PUBLIC HEALTH
December 1, 2008

Gulf War Illness Cause Found

After 17 years, the symptoms plaguing many Gulf War veterans finally have a known cause. Or at least a partial cause.

It has taken seventeen years, but the cause of Gulf War illness appears to have been finally unraveled.

Gulf War illness has a long and varied collection of symptoms. Chronic headache, fatigue, memory and concentration problems, and widespread pain are most often mentioned. Other symptoms can include persistent digestive problems, respiratory difficulties and skin rashes. It is estimated to affect at least 25% of the 700,000 U.S. veterans from the 1991 Gulf War. No effective treatment for it has been found so far.

...[W]hile pyridostigmine bromide is still in use by the military, it is no longer being given out on a widespread basis.

The culprits appear to be the chemical pyridostigmine bromide and certain pesticides used during the war. Ironically, pyridostigmine bromide was given to U.S. troops to protect them from the effects of an Iraqi nerve gas attack that never came. It acts as a cholinesterase inhibitor. Too little cholinesterase causes certain nerves in the body to continue firing once they've been activated. Normally, these nerves fire only once and then stop, returning to a resting state. The pesticides in question are also cholinesterase inhibitors.

Gulf War illness was originally dismissed by many as a "psychosomatic" illness. This is reminiscent of what occurred when soldiers in Vietnam were exposed to the defoliant Agent Orange. It took twenty years to admit Agent Orange's role as a cause of illness.

The findings appear in a report from a federal panel of scientific experts and veterans, known as the Research Advisory Committee on Gulf War Veterans' Illnesses. The 450 page report was issued on November 17 and presented to the House Committee on Veterans' Affairs.

Dr. Lea Steele, scientific director of the committee, points out that the Gulf War was the only time that a lot of people took pyridostigmine bromide. "It turns out that people who took those pills have a higher rate of Gulf War illness. And people who took more pills have even higher rates of Gulf War illness. This type of illness has not been seen after other wars."

Dr. Steele adds that while pyridostigmine bromide is still in use by the military, it is no longer being given out on a widespread basis and that the military has also cut back on its use of pesticides since the 1991 war.

The panel couldn't rule out some other factors that may have contributed to Gulf War illness. These include fires from oil wells, actual exposure to nerve agents and certain vaccines given to the troops. It doesn't consider these factors as likely causes.

The panel also noted that Federal funding for Gulf War research, including Gulf War illness, has declined substantially in recent years. It urged lawmakers to budget $60 million dollars annually for these purposes.

Dr. Steele is an epidemiologist and assistant professor at Kansas State University.

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