Preface
Figure and Tables
Summary
Acknowledgments
Background
Purpose
Organization of This Document
Overview of What We Know About Diseases
Common Illnesses in Gulf War Veterans
Infectious Diseases in Gulf War Troops
Gastrointestinal Diseases
Respiratory Diseases
Other Diseases
Infectious Diseases in the Persian Gulf But Not Identified in Gulf War Troops
Other Infectious Diseases Considered
Chapter Two: Infectious Diseases as a Possible Cause of Gulf War Illnesses
Reasons to Consider an Infectious Etiology
Epidemiologic Relationship
History of Infectious Diseases
Some Infectious Diseases Were Identified
Reasons to Dismiss an Infectious Etiology
Koch's Postulates
A Missing Specific Finding
Some Evidence Does Not Fit
Chapter Three: Bacterial Diseases (Mycoplasma)
Background on Mycoplasmas
Mycoplasma and Disease in Those with Dysfunctional Immune Systems
Mycoplasma and Disease in Those with Normal Immune Function
Mycoplasma in Gulf War Veterans
Evaluating Elements of the Mycoplasma Hypothesis
Origin
Testing of Veterans for Mycoplasma
Theoretical Compatibility of Mycoplasma Infection with Symptoms in Gulf War Veterans
Evidence of Mycoplasma in Ill Gulf War Veterans
Treatment of Veterans with Antibiotics
Correlation with Gulf War Illnesses
Summary
Chapter Four: Bacterial Diseases (Other Than Mycoplasma)
Typhoid Fever
Introduction
What Infected Patients Experience
Diagnosis
Prevention
Correlation with Gulf War Illnesses
Summary
Mycobacteria Tuberculosis
Introduction
Epidemiologic Information
What Infected Patients Experience
Diagnosis
Treatment and Prevention
Correlation with Gulf War Illnesses
Summary
Enteric Agents: Enterotoxigenic E. Coli, Campylobacter, Shigella, and Other Salmonella
Introduction
Epidemiologic Information
What Infected Patients Experience
Diagnosis
Treatment and Prevention
Correlation with Gulf War Illnesses
Summary
Meningococcus
Introduction
Epidemiologic Information
What Infected Patients Experience
Diagnosis
Treatment and Prevention
Correlation with Gulf War Illnesses
Summary
Brucella
Introduction
Epidemiologic Information
What Infected Patients Experience
Diagnosis
Prevention
Correlation with Gulf War Illnesses
Summary
Cholera
Introduction
Epidemiologic Information
What Infected Patients Experience
Diagnosis
Treatment and Prevention
Correlation with Gulf War Illnesses
Summary
Viral Hepatitis
Introduction
Epidemiologic Information
What Infected Patients Experience
Diagnosis
Treatment and Prevention
Correlation with Gulf War Illnesses
Summary
Crimean-Congo Hemorrhagic Fever
Introduction
Epidemiologic Information
What Infected Patients Experience
Diagnosis
Treatment and Prevention
Correlation with Gulf War Illnesses
Summary
West Nile Fever
Introduction
Epidemiologic Information
What Infected Patients Experience
Diagnosis
Treatment and Prevention
Correlation with Gulf War Illnesses
Summary
Sindbis
Introduction
Epidemiologic Information
What Infected Patients Experience
Diagnosis
Treatment and Prevention
Correlation with Gulf War Illnesses
Summary
Rift Valley Fever
Introduction
Epidemiologic Information
What Infected Patients Experience
Diagnosis
Treatment and Prevention
Correlation with Gulf War Illnesses
Summary
Rabies
Introduction
Epidemiologic Information
What Infected Patients Experience
Diagnosis
Treatment and Prevention
Correlation with Gulf War Illnesses
Summary
Dengue
Introduction
Epidemiologic Information
What Infected Patients Experience
Diagnosis
Treatment and Prevention
Correlation with Gulf War Illnesses
Summary
Sandfly Fever
Introduction
Epidemiologic Information
What Infected Patients Experience
Diagnosis
Treatment and Prevention
Correlation with Gulf War Illnesses
Summary
Leishmaniavirus
Introduction
Epidemiologic Information
What Infected Patients Experience
Diagnosis
Treatment and Prevention
Correlation with Gulf War Illnesses
Summary
Chapter Six: Parasitic Diseases
Leishmaniasis
Introduction
Epidemiologic Information
What Infected Patients Experience
Diagnosis
Treatment and Prevention
Correlation with Gulf War Illnesses
Summary
Malaria
Introduction
Epidemiologic Information
What Infected Patients Experience
Diagnosis
Treatment and Prevention
Correlation with Gulf War Illnesses
Summary
Giardia
Introduction
Epidemiologic Information
What Infected Patients Experience
Diagnosis
Treatment and Prevention
Correlation with Gulf War Illnesses
Summary
Amoeba
Introduction
Epidemiologic Information
What Infected Patients Experience
Diagnosis
Treatment and Prevention
Correlation with Gulf War Illnesses
Summary
Schistosomiasis
Introduction
Epidemiologic Information
What Infected Patients Experience
Diagnosis
Treatment and Prevention
Correlation with Gulf War Illnesses
Summary
Chapter Seven: Biological Warfare Agents
Anthrax
Introduction
What Infected Patients Experience
Prevention
Botulinum Toxin
Introduction
Epidemiologic Information
What Infected Patients Experience
Summary
Chapter Eight: Unidentified Infections
General Processes for Identification
Representational Difference Analysis (RDA)
Serial Analysis of Genomic Expression (SAGE)
CDNA Expression Analysis
Chapter Nine: Conclusions and Recommendations
Appendix: Additional Consideration on Mycoplasma
A Review of the Scientific Literature as it Pertains to Gulf War Illnesses, Volume 1: Infectious Diseases, Lee H. Hilborne and Beatrice Alexandra Golomb , MR-1018/1-OSD, 2000. RAND is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions or policies of its research sponsors..
Copyright © 2000 RAND
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Published 2000 by RAND