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Completed Research Projects
Title: Disease Cluster in a Pennsylvania Air National Guard Unit, EPI-AID 95-18
Synopsis: This study evaluated disease reports of a Pennsylvania Air National Guard unit.
Overall Summary: See project objective.
Overall Project Objective: At request of VA, DoD, and the Pennsylvania Health Department, CDC investigators conducted an EPI-AID to evaluate reported cluster of illness in the Pennsylvania 193rd Air National Guard.
Results to Date: The cross-sectional questionnaire survey included 3723 currently active volunteers, irrespective of health or Gulf War participation, from four Air Force populations. The cross-sectional clinical evaluation included 158 Gulf War veterans from one unit, irrespective of health status. The study involved the development of a symptom-based case definition, assessment of case prevalence rate for Gulf War veterans and non-deployed personnel, and analysis of clinical and laboratory findings among veterans who met the case definition. We defined a case as having one or more chronic symptoms from at least 2 of 3 categories (fatigue, mood-cognition, and musculoskeletal). The prevalence of mild-to-moderate and severe cases was 39% and 6%, respectively, among 1155 Gulf War veterans compared with 14% and 0.7% among 2520 non-deployed personnel. Illness was not associated with time or place of deployment or with duties during the war. Fifty-nine clinically evaluated Gulf War veterans (37%) were non-cases, 86 (54%) were mild-to-moderate cases, and 13 (8%) were severe cases. Although no physical examination, laboratory, or serologic findings identified cases, veterans who met the case definition had significantly diminished functioning and well-being. Among current active members of four Air Force populations, a chronic multisymptom condition was significantly associated with deployment to the Gulf War. The condition was not associated with specific Gulf War exposures and also affected non-deployed personnel.
Subsequent analyses have examined the association between physical, chemical, and emotional deployment stressors reported by Gulf War veterans and the development of chronic multisymptom illness following the war. The illness defined in this study was found to be related to reporting pyridostigmine bromide use, insect repellent use, injuries that required medical attention, and a belief that biological or chemical weapons had been used. Our original plans, to begin high density filter array assays to measure gene expression profiles on veterans who met our case definition and controls, has been put on hold, pending interpretation and discussion of results of similar testing among chronic fatigue syndrome patients.
Project: HHS-2
Agency: Department Of Health And Human Services
Location: CDC,State of Pennsylvania,State of Florida
P.I. Name: W C Reeves
Status: Complete
Study Start Date: December 01, 1994
Estimated Completion Date: June 01, 2000
Specific Aims: Characterize patients, determine if there was a cluster of illness, determine if the illness was unique to the 193rd ANG, related to residence in Pennsylvania, or related to GW service, characterize the illness and derive a working case definition, and identify risk factors for illness.
Methodology: Stage 1 case series; stage 2 cross sectional population-based interview; stage 3 physical exam, psychometric testing, clinical laboratory, research laboratory assessment and nested case control study.
Publications:
Fukuda K , Nisenbaum R , Stewart G , Thompson W W, Robin L , Washko R M, Noah D L, Barrett D H, Randall B , Herwaldt B L, Mawle A C, Reeves W C. JAMA.1998;280:981-8.
Nisenbaum R , Barrett D H, Reyes M , Reeves W C. J Nerv Ment Dis.2000;188:259-66.
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