thedrifter
03-23-03, 10:27 AM
Military Readies For Gulf War Illness
Precautions, Monitoring Already In Place for Iraq War Troops By Daniel DeNoon
Reviewed By Michael Smith, MD
on Thursday, March 20, 2003
WebMD Medical News
March 20, 2003 -- Thousands of veterans of the 1990-1991 Gulf War remain disabled from mysterious medical problems now known as Gulf War veterans' illnesses. What happened? Nobody knows. And there's no way to be sure it won't happen again.
Despite more than a decade of study, nobody knows what causes gulf war illness. There's no cure -- and no sure way to prevent it, says Matthew Hotopf, MD, PhD, senior researcher at the Gulf War Illnesses Research Unit of Guy's, King's, and St. Thomas' School of Medicine, London.
Symptoms of Gulf War illness are all over the map. They include disabling fatigue, sleep problems, trouble with memory and concentration, pain, intestinal complaints, and other medical problems. Because different patients have different symptoms, the old name of the malady -- Gulf War syndrome -- was changed to Gulf War illness.
"The key thing we know is that there is not a single conclusive causative agent," Hotopf tells WebMD. "It's now 10 to 12 years down the line, so it is unlikely we ever will find one. ... We know now that people who went to the Gulf War experience considerably more symptoms then you would expect them to. It is more about symptoms than about more clear-cut outcomes like mortality or onset of new diseases. There is little evidence of an emerging epidemic of new disease entities in these veterans. What does that mean? The population of people who went to the [first] Gulf War is showing more symptoms [than the general population]. Some are at the far end of the distribution and are more disabled."
Earlier this week researchers announced that a non-specific treatment can help some veterans suffering with gulf war illness (see "Treatment for Gulf War Illness Works"). It's far from a cure. Yet tomorrow's second Gulf War troops stand a better chance of avoiding disabling gulf war illness -- and of getting much faster, much better treatment if they do get sick, says Nelda P. Wray, MD, MPH, chief research and development officer for the U.S. Department of Veterans Affairs.
"I think it will allow us, if individuals return from Gulf War II with symptoms, to have these therapies put in place at a much earlier stage," Wray tells WebMD. "And we are doing many other things... to develop knowledge that will help us understand this disease."
The VA's gulf war illness expert is Kelley Brix, MD, assistant chief R&D officer.
"There are many lessons that the VA and Department of Defense have learned since first Gulf War," Brix tells WebMD. "Both agencies are taking preventive-medicine initiatives to protect the health of our troops more carefully than in the past. There have been a number of improvements."
A decade ago, when researchers began to take gulf war illness seriously, it was hard to understand what might have happened to any individual veteran. This time, it won't be so hard.
A few weeks before going overseas, Brix says, troops get individual checkups. They also get vaccinations before deployment, so any vaccine side effects can be seen prior to exposure to alien environments. Military personnel also get much more education and information about their personal protective equipment and medical countermeasures against possible chemical warfare.
During deployment, much of this education and information is repeated. There is a systematic explanation of health hazards -- such as air and water pollution -- that troops may encounter. Perhaps most importantly, there will be much better records of exactly where each individual soldier is at any given time. And these records will include complete reporting of any injuries or exposures, even those not related to combat.
After troops come home, they'll get another individual medical checkup -- even if they feel fine. And officials have established guidelines to ensure that doctors get similar kinds of information from all veterans who develop medical problems after leaving the military.
"We will have much more data to better understand what might be the cause of these Gulf War illnesses," Wray says. "We are committed to studies to try to understand what this illness is."
SOURCES: Matthew Hotopf, MD, PhD, senior researcher, Gulf War Illnesses Research Unit of Guy's, King's, and St. Thomas' School of Medicine, London. Nelda P. Wray, MD, MPH, chief research and development officer, U.S. Department of Veterans Affairs. Kelley Brix, MD, assistant chief research and development officer, U.S. Department of Veterans Affairs.
© 2003 WebMD Inc. All rights reserved.
Sempers,
Roger
Precautions, Monitoring Already In Place for Iraq War Troops By Daniel DeNoon
Reviewed By Michael Smith, MD
on Thursday, March 20, 2003
WebMD Medical News
March 20, 2003 -- Thousands of veterans of the 1990-1991 Gulf War remain disabled from mysterious medical problems now known as Gulf War veterans' illnesses. What happened? Nobody knows. And there's no way to be sure it won't happen again.
Despite more than a decade of study, nobody knows what causes gulf war illness. There's no cure -- and no sure way to prevent it, says Matthew Hotopf, MD, PhD, senior researcher at the Gulf War Illnesses Research Unit of Guy's, King's, and St. Thomas' School of Medicine, London.
Symptoms of Gulf War illness are all over the map. They include disabling fatigue, sleep problems, trouble with memory and concentration, pain, intestinal complaints, and other medical problems. Because different patients have different symptoms, the old name of the malady -- Gulf War syndrome -- was changed to Gulf War illness.
"The key thing we know is that there is not a single conclusive causative agent," Hotopf tells WebMD. "It's now 10 to 12 years down the line, so it is unlikely we ever will find one. ... We know now that people who went to the Gulf War experience considerably more symptoms then you would expect them to. It is more about symptoms than about more clear-cut outcomes like mortality or onset of new diseases. There is little evidence of an emerging epidemic of new disease entities in these veterans. What does that mean? The population of people who went to the [first] Gulf War is showing more symptoms [than the general population]. Some are at the far end of the distribution and are more disabled."
Earlier this week researchers announced that a non-specific treatment can help some veterans suffering with gulf war illness (see "Treatment for Gulf War Illness Works"). It's far from a cure. Yet tomorrow's second Gulf War troops stand a better chance of avoiding disabling gulf war illness -- and of getting much faster, much better treatment if they do get sick, says Nelda P. Wray, MD, MPH, chief research and development officer for the U.S. Department of Veterans Affairs.
"I think it will allow us, if individuals return from Gulf War II with symptoms, to have these therapies put in place at a much earlier stage," Wray tells WebMD. "And we are doing many other things... to develop knowledge that will help us understand this disease."
The VA's gulf war illness expert is Kelley Brix, MD, assistant chief R&D officer.
"There are many lessons that the VA and Department of Defense have learned since first Gulf War," Brix tells WebMD. "Both agencies are taking preventive-medicine initiatives to protect the health of our troops more carefully than in the past. There have been a number of improvements."
A decade ago, when researchers began to take gulf war illness seriously, it was hard to understand what might have happened to any individual veteran. This time, it won't be so hard.
A few weeks before going overseas, Brix says, troops get individual checkups. They also get vaccinations before deployment, so any vaccine side effects can be seen prior to exposure to alien environments. Military personnel also get much more education and information about their personal protective equipment and medical countermeasures against possible chemical warfare.
During deployment, much of this education and information is repeated. There is a systematic explanation of health hazards -- such as air and water pollution -- that troops may encounter. Perhaps most importantly, there will be much better records of exactly where each individual soldier is at any given time. And these records will include complete reporting of any injuries or exposures, even those not related to combat.
After troops come home, they'll get another individual medical checkup -- even if they feel fine. And officials have established guidelines to ensure that doctors get similar kinds of information from all veterans who develop medical problems after leaving the military.
"We will have much more data to better understand what might be the cause of these Gulf War illnesses," Wray says. "We are committed to studies to try to understand what this illness is."
SOURCES: Matthew Hotopf, MD, PhD, senior researcher, Gulf War Illnesses Research Unit of Guy's, King's, and St. Thomas' School of Medicine, London. Nelda P. Wray, MD, MPH, chief research and development officer, U.S. Department of Veterans Affairs. Kelley Brix, MD, assistant chief research and development officer, U.S. Department of Veterans Affairs.
© 2003 WebMD Inc. All rights reserved.
Sempers,
Roger