Researchers analyze symptoms in search of a Gulf War syndrome

WASHINGTON, August 18, 2000 (GulfLINK) - The phrase "Gulf War Syndrome" coined by the media has haunted medical researchers who are trying to identify a new disease that will explain the symptoms experienced by many Gulf War veterans. The wide variety of symptoms experienced by thousands of sick veterans has complicated diagnosing their conditions. Even the most recent examination of those symptoms still does not identify a unique Gulf War syndrome.

In medical terms, a syndrome is a group of symptoms or physical findings that together are characteristic of a specified condition. Although most doctors have accepted the fact that many Gulf War veterans are sick, they are not convinced that veterans share a common syndrome, said Michael E. Kilpatrick, M.D., of the special assistant's office for Gulf War illnesses.

"We're still trying to determine if there really is a syndrome," said Kilpatrick. "If a set of symptoms could be tied to Gulf War service, they would constitute a clinical marker; that is, a way for doctors to tell that a person's illness was due to his or her service in the Gulf War."

Several epidemiologists have used factor analysis to determine if symptoms within a group of Gulf War veterans can be used to determine a syndrome. Factor analysis is a mathematical process to see who in a particular group has what symptoms, and to see if these symptoms can be grouped. If one set of symptoms appears to generally occur in conjunction with others, that might be evidence of a distinct disease or syndrome. Dr. Robert Haley has published his identifying three syndromes and several overlapping syndromes. Two other groups have published their not being able to determine a syndrome based on factor analysis.

Scientists from the Naval Health Research Center in San Diego recently attempted to determine if a syndrome or disease effects Gulf War veterans. Their results were published in the American Journal of Epidemiology in August 2000.

The study titled "Factor Analysis of Self-Reported Symptoms: Does It Identify a Gulf War Syndrome?" is based on a survey of 524 Gulf War veterans and 935 non-deployed Gulf War-era veterans who were asked to list their symptoms. The test subjects were chosen from among the 5,000 U.S. Navy Seabees who served during the Gulf War.

Scientists reviewed the questionnaires looking for data that would indicate a syndrome. Factor analysis did not identify any unique Gulf War syndromes. In fact, deployed and non-deployed veterans reported similar clusters of symptoms and illnesses.

Although Gulf War veterans reported those illnesses more often, their symptoms were not unique or significantly different from the symptoms reported by the non-deployed veterans.

The study selected subjects from active-duty units. In their paper, researchers say they wanted to reduce the likelihood that veterans might be affected by exposures to potentially harmful materials encountered on their civilian jobs.

The study indicated that veterans' symptoms did not seem related to any specific possibly harmful exposure. Instead, data analysis indicated that nearly all the exposures were related to almost all the symptoms. While these results do not help doctors to identify a Gulf War-related illness, Kilpatrick says this kind of research is still very valuable.

"We have veterans who are sick, who have symptoms," Kilpatrick said. "We don't believe the symptoms are imaginary. Medical science has not been able to explain why veterans have them. In trying to determine some kind of clinical marker, a questionnaire that could be asked to identify people with a disease process that is related to service in the Gulf would be ideal."

For now, Kilpatrick says, research must continue. But in the absence of strong evidence that a Gulf War Syndrome does exist, doctors should focus on making our Gulf War veterans well, regardless of what symptoms they have.

Gulf War veterans desiring a free, in-depth medical examination should call the DoD's Comprehensive Clinical Evaluation Program at (800) 796-9699 or the Veteran Affair's Persian Gulf Registry at (800) 749-8387 to enroll.