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Contagious

Q. Are 1990-1991 Gulf War veterans’ illnesses contagious?

A. A few veterans' illnesses are known to be contagious, but there is little reason to believe that most veterans' illnesses can be spread to other persons. Of all the veterans (33,542) who have completed the detailed medical evaluations at the DoD clinics and hospitals, about 3% were found to have an infection as their main diagnosis. A small number of these veterans had infections well known to medical science which could be passed on to other persons (viral hepatitis, herpes simplex infections, HIV infection, and tuberculosis). Otherwise, the vast majority of the infections were either brief, one-time illnesses, easily treated and cured illnesses, or infections that are not contagious from person to person. Other than the specific infections of malaria and leishmaniasis (which are not spread from person to person), none of the veterans' infections can be specifically linked to service in the Persian Gulf. The infectious diseases among veterans resemble the range of illnesses common in the population at large. Despite the above, however, DoD and the VA continue to pursue research studies of the questions of contagion and of previously unrecognized causes of infection.

Q. What are mycoplasmas?

A. Mycroplasmas are the smallest, free-living infectious agents. They are distinct from viruses because of their ability to grow in cell-free media and from bacteria because they lack a cell wall and the ability to synthesize cell wall precursors. A variety of plant and animal diseases are caused by the mycoplasmas. However, only certain types have been clearly shown to cause disease in humans.

Q. What research is being conducted to determine if any of the 1990-1991 Gulf War illnesses are contagious?

A. An ongoing study at Walter Reed Army Medical Center is looking at the possibility that veterans are infected with a bacterium called Mycoplasma fermentans. This study is a collaboration with Garth Nicolson, Ph.D. who has reported that a gene tracking test which he developed has detected evidence of M. fermentans in many 1990-1991 Gulf War veterans, their family members, and other persons. The study will first attempt to validate Dr. Nicolson's technique for detecting the bacterium. Results of the validity testing are expected within the next year. If the test is validated, then additional studies will explore the best way to test for the presence of M. fermentans, its potential role in human disease, and, if it causes disease, the best way to eradicate the infection. These studies will be sponsored by the Persian Gulf Veterans Coordinating Board's Research Working Group.

Q. What is the nature of the illnesses suffered by Gulf War Veterans?

A. Our best information on this question comes from the Comprehensive Clinical Evaluation Program (CCEP) which provides thorough medical evaluations of 1990-1991 Gulf War veterans in DoD health care facilities. Through June 1998, approximately 32,392 veterans have completed CCEP evaluations. Seventy five percent of all 32,392 CCEP participants have as their primary (main) diagnosis one of the following 42 most common diagnoses (ICD-9 Codes are shown in parentheses):

Musculoskeletal Disorders, Number of Participants 5224 / Percent of All Participants 16.2%

(specified below)

Pain in Joint (719.4) 1776

Osteoarthrosis (715) 1148

Back Pain and Other Back Disorders (724) 901

Disorders of Tendons, Muscle Attachments (726) 497

Other Disorders of Soft Tissue (729) 464

Vertebral Disc Disorders (722) 294

Knee Derangements (717) 144

Symptoms which the CCEP Evaluation was unable to establish an explanatory diagnosis,
Number of Participants 4397 / Percent of All Participants 13.6 %

(as specified below)

Malaise and/or fatigue (780.7) 1381

Sleep Disturbances (780.5) 1067

General Symptoms and Hyperhidrosis (780.8-780.9) 625

Symptoms of Respiratory System and Chest (786) 530

Symptoms Involving the Skin (782) 334

Alterations of Consciousness, Awareness (780-780.4) 197

Abdominal Pain in Various Locations (789.0) 136

Symptoms of Digestive System (787) 127

Psychological Disorders, Number of Participants 3989 / Percent of All Participants 12.3 %

(as specified below)

Depressive Disorder (311) 942

Neuroses (300) 897

Prolonged PTSD (309.81) 850

Affective Disorders (296) 563

Adjustment Reactions (309) 387

Sleep Disorders (307.4) 179

Organic Brain Syndromes (293-4) 171

Healthy, Number of Participants 2904 / Percent of All Participants 9.0 %

(as specified below)

Feared Complaint, No Diagnosis (V65.5) 2586

Routine General Medical Examination (V70) 318

Headaches, Number of Participants 2757 / Percent of All Participants 8.5 %

(as specified below)

Tension headache (307.81) 1016

Migraine (346) 950

Headache (784.0) 791

Respiratory Conditions, Number of Participants 1681 / Percent of All Participants 5.2 %

(as specified below)

Asthma (493) 719

Allergic Rhinitis (477) 501

Chronic Upper Respiratory Inflammation (472-476) 461

Skin Disorders, Number of Participants 1387 / Percent of All Participants 4.3%

(as specified below)

Alopecia, hirsutism, and other diseases of hair and hair follicles (704) 407

Fungus Infections (110-111) 406

Contact dermatitis and other Eczema (692) 399

Urticaria, various types (708) 175

Gastrointestinal Disorders, Number of Participants 1262 / Percent of All Participants 3.9%

(as specified below)

Irritable Colon (564.1) 496

Esophageal Reflux (530.81) 429

Enteritis and Colitis (558) 214

Gastritis and Duodenitis (535) 123

Hypertension, Essential(401), Number of Participants 393 / Percent of All Participants 1.2%

Endocrine and Metabolic Disorders, Number of Participants 292 / Percent of All Participants 0.9 %

(as specified below)

Lipoid Metabolism Disord. (272) 168

Hypothyroidism (243-244) 124

Hearing Loss (388.02-388.2, 389), Number of Participants 130 / Percent of All Participants 0.4 %

TOTALS: Number of Participants 24,416 / Percent of All Participants 75.4 %

The Institute of Medicine’s Evaluation of the U.S. Department of Defense Persian Gulf Comprehensive Clinical Evaluation Program http://www.nap.edu/readingroom/books/ccep/

A Comprehensive Clinical Evaluation of 20,000 Persian Gulf War Veterans (Abstract)

The Institute of Medicine's Evaluation of the U.S. Department of Defense Persain Gulf Comprehensive Clinical Evaluation Program

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