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Gulf War Syndrome

I read with great interest Gary Matsumoto's essay "The Pentagon's Toxic Secret" (Vanity Fair, April 1999) regarding the possible role of squalene in Gulf War Illness. Squalene is an ingredient of "Freund's adjuvant", rarely given to humans. It boosts humoral (antibody) response to the antigen given together with it (causing "polyclonal gammopathy"), but depresses cell-mediated immunity. Antibody immunity is involved in protection against sugar coated organisms, such as meningococcus, streptococcus, pneumococcus, etc., whereas cell-mediated immunity protects against viruses and strange organisms including parasites, yeast and other fungi, mycobacterium tuberculosis and mycobacterium of leprosy.

Too much of this can lead to marked overproduction of antibody to a single injected agent, resulting in a malignancy of the antibody producing cells -- termed multiple myeloma. Freund himself died of multiple myeloma, as did several other immunologists of his vintage (right after World War II), who were engaged in studies using this new adjuvant. (This was 20 years before cell-mediated immunity was known.)

As a member of a committee appointed by the National Research Council of the Natl. Acad. of Sciences, I had an opportunity 20 years ago to examine the records of technicians working at our biologic warfare facility; Fort Detrick, Maryland, who had been injected with "preventative" vaccines to protect against those organisms with which they were working. These technicians all had polyclonal gammopathy. We were given records, but none showed that they had been given Freund's adjuvant. I have also corresponded with the then-Asst. Secretary of Defense handling Gulf War illnesses in 1996. He did not mention Freund's adjuvant. This plus Anthrax bacillus would form a deadly combination.

The RAND Corporation has recently issued a report on Gulf War Illness that makes no mention of vaccines or petrochemicals. The role of vaccines in both suppressing cell-mediated immunity and causing infection have been well-documented by several authors (see below), but have been covered up by US Defense Department and British Ministry of Defense. This follows papers in the Lancet, 16 January on the Gulf War Illnesses by Catherine Unwin and colleagues1 and Khalifda Ismail and colleagues2 conclude that "there is no unique Gulf War syndrome" are a great oversimplification- and completely unwarranted; at least 3 Gulf War illnesses exist, either alone or in combination.

The first of these syndromes (approx. 80%) is due to the marked depression of cell-mediated immunity by more than 3 vaccines given simultaneously-and many soldiers received 17 simultaneously3; many of these were hurriedly and poorly attenuated, and hence potent infectious agents, but with a prolonged latent period.

In my many inquires of patients and their physicians over 4 years (1993-96) until at least 12 months ago, neither the many Dept. of Defense, Veteran's Administration or physicians in private practice asked the patients about vaccines (a "hush" topic); nor were any relevant immune function tests performed--or any test of cell mediated immunity3. I called these to the attention of the American Department of Defense on many occasions (reply to first letter enclosed) and the British Ministry of Defense in 1996. I have published that tests of cell mediated immunity have a characteristic profile in 80 per cent of those so diagnosed, and this pattern is restricted to vaccine recipients not exposed to petrochemicals or organophosphate insecticides.3

About 20-25% of all U.S. troops, and of British and Canadian troops in the area, developed symptoms. However, none of the French, Algerian, or Moroccan troops, all of whom refused the vaccines, developed symptoms of this illness. Some of the troops from the Czech Republic and Slovakian Republic who received these vaccines developed identical symptoms. However, the incidences of those receiving the vaccines in Slovakia and the Czech Republic and those developing the highly infectious Gulf War syndrome with its characteristic symptoms are unknown.

Some of my patients who received the 17 vaccines, many poorly if at all attenuated, developed full blown illness even though the war ended 2-3 days before they were to be sent over, and they remained on U.S. soil for the whole duration of the conflict, never setting foot in the Gulf3.

The role of the vaccines is complicated by the pyridostigmine administration--the latter caused severe vomiting and diarrhea for as long as it was taken, and most of the American troops date the onset of illness from the day after they began taking "the pill".

Unless and until they are treated successfully (with immunotherapy), these veterans do not remember that there was an interval of 6-18 months before other symptoms appeared, including in some, a blindness of about 15 months duration, for which ophthalmologists could find no cause, a finding suggestive of anthrax.

The second of the Gulf War syndromes is apparently associated with, and presumably due to, ORGANOPHOSPHATE TOXICITY. Seventy-seven per cent of British Troops refused the vaccines4. But the British troops were housed in tents painted with organophosphates to protect against mites and other insects.5 In addition to the symptoms of the 1st group, they developed other symptoms including tightness in the chest, coughing, dyspnea, and pulmonary edema (the cough and breathing difficulties were originally ascribed by the US Defense Dept. to fine sand particles6), bizarre behavior, sweating, salivation, and blurred and/or dark vision. (This agent inhibits blood cholinesterase; it was originally developed as a biologic warfare agent!) Requests to the US Defense Department for information on whether any American troops were housed in such tents, what percent of these received the vaccines and what percent did not, remain "classified information." The American troops with this syndrome whom I have talked to said they slept on the ground and wore petrochemical insecticide collars. It is noteworthy that the French troops (who, again, refused the vaccines), under separate command, refused such pesticides7.

However, M. Hooper, Professor Emeritus of Medicinal Chemistry from the University of Sunderland, has obtained some data by spending much time visiting with officials of British Gulf War Veterans Associations7 The same agent is used in some areas of the U.S. as an insecticide and in Northern England for "dipping" sheep to protect against insect infestation, The "sheepherders syndrome", indistinguishable in symptoms from those described above,8 is now defined as recognized medical entity by the Ministry of Health9; is no longer considered psychological, and sheep dipping is no longer mandatory. Many of the victims have myocardial disease, a finding characteristic of many patients with Coxsackie virus -induced myalgic enkephalitis, and in an experimental model thereof in inbred mice by mouse Coxsackie virus B69. Furthermore, the selective immunosuppression observed in CFIDs and in organophosphate toxicity is also induced by Coxsackie B virus infection10

The third Gulf war illness is related to being drenched in petrochemical-soaked clothing for 3 days, after explosion of oil wells by Allied missiles.10 The percentage of troops who suffered from such environmental exposure is unknown, and those who previously had (or developed from such exposure) petrochemical hypersensitivity therefore had additional symptoms11- some are now universal reactors to all chemicals. Some Czech troops had both vaccine exposure and petrochemical exposure of the type outlined if not described above.

Some of those with petrochemical hypersensitivity who also received the vaccines had symptoms of Myalgic Enkephalitis plus neurologic symptoms similar to multiple sclerosis. The situation is further complicated by the so-far lack of data on differences in symptoms between those that received vaccinations plus the "pill" versus those that received vaccinations without the pill; and also between data on those who were and those who were not exposed to massive doses of organophophosphates (the French were not); and between those who were exposed to the vaccines with, and those who received vaccines without, petrochemical exposure, etc.

The article by Dr. Ismael and Dr. Wessel, one of the co-authors referred to above, implies that there is no characteristic illness; they appear unaware, since the illness of those who received the vaccines was highly infectious,6 with 80% of spouses and 60% of children living in the same household developing the same symptoms, and 40% of DOGS and/or CATS IN THE HOUSEHOLD DEVELOPING NEUROLOGIC SYMPTOMS,5 again within 6-18 months after exposure to an affected veteran. Perhaps the other 20% who did not infect household contacts suffered from type 2 or 3, rather than type 1 GWI.

I have also seen silent carriers of the infectious agent(s) e.g., a healthy Canadian nurse who apparently transmitted disease to her mother12 The mother developed the disease 6 months after exposure to her daughter for 3 months beginning in Nov. 1993. SEVERE SYMPTOMS DEVELOPED in March 1994. The carrier, a nurse who had worked in a Saudi Hospital, had been on vacation in Canada at her parents' house during these 3 months, before returning to the Gulf Hospital.) Symptoms persist to this day, undiminished in severity, and the patient is confined to the house, as she is now a "UNIVERSAL REACTOR" to all chemicals. Her daughter remains well, but the daughter's child, age 25 months, was hospitalized in the same Hospital with a mysterious illness.

As for the extensive epidemiological studies by Unwin referred to above, Servicemen who served in the Gulf, those who served in Bosnia, and those in service but who were not combatants in either were compared. The findings that servicemen involved in active conflict have a higher incidence and more severe disease than non-combatants is not surprising. But they have used a cannon to kill a mouse and, deliberately or by accident, ignored the most significant finding in the mass of data amassed from the respondents, the approximately 4250 veterans in each group who were sent questionnaires for this cross-sectional epidemiological survey who did not respond or refused to respond. In a second questionnaire sent to 7515 Gulf War veterans, 4583 did not respond, and 201 refused to participate. Another questionnaire was then sent to each of the 4583 non-responders: only 1460 responded, 2914 did not and 302 refused to respond -- this indicates a high degree of mistrust by these veterans of any data requested by the U.S. Dept. of Defense, Veterans Administration, or even the NIH, and of similar U.K. agencies such as the Royal Defense Medical College, a fact not surprising in that the dread exposures and dread results were covered up for so long. Furthermore, some of the veterans may have been too ill to respond -- severe cognitive function and complete exhaustion occur in many.

Indeed, immunologic testing has still not been performed. In addition, in the absence of abnormalities on physical examination or routine blood chemistries, a psychiatric diagnosis of post-traumatic stress disorder was often made--and many veterans died at an early age with no diagnosis save post-traumatic stress syndrome.

An eminent psychiatrist, Professor of Medicine at UCLA, examined many of these patients and came to the conclusion that their illness(es) were not psychiatric, psychological, or psychosomatic in origin, that post-traumatic stress syndrome accounted for no more than 10% of cases and that the remainder were purely organic, usually neurologic in nature. He was warned that unless he conformed to the hospital diagnostic policy in this area, he would be fired, tenured or not.3

In any event, troops in Bosnia who received ANY ONE of the Biologic warfare vaccines cited (anthrax, plague, and pertussis;) in U.S also Brucellosis, tularemia, botulism toxin and others, some not approved by FDA; requests for informed consents denied) were only 2.9 % of the total, whereas they comprised 58.4% of the Gulf War contingent. It is therefore not surprising that in the Gulf War veteran population, the incidence and severity of illness is considerably higher than in the Bosnia veterans. Also noteworthy is that the authors found no interaction between pyridostigmine bromide, another deadly agent, and multiple vaccination. Since I have seen similar incidence and severity of dread symptoms in a small cohort of U.S. troops immunized but who did not get to the Gulf, it would be of considerable interest, and shed considerable light on etiology, if British troops who were vaccinated with the same vaccines but did not get to the Gulf War were similarly studied.

Again, if this is done I urge appropriate immunologic studies. The Chronic Fatigue - Immune Dysregulation Syndrome (CFIDS) was originally dismissed as a psychiatric or stress disorder, although subsequently SPECt Scans, Beam Scans, and MRAs showed a characteristic abnormality.13 A characteristic profile also observed in 2 of the 5 CD8+ lymphocyte subsets is also diagnostic14 (Only the entire CD8+ population is measured in England; this value is worthless for the purpose of diagnosing CFIDS, Gulf War syndrome, petrochemical toxicity, etc.)

That the commentary15 should by S.E. Strauss of the NIH is ironic, as is his conclusion that there is no Gulf War Syndrome, and that the symptoms are largely the result of post-traumatic stress. Dr. Strauss maintained for many years that the symptoms of CFIDS were psychological in origin, excluded anyone with depression from CFIDS group studies16 (although CFIDS depression differs from ordinary depression in that it is worse at 1-3 PM, when cell-mediated immunity is at its lowest,17,18 and is made worse rather than better by tranquilizers, benzodiazepenes, or an early morning walk.19 These findings clearly differentiate CFIDS depression, present in 50% of such patients, from ordinary depression. Furthermore, the abnormalities in 24-hr cortisol in ordinary depression and CFIDS depression are diametrically reversed. And Gulf War veterans have as little respect for the CDC criteria for CFIDS as they do for any CDC, Veterans Administration, or Defense Department data on Gulf War Illness. With respect to diagnostic criteria for CFIDS, many of the most eminent CFIDS and Myalgic Enkephalitis investigators continue to reside in Canada and the UK.  

 

References

  1. Unwin, C., Blatchley, N., Coker, W., Ferry, S., Hotopf, M., Hull, L., Ismail, K., Palmer, I., David, A., Wessely, S. Health of UK servicemen who served in Persian Gulf War. Lancet 1999, Volume 353 #9149, p. 169.
  2. Ismail, K., Everitt, B., Blatchley, N., Hull, L., Unwin, C., David, A., Wessely, D. Is There a Gulf War syndrome? Lancet 1999; Volume 353 #9148, p. 179.
  3. Fudenberg, H.H. A scientific analysis of the Government's mistreatment of Gulf War Veterans, Part 1. Criminal Politics, 1997 p18-22, April 30, 1997. Part 2. Ibid. May 30, 1997.
  4. Investor's Business Daily citing UK publication, 15 Jan 1999.
  5. Hooper, M. 1999, personal communication.
  6. Nicholson, N.L, Hyman. L., Both, A., et al. Inter. J. Occup. Health Toxicol. 1995; 4: 365-370.
  7. Hooper, M., 1999, in preparation.
  8. Bernardt, G. Organophosphate Sheep Dips and Human Health. Conference Report, June 2, 1995, 17-19.
  9. London Times, Nov. 13, l998.
  10. Rouknagle, L., in preparation.
  11. Bendenelli, M. and Matteucci, D. The immunosuppressive effects of Group B Coxsackie virus infections. In: The Clinical and Scientific Basis of Myalgic Encephalitis/Chronic Fatigue Syndrome. Byron Hyde, ed. P. 298-304; U. Ottawa Press, Ogdensburg, N.Y. 1991.
  12. Mena, V. and Meyer, J. Study of Cerebral Perfusion by NeuroSPECT in Patients with CFS. In: The Clinical & Scientific Basis of Myalgic Enkephalitis/Chronic Fatigue Syndrome. B. Hyde Editor. Ottawa University Press, Ogdensburg, N.YH. 1991.
  13. a) Hyde, B. Magnetic Resonance Arterial changes in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. Proceedings of the Newcastle Research Group's International Workshop on ME/CFIDS, Newcastle on Tyne, UK, Nov. 12-14 1998.
    b) Fudenberg, H.H. Immunologic studies in Chronic Fatigue Syndrome and Gulf War Syndrome. Proceedings of the Newcastle Research Group's International Workshop on Myalgic Encephalitis/CFID, Newcastle on Tyne, UK, Nov 12-14, 1998.
  14. Strauss, S.E. Psychiatric diagnosis in patients who have Chronic Fatigue Syndrome. J. Clin. Psych. 1989, 50:53-56.
  15. Strauss, SE. Bridging the Gulf in War Syndromes. Lancet 1999; Volume 353, #9148, Commentary p.162.
  16. Johnson, H. Osler's Web. 1989; Crown Press, New York, N.Y.
  17. Carter, A.B., Barr, G.D., Levin, A.S, Circadian Rhythm of DNA synthesis in unstimulated normal peripheral blood lymphocytes. J Allergy Clin. Immunol. 1975; 56: 191-205.
  18. Kaplan, M.S., Byers, V, and Levin, A.S. Circadian Rhythm of normal peripheral blood Lymphocyte DNA synthesis in response to mitogen and to SKSD. J. Allerg. Clin. Immunol. 1976, 58, 180-189.
  19. Fudenberg, H.H. The Florence Nightingale Disease, A Multi-system Experiment of Nature; a Five Year Follow-up of Patients. In: Myalgic Enkephalitis / Chronic Fatigue Syndrome, B. Hyde, editor, U. Ottawa Press, Ogdensburg, N.Y. 1991.