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Persian Gulf War Syndrome

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									Persian Gulf War Syndrome

Elective Subject :Current Health Problem
   Elaborated by Mostafa Jamaliramin




                                           1
    What is Gulf war syndrome?

• In the years since the end of the war a great deal of
  research and investigation has been devoted to this
  question. At this point, we can offer some general
  possibilities and answers. Gulf War Syndrome
  (GWS) is probably not a single, new illness or
  disorder. Rather, GWS is most likely a collection
  of different illnesses with similar symptoms. This
  has caused confusion and has made it difficult for
  researchers to come up with a case definition.

                                                      2
    Chronology of events that lead to
    the current Gulf War Syndrome:
1. Iraq invades Kuwait, 'Desert Shield' begins.
2. U.S. warns of Iraq's military and chemical,
   biological and nuclear weapons capabilities.
3. 'Desert Storm' begins. Troops invade Iraq and
   Kuwait, and return Kuwait to it's former rulers,
   in one of the shortest wars on record.
4. Troops return home and begin to complain of
   unusual symptoms.
5. Gulf War Syndrome is discovered.
                                                      3
   Medical problems by soldier
           nationality
• US & UK the highest rates of excessive
  illness
• As of March 1996,of the 697,000 U.S.
  troops who served in the war,
  approximately 108,000 are on a Registry
• French & Australian troops the lowest
  illness rate

                                            4
Symptom U.S.       UK    Australia Denmark
Fatigue      23%   23%   10%      16%
Headache     17%   18%   7%       13%
Memory       32%   28%   12%      23%
problem
Muscle/      18%   17%   5%       2%
joint pain
Diarrhea     16%     _   9%       13%
dyspepsia    12%     _   5%       9%
Skin         16%     _   8%       12%
problem
Shortness    13%     _   9%       11%
of breath                               5
      Symptoms of Gulf War
            Illnesses
•   Chronic Fatigue
•   Signs and symptoms involving skin rashes
•   Headache
•   Muscle pain
•   Neurological signs or symptoms
•   Neuropsychological signs or symptoms
•   Sleep disturbances
•   Gastrointestinal signs or symptoms
•   Cardiovascular signs or symptoms
•   Menstrual disorders                        6
           Possible Causes
• combustion products from depleted uranium
  munitions,
• side-effects from the early 1990s' anthrax
  vaccine
• infectious diseases from parasites,
• chemical weapons such as nerve gas or
  mustard gas
• and combinations of the above factors
                                           7
          Anthrax Vaccine
                            Anthrax vaccine is a
What is Anthrax?            vaccine against the
Anthrax (Greek for coal)    infectious disease,
is an acute disease in      anthrax.
humans and pigs that is
caused by the bacterium     A study linking squalene ,an
Bacillus anthracis and is   experimental vaccine
highly lethal in some       adjuvant, to individuals with
forms. Anthrax is one of    the clinical signs of Gulf
                            War Syndrome was
only a few bacteria that    published in 2002. The
can form long lived         published findings strongly
spores.                     suggest that the squalene
                            contaminated vaccines could
                            be responsible for the Gulf
                            War Syndrome
                                                            8
• The anthrax vaccine was originally licensed in
  1970 by the U.S. National Institutes of Health

• 41% of U.S. combat soldiers and 57-75% of UK
  combat soldiers were vaccinated against anthrax

• The early 1990s version of the anthrax vaccine
  was a source of several serious side effects
  including GWI symptoms




                                                    9
• From 1998 to 2000, more than 1,859,000 doses of anthrax
  vaccine were distributed in the United States.During that
  decade, 1,544 adverse events were reported to the Vaccine
  Adverse Event Reporting System (VAERS), 76 of these
  events (5%) were serious (results in death, hospitalisation,
  or permanent disability or is life-threatening)

• Primary vaccination consists of three subcutaneous
  injections at zero, two, and four weeks, and three
  vaccinations at six, twelve, and eighteen months followed
  by annual boosters. For prolonged protection, annual
  boosters are recommended



                                                                 10
  Chemical weapons              Depleted uranium

• (Deleted Uranium) was         • Many of the symptoms,
  used in tank kinetic energy     other than low cancer
  penetrator on a large scale     incidence rates, of Gulf
  for the first time in the       War syndrome are similar
  Gulf War. DU munitions          to the symptoms of
  often burn when they            organophosphate, mustard
  impact a hard target,           gas, and nerve gas
  producing toxic                 poisoning. Gulf War
  combustion products.            veterans were exposed to a
                                  number of sources of these
                                  compounds, including
                                  nerve gas and pesticides.

                                                          11
 Infectious diseases               Stress

                           • War is a stressful
• There are some who         experience or that all
  believe that Gulf War      wars carry psychological
  Syndrome is the result     consequence
  of a contagious
  bacteria                 • Many psychiatric
                             conditions, including
                             depression and Post
• There are anecdotal        Traumatic Stress
                             Disorder (PTSD) can
  reports of                 present with physical as
  improvement in some        well as psychological
  victims when treated       symptoms.
  with antibiotics
                                                    12
                        Controversy

  There has been considerable controversy over whether or not
  Gulf War syndrome is a physical medical condition related to
                  sufferers' Gulf War service


  Evidence for
• US veteran affairs secretary panel research found:
  The veterans' illnesses are neurological and apparently
  are linked to exposure to neurotoxins, such as the nerve
  gas sarin, the anti-nerve gas drug pyridostigmin
  bromide, and pesticides that affect the nervous system.



                                                          13
• Research studies conducted since the war have
  consistently indicated that psychiatric illness,
  combat experience or other deployment-related
  stressors do not explain Gulf War veterans
  illnesses in the large majority of ill veterans.

• lower fertility & 40 to 50% more likely to be
  unable to start a pregnancy




                                                     14
Evidence against:
• Similar syndromes have been seen as an after
  effect of other conflicts

• Post traumatic stress disorder(PTSD) after the
  Vietnam war & shell shock after World War 1
  have similar syndromes of the GWS

• No single cluster of symptoms that constitute a
  syndrome unique to Gulf War veterans has been
  identified

                                              15
       Is This a Real Disease?
• A November 1996 article in the New England
  Journal of Medicine found no difference in death
  rates, hospitalisation rates or self-reported
  symptoms between Persian Gulf vets and non-
  Persian Gulf vets

• The studies did find a statistically
  significant elevation in the number of traffic
  accidents suffered by Persian Gulf vets vs.
  non-Persian Gulf vets.

                                                     16
• New research from the UK, comparing the
  health of those who served in gulf war with
  those who did not, found no evidence of any
  rise in multi symptom conditions associated
  with Gulf War Syndrome

• This casts doubts on the role of certain
  exposures such as anthrax vaccine, depleted
  uranium,…..


                                            17
• Gulf War Syndrome is, most likely, an
  unfortunate bi-product of a
  combination of things:

1.Tremendous media hype surrounding the
  threat of chemical and biological weapons
  during the First Gulf War
2.The litigious nature of our society
3.The fact that the United States Government
  is a target for litigation and those with anti-
  war sentiment
                                                18
          Acknowledgement
• Database set up by the American Legion

• http://en.wikipedia.org

• American Gulf War Veteran Association



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