Gulf War Illness: Looking Back to Move Forward
JUNE 18, 2016 — Gulf War Illness (GWI) remains shrouded in mystery. It’s varied, chronic and seemingly unrelated symptoms have confused and frustrated physicians, while researchers have struggled to retroactively identify causes of the illness.
Georgetown University Medical Center and the Brookings Institution co-hosted “Desert Storm after 25 years: Confronting the Exposures of Modern Warfare” on June 17 to examine the history of GWI and discuss a way forward.
Representative Mike Coffman (R-Col.), a Gulf War veteran, delivered the keynote address, moderated by Michael O’Hanlon, co-director of Center for 21st Century Security and Intelligence at Brookings.
A panel followed moderated by Joel Kupersmith, MD, adjunct professor of medicine at Georgetown. Kupersmith was joined by James Baraniuk, MD, professor of medicine at Georgetown, Carolyn Clancy, MD, of the Department of Veterans Affairs and Adrian Atizado of Disabled American Veterans.
The symptoms of GWI range from mild to debilitating, and include fatigue, generalized pain, unrefreshing sleep and cognitive impairment. Researchers have hypothesized that the disease could have been caused by various exposures — smoke from “oil well fires” that were set by Iraqi forces, insecticides, sarin or anti-nerve gas measures.
“I remember the oil well fires getting so bad that you could literally see a wall of smoke coming at you. You would be in that for days at a time,” commented Coffman.
But he also remembers something else.
“In the aftermath of the fighting I saw a large plume of white smoke that wasn’t moving. And I reported it.”
Coffman never got a response to his report. He later learned that the coalition forces had discovered a stockpile of chemical weapons, which they had blown up, causing the white cloud.
Researchers have not been unable to link GWI to a specific cause, but many, including Baraniuk, believe that low dose exposure to nerve agents could be to blame.
For many years, veterans with GWI illness were told that it was all in their head.
“The entire psychosomatic bias that developed after 1991, in which symptoms were discredited because they didn’t fit into a medical textbook definition, has had a long-term stigmatic burden on these veterans,” said Baranuik, who published physical evidence of Gulf War Illness.
In the years following the Gulf War, many with GWI felt that the US government and other institutions accused then of trying to game the system by inventing their disease.
Kupersmith added that physicians need “to listen to your patients.”
Should resources be focused on finding the cause of GWI, or uncovering new treatments or even a cure?
“There’s no right or wrong answer here,” said Clancy.
But there is research being done. The VA has invested more than $14 million in GWI research in 2016, according to Clancy. Studies are being done on everything from acupuncture as a treatment for GWI to the application of existing treatments for sleep apnea for sleep-related symptoms.
For Georgetown’s part, Baraniuk and his colleagues continue their research with Gulf War patients with the hopes that a blood test might one day be a reality for diagnosis.
Leigh Ann Sham