Gulf War syndrome

Gulf War syndrome
Other namesChronic multisymptom illness
Summary of the Operation Desert Storm offensive ground campaign, February 24–28, 1991, by nationality
SymptomsVary somewhat among individuals and include fatigue, headaches, cognitive dysfunction, musculoskeletal pain, insomnia, and respiratory, gastrointestinal, and dermatologic complaints
DurationLife-long
CausesExposure to acetylcholinesterase inhibitors such as sarin, and possibly other toxic exposures during the 1990–91 Persian Gulf War. See Congressional records for testimony about chemical weapon disposal accident.
Risk factorsLower levels of PON1, a protein in humans responsible for breaking down organophosphates.
Differential diagnosismyalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS); fibromyalgia; multiple sclerosis (MS)
Frequency25% to 34% of the 697,000 U.S. troops of the 1990–91 Gulf War
Named afterGulf War

Gulf War syndrome (GWS) also known as Gulf War Illness or Chronic Multi-symptom Illness, is a chronic and multi-symptomatic disorder affecting military veterans of both sides of the Gulf War (1990–1991). A wide range of acute and chronic symptoms have been linked to it, including fatigue, muscle pain, cognitive problems, insomnia, rashes and diarrhea. Approximately 250,000 of the 697,000 U.S. veterans who served in the Gulf War have an enduring chronic multi-symptom illness. From 1995 to 2005, the health of combat veterans worsened in comparison with nondeployed veterans, with the onset of more new chronic diseases, functional impairment, repeated clinic visits and hospitalizations, myalgic encephalomyelitis/chronic fatigue syndrome-like illness, post-traumatic stress disorder, and greater persistence of adverse health incidents.

Since 2022, Gulf War syndrome has been primarily linked to exposure to sub-lethal amounts of organophosphate nerve agents, particularly sarin and cyclosarin, released atmospherically during Coalition attacks on Iraqi chemical weapons facilities. Susceptibility was influenced by an allele in the PON1 gene. Exposure to pesticides containing other organophosphates and exposure to pills containing pyridostigmine bromide, used as a pretreatment to protect against nerve agent effects, has been found to be associated with the neurological effects seen in Gulf War syndrome. Other potential causes that have been investigated are mustard gas and emissions from oil well fires, but their relationships to the illness are not as clear. Gulf War illness is not the result of combat or other stressors, and Gulf War veterans have lower rates of post-traumatic stress disorder (PTSD) than veterans of other wars.

The Royal British Legion said research suggested up to 33,000 UK Gulf War veterans could be living with Gulf War illness, with 1,300 claiming a war pension for conditions connected to their service. In 2007 the Royal British Legion produced a comprehensive report entitled Legacy of Suspicion, which made recommendations about necessary research and compensation. The Royal British Legion is still campaigning for the UK government to properly address symptoms experienced by veterans of the Gulf War.

According to a 2013 report by the Iraq and Afghanistan Veterans of America, veterans of the U.S. wars in Iraq and Afghanistan may also have Gulf War illness, though later findings identified causes that would not have been present in those wars.