A Review of the Scientific Literature As It Pertains to the Gulf War Illnesses, Volume 1: Infectious Diseases

Lee H. Hilborne and Beatrice Alexandra Golomb

Contents

Preface
Figure and Tables
Summary
Acknowledgments

Chapter One: Introduction

Background
Purpose
Organization of This Document
Overview of What We Know About Diseases
Common Illnesses in Gulf War Veterans
Infectious Diseases in Gulf War Troops
      Gastrointestinal Diseases
      Respiratory Diseases
      Other Diseases
Infectious Diseases in the Persian Gulf But Not Identified in Gulf War Troops
Other Infectious Diseases Considered

Chapter Two: Infectious Diseases as a Possible Cause of Gulf War Illnesses

Reasons to Consider an Infectious Etiology
      Epidemiologic Relationship
      History of Infectious Diseases
      Some Infectious Diseases Were Identified
Reasons to Dismiss an Infectious Etiology
      Koch's Postulates
      A Missing Specific Finding
      Some Evidence Does Not Fit

Chapter Three: Bacterial Diseases (Mycoplasma)

Background on Mycoplasmas
      Mycoplasma
and Disease in Those with Dysfunctional Immune Systems
      Mycoplasma
and Disease in Those with Normal Immune Function
Mycoplasma
in Gulf War Veterans
Evaluating Elements of the Mycoplasma Hypothesis
      Origin
      Testing of Veterans for Mycoplasma
      Theoretical Compatibility of Mycoplasma Infection with Symptoms in Gulf War Veterans
      Evidence of Mycoplasma in Ill Gulf War Veterans
      Treatment of Veterans with Antibiotics
      Correlation with Gulf War Illnesses
      Summary

Chapter Four: Bacterial Diseases (Other Than Mycoplasma)

Typhoid Fever
      Introduction
      What Infected Patients Experience
      Diagnosis
      Prevention
      Correlation with Gulf War Illnesses
      Summary
Mycobacteria Tuberculosis
      Introduction
      Epidemiologic Information
      What Infected Patients Experience
      Diagnosis
      Treatment and Prevention
      Correlation with Gulf War Illnesses
      Summary
Enteric Agents: Enterotoxigenic E. Coli, Campylobacter, Shigella, and Other Salmonella
      Introduction
      Epidemiologic Information
      What Infected Patients Experience
      Diagnosis
      Treatment and Prevention
      Correlation with Gulf War Illnesses
      Summary
Meningococcus
      Introduction
      Epidemiologic Information
      What Infected Patients Experience
      Diagnosis
      Treatment and Prevention
      Correlation with Gulf War Illnesses
      Summary
Brucella
      Introduction
      Epidemiologic Information
      What Infected Patients Experience
      Diagnosis
      Prevention
      Correlation with Gulf War Illnesses
      Summary
Cholera
      Introduction
      Epidemiologic Information
      What Infected Patients Experience
      Diagnosis
      Treatment and Prevention
      Correlation with Gulf War Illnesses
      Summary

Chapter Five: Viral Diseases

Viral Hepatitis
      Introduction
      Epidemiologic Information
      What Infected Patients Experience
      Diagnosis
      Treatment and Prevention
      Correlation with Gulf War Illnesses
      Summary
Crimean-Congo Hemorrhagic Fever
      Introduction
      Epidemiologic Information
      What Infected Patients Experience
      Diagnosis
      Treatment and Prevention
      Correlation with Gulf War Illnesses
      Summary
West Nile Fever
      Introduction
      Epidemiologic Information
      What Infected Patients Experience
      Diagnosis
      Treatment and Prevention
      Correlation with Gulf War Illnesses
      Summary
Sindbis
      Introduction
      Epidemiologic Information
      What Infected Patients Experience
      Diagnosis
      Treatment and Prevention
      Correlation with Gulf War Illnesses
      Summary
Rift Valley Fever
      Introduction
      Epidemiologic Information
      What Infected Patients Experience
      Diagnosis
      Treatment and Prevention
      Correlation with Gulf War Illnesses
      Summary
Rabies
      Introduction
      Epidemiologic Information
      What Infected Patients Experience
      Diagnosis
      Treatment and Prevention
      Correlation with Gulf War Illnesses
      Summary
Dengue
      Introduction
      Epidemiologic Information
      What Infected Patients Experience
      Diagnosis
      Treatment and Prevention
      Correlation with Gulf War Illnesses
      Summary
Sandfly Fever
      Introduction
      Epidemiologic Information
      What Infected Patients Experience
      Diagnosis
      Treatment and Prevention
      Correlation with Gulf War Illnesses
      Summary
Leishmaniavirus
      Introduction
      Epidemiologic Information
      What Infected Patients Experience
      Diagnosis
      Treatment and Prevention
      Correlation with Gulf War Illnesses
      Summary

Chapter Six: Parasitic Diseases

Leishmaniasis
      Introduction
      Epidemiologic Information
      What Infected Patients Experience
      Diagnosis
      Treatment and Prevention
      Correlation with Gulf War Illnesses
      Summary
Malaria
      Introduction
      Epidemiologic Information
      What Infected Patients Experience
      Diagnosis
      Treatment and Prevention
      Correlation with Gulf War Illnesses
      Summary
Giardia
      Introduction
      Epidemiologic Information
      What Infected Patients Experience
      Diagnosis
      Treatment and Prevention
      Correlation with Gulf War Illnesses
      Summary
Amoeba
      Introduction
      Epidemiologic Information
      What Infected Patients Experience
      Diagnosis
      Treatment and Prevention
      Correlation with Gulf War Illnesses
      Summary
Schistosomiasis
      Introduction
      Epidemiologic Information
      What Infected Patients Experience
      Diagnosis
      Treatment and Prevention
      Correlation with Gulf War Illnesses
      Summary

Chapter Seven: Biological Warfare Agents

Anthrax
      Introduction
      What Infected Patients Experience
      Prevention
Botulinum Toxin
      Introduction
      Epidemiologic Information
      What Infected Patients Experience
Summary

Chapter Eight: Unidentified Infections

General Processes for Identification
Representational Difference Analysis (RDA)
Serial Analysis of Genomic Expression (SAGE)
CDNA Expression Analysis

Chapter Nine: Conclusions and Recommendations

Appendix: Additional Consideration on Mycoplasma

Bibliography


A Review of the Scientific Literature as it Pertains to Gulf War Illnesses, Volume 1: Infectious Diseases, Lee H. Hilborne and Beatrice Alexandra Golomb , MR-1018/1-OSD, 2000. RAND is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions or policies of its research sponsors..

Copyright © 2000 RAND

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Published 2000 by RAND