From the Publisher
Veterans of the Persian Gulf War report a variety of physical and psychological symptoms, some of which remain unexplained.In an effort to determine the extent to which these symptoms may be related to Gulf War service and to develop policies tobetter deal with health risks in future deployments, the Secretary of Defense designated a special assistant to oversee allDepartment of Defense (DoD) efforts related to the illnesses of Gulf War veterans. The Office of the Special Assistant for GulfWar Illnesses (OSAGWI) is charged to do everything possible to understand and explain the illnesses, to inform veterans andthe public of its progress and findings, and to recommend changes in DoD policies and procedures to minimize such problemsin the future. This literature review, one of eight commissioned by the Special Assistant to the Deputy Secretary of Defense for Gulf WarIllnesses, examines the existing scientific literature on what is known about the health effects of infectious diseases that may haveaffected service members who served in Operations Desert Shield and Desert Storm. The eight RAND reviews are intended tocomplement efforts by the DoD and other federal agencies as they attempt to understand the full range of health implications ofservice in that conflict. The other seven RAND literature reviews deal with chemical and biological warfare agents, depleted uranium, oil well fires,pesticides, pyridostigmine bromide, immunizations, and stress. These represent plausible causes of some of the illnesses GulfWar veterans have reported. These reviews are intended principally to summarize the scientific literature on the known health effects of given exposures tothese risk factors. Where available evidence permits, the other seven reviews also summarize what is known about the range ofactual exposures in the Gulf and assess the plausibility of the risk factor at hand as a cause of illness. Statements related to theGulf War experience should be regarded as suggestive rather than definitive, for more research on health effects and exposuresremains to be completed before definitive statements can be made. Recommendations for additional research whereappropriate are included. These reviews are limited to literature published or accepted for publication in peer-reviewed journals, books, governmentpublications, and conference proceedings. Unpublished information was occasionally used, but only to develop hypotheses.This review covers literature published before the spring of 1999 but in some cases includes additional references primarily as aresult of the peer-review process. This work is sponsored by the Office of the Special Assistant and was carried out jointly by RAND Health1s Center forMilitary Health Policy Research and the Forces and Resources Policy Center of the National Defense Research Institute. Thelatter is a federally funded research and development center sponsored by the Office of the Secretary of Defense, the JointStaff, the unified commands, and the defense agencies.
About the Author
Beatrice Alexandra Golomb (PhD, Biology, University of California, San Diego, June, 1988MD, University of California, San Diego, June, 1989) is a Health Consultant at RAND.