has detected evidence of M. fermentans in many 1990-1991 Gulf War veterans, their
family members, and other persons. The study will first attempt to validate
Dr. Nicolson's technique for detecting the bacterium. Results of the validity
testing are expected within the next year. If the test is validated, then
additional studies will explore the best way to test for the presence
of M. fermentans, its potential role in human disease, and, if it causes
disease, the best way to eradicate the infection. These studies will be
sponsored by the Persian Gulf Veterans Coordinating Board's Research Working
Group.
Q. What is the nature of the illnesses suffered by Gulf
War Veterans?
A. Our best information on this question comes from
the Comprehensive Clinical Evaluation Program (CCEP) which provides thorough
medical evaluations of 1990-1991 Gulf War veterans in DoD health care facilities.
Through June 1998, approximately 32,392 veterans have completed CCEP evaluations.
Seventy five percent of all 32,392 CCEP participants have as their primary
(main) diagnosis one of the following 42 most common diagnoses (ICD-9
Codes are shown in parentheses):
Musculoskeletal Disorders, Number of Participants 5224 / Percent
of All Participants 16.2%
(specified below)
Pain in Joint (719.4) 1776
Osteoarthrosis (715) 1148
Back Pain and Other Back Disorders (724) 901
Disorders of Tendons, Muscle Attachments (726) 497
Other Disorders of Soft Tissue (729) 464
Vertebral Disc Disorders (722) 294
Knee Derangements (717) 144
Symptoms which the CCEP Evaluation was unable to establish an explanatory
diagnosis,
Number of Participants 4397 / Percent of All Participants 13.6 %
(as specified below)
Malaise and/or fatigue (780.7) 1381
Sleep Disturbances (780.5) 1067
General Symptoms and Hyperhidrosis (780.8-780.9) 625
Symptoms of Respiratory System and Chest (786) 530
Symptoms Involving the Skin (782) 334
Alterations of Consciousness, Awareness (780-780.4) 197
Abdominal Pain in Various Locations (789.0) 136
Symptoms of Digestive System (787) 127
Psychological Disorders, Number of Participants 3989 / Percent
of All Participants 12.3 %
(as specified below)
Depressive Disorder (311) 942
Neuroses (300) 897
Prolonged PTSD (309.81) 850
Affective Disorders (296) 563
Adjustment Reactions (309) 387
Sleep Disorders (307.4) 179
Organic Brain Syndromes (293-4) 171
Healthy, Number of Participants 2904 / Percent of All Participants
9.0 %
(as specified below)
Feared Complaint, No Diagnosis (V65.5) 2586
Routine General Medical Examination (V70) 318
Headaches, Number of Participants 2757 / Percent of All Participants
8.5 %
(as specified below)
Tension headache (307.81) 1016
Migraine (346) 950
Headache (784.0) 791
Respiratory Conditions, Number of Participants 1681 / Percent
of All Participants 5.2 %
(as specified below)
Asthma (493) 719
Allergic Rhinitis (477) 501
Chronic Upper Respiratory Inflammation (472-476) 461
Skin Disorders, Number of Participants 1387 / Percent of All Participants
4.3%
(as specified below)
Alopecia, hirsutism, and other diseases of hair and hair follicles
(704) 407
Fungus Infections (110-111) 406
Contact dermatitis and other Eczema (692) 399
Urticaria, various types (708) 175
Gastrointestinal Disorders, Number of Participants 1262 / Percent
of All Participants 3.9%
(as specified below)
Irritable Colon (564.1) 496
Esophageal Reflux (530.81) 429
Enteritis and Colitis (558) 214
Gastritis and Duodenitis (535) 123
Hypertension, Essential(401), Number of Participants 393 / Percent
of All Participants 1.2%
Endocrine and Metabolic Disorders, Number of Participants 292
/ Percent of All Participants 0.9 %
(as specified below)
Lipoid Metabolism Disord. (272) 168
Hypothyroidism (243-244) 124
Hearing Loss (388.02-388.2, 389), Number of Participants 130 /
Percent of All Participants 0.4 %
TOTALS: Number of Participants 24,416 / Percent of All Participants
75.4 %
The Institute of Medicines Evaluation of the U.S. Department of
Defense Persian Gulf Comprehensive Clinical Evaluation Program http://www.nap.edu/readingroom/books/ccep/
A
Comprehensive Clinical Evaluation of 20,000 Persian Gulf War Veterans
(Abstract)
The
Institute of Medicine's Evaluation of the U.S. Department of Defense Persain
Gulf Comprehensive Clinical Evaluation Program
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