Gulf War syndrome could be caused by something as common as a fly, as frightening as half-used uranium, as ironic as a drug used to keep troops safe from a chemical attack that never came.
Or did it? Some experts say the fatigue, nausea, pains and confusion suffered by some veterans are the result of low levels of chemical or biological weapons released from Iraqi missiles or the destruction of that country’s weapons stockpiles.
No, it’s the smoke from the oil fields that Saddam Hussein torched as the allies tightened their noose, say others.
No, it’s a combination of insecticides and oil smoke. Or micro-organisms and battle fatigue.
Or something else. Several somethings.
In a recent Journal of the American Medical Association, Robert Haley of the University of Texas Southwestern Medical Center argues that Gulf War illness could be three distinct syndromes involved in most cases, and three other syndromes in a small number of other cases.
Haley and other researchers believe the main culprits are a combination of exposure to low doses of chemical weapons, insecticides and drugs issued to troops to prevent heavy casualties from Iraqi chemical attacks. He estimates about a third of veterans who are reporting symptoms suffer from such multiple exposures.
The remaining veterans could be suffering from something else related to their service in the gulf, he said. Or it may have nothing to do with the war.
Here are some theories that different researchers have suggested for the cause of gulf veterans’ problems:
Post traumatic stress disorder: Veterans of every American war since the Civil War have reported such medical problems as sleeplessness, rage, tremors and memory loss. Some doctors argue that Gulf War syndrome is the current manifestation of World War I’s shell shock, World War II’s battle fatigue, and Vietnam’s delayed stress syndrome. The President’s Advisory Committee on Gulf War Veterans Illnesses says stress “is likely to be an important contributing factor” for many ailments. But suffering vets often interpret a stress diagnosis as being told “it’s all in your head.”
Chronic fatigue syndrome: A condition that has puzzled doctors for centuries, it is characterized by sleep problems, headaches, sore throats, swollen glands and inability to concentrate. One problem with this diagnosis is that doctors don’t really know what causes this condition, so a patient isn’t any better off just trading syndromes.
Fibromyalgia: Another poorly understood condition that results from inflammation of the nerve tissues. It causes muscle and joint aches as well as headaches, sleep disorders and thinking problems. Doctors who treat veterans note that classifying Gulf War syndrome as fibromyalgia doesn’t help much, because standard treatments haven’t been established.
Chemical weapon exposure: Gulf troops reported that warning sirens often sounded when equipment sensed chemical weapons. The Pentagon has said almost all were false alarms. Last year it did admit that the destruction of an Iraqi bunker where chemical weapons were stored resulted in low-level exposure of troops - causing some veterans groups to charge it had engaged in a cover-up. The number of exposed troops is uncertain, but growing.
Pyridostigmine bromide: To help troops survive a possible attack of nerve gas, most Gulf War troops were ordered to take pyridostigmine bromide. The Pentagon notes the drug is safe and has been used for years to treat some serious neuromuscular diseases, but critics say the troops were given smaller dosages than years of studies recommend - perhaps too little to safeguard against nerve gas, but enough to create problems with some vets’ immune systems.
Leishmaniasis: A parasite transmitted by the bite of a sand fly, this causes oozing rashes, lethargy, muscle aches and fever. The disease is not contagious and treatment is possible, but so dangerous it must be carefully monitored. Pentagon researchers point out that there are only about 25 confirmed cases of leishmaniasis among gulf vets, but critics note that it is extremely hard to diagnose, requiring a sample of bone marrow.
Pesticides: To protect against sand flies and a half-dozen other insect-borne diseases common in the Middle East, the military sprayed frequently and gave troops a common insecticide called DEET to rub on their skin. Some troops also wore pesticide-treated flea collars, designed for dogs or cats, to ward off bugs. Such chemicals, known as organophosphates, have been suspected of causing nerve disorders in people exposed for long periods, such as farmers.
Vaccines: All troops sent overseas received a battery of shots to protect them against diseases that are not common in the United States. Gulf troops were inoculated against cholera, tetanus, typhoid, diphtheria and measles. Many also were inoculated against anthrax and a lesser number against botulism, two of the biological agents the Iraqis had. The Pentagon acknowledges that some troops had serious reactions to the vaccinations, including lethargy, fever and nausea now associated with Gulf War syndrome, but contends those were temporary effects. Researchers are studying the combined effects of multiple vaccines and other exposures.
Mycoplasma fermentans: A bacteria without cell walls, this hard-to-detect infection was found in select groups of veterans and some of their family members. Mycoplasma can be spread by prolonged human contact, and conspiracy theorists claim it was a contaminant in the vaccines troops were given or part of a plot to weaken the military and help usher in a “one-world government.” Researchers disagree on whether mycoplasma fermentans can cause the symptoms vets report.
Oil field smoke: Kuwaiti oil fields were set ablaze by retreating Iraqis, and some burned for 10 months. Tests by the Pentagon indicate the levels of dangerous chemical compounds in the air stayed below the amounts found in some U.S. cities, but critics note those tests primarily detect cancer-causing chemicals.
Depleted uranium: Allied troops used shells made of depleted uranium to pierce Iraqi tanks, and used the extremely dense substance to protect some of their armored vehicles. When a depleted uranium shell hits, some particles form into a fine powder that some troops could have gotten on their skin or inhaled. The effects of that type of exposure are not known, although the Pentagon notes that the most dangerous particles - gamma rays - are what has been depleted from the uranium.
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