Gulf War Illness in the 1991 Gulf War and Gulf Era Veteran Population: An Application of the Centers for Disease Control and Prevention and Kansas Case Definitions to Historical Data

摘要

In the initial years following the 1990–1991 Gulf War,reports of a complex array of medically unexplainedsymptoms began to emerge among US Gulf Warveterans.1,2 This cluster of symptoms, which includedfatigue, pain, gastrointestinal symptoms, respiratorysymptoms, dermatological symptoms, neurologicalsymptoms and cognitive symptoms,3-9 collectivelybecame known as Gulf War illness (GWI). Twenty-sixyears later, GWI remains the most pressing healthissue of Gulf War veterans. Although several warrelated exposures have been associated with GWI,10-14 no single exposure has been confrmed as thecausative agent and no one single treatment hasbeen identifed.15 There is no objective diagnostictest for GWI and the International Classifcationof Diseases Manual 10th edition has no diagnosticcode for GWI. Although some unexplained illnessesand symptoms consistent with GWI are recognisedas compensatable disabilities by the US Departmentof Veterans Affairs (VA), there is not a single validatedand accepted case defnition.16 The lack of a singleagreed-upon case defnition has been challenging forboth researchers and clinicians.