"Some 700,000 Servicemen and Servicewomen served in the Gulf War, and the vast
majority came home healthy," Secretary of Defense William Perry said.
"For
those who did not, we must continue to aggressively pursue the illnesses that
still afflict some of our Service-members and their families.
It is our
commitment to ensure that those in our active duty military family who are ill
get the care they need to recover.
And, we must learn more about the effects
of deployment to various environments in order to better prepare for future
missions."
In a further effort to focus directly on these patients the Department of
Defense is establishing two specialized treatment centers to be located in
Washington, D. C. at Walter Reed Army Medical Center, and the National Naval
Medical Center Bethesda, and in San Antonio, Texas, at Wilford Hall, U. S. Air
Force Medical Center, and Brooke Army Medical Center.
These centers will
concentrate on the aggressive investigation and treatment of those individuals
for whom diagnosis remains a problem.
To further pursue the problem of undiagnosed illnesses, the DoD will propose a
budget item for a total line-item of $ 15-20 million in the up-coming 1996
budget proposal.
DoD will also pursue the following initiatives:
Implement changes to the pre- and post-deployment policies which have been
developed
and refined with the most recent deployments.
These policies include: 1)
pre-eployment
assessment of servicemembers' health, 2) briefings including preventive
medicine
information on potential health hazards, 3) enhanced family support systems,
4) early
deployment of medical teams with epidemiological expertise to assess
environmental
health risks, and 5) post-deployment evaluation and treatment of the health
care needs of
servicemembers.
Conduct epidemiological and clinical investigations to identify potentially
unifying diagnoses or common causes for the "unexplained illnesses" possibly
related to the Persian Gulf War.
Work with the Institute of Medicine and other
agencies for independent reviews of these investigations.
"Staying Healthy" handbooks, containing health information specific to the
deployment
destination, will be provided to all deploying troops.
Conduct studies on the role of stress in the military environment and as a
consequence of
deployments.
Of particular interest will be potential causes of stress as
well as its impact,
prevention and treatment.
Continue to work in close collaboration with the Veterans Administration (VA)
to
evaluate and treat individuals experiencing health care problems possibly
related to
the Persian Gulf.
The Department of Defense can also report today the preliminary findings of
the Comprehensive Clinical Evaluation Program (CCEP). The initial results taken
from a register of about 11,000 active duty Gulf War veterans and some family
members disclosed that of the first 1,019 fully evaluated CCEP patients about
85 percent have definitive diagnoses. These diagnoses represent a broad range
of known clinical conditions for which these patients are receiving treatment
and are responding favorably.
Of the patients who have completed their CCEP
evaluations, about 15 percent suffer from conditions for which there is a less
clear diagnosis.
A categorization of these diagnoses is attached.
An early version of the CCEP's preliminary findings were provided to the
Institute of Medicine (IOM) of the National Academy of Sciences for their
expert evaluation and recommendations.
The IOM has selected a panel of experts
from across the country to review the progress of our evaluation process and
findings.
An initial report from the IOM was released yesterday evening.
So far, almost 11,000 people have registered for the Department of Defense
evaluation and treatment program.
The next group of fully evaluated results,
based on several thousand additional CCEP patients, is expected to be ready
this Spring.
A similar process will be followed, with the IOM contributing
recommendations for additional screening tests as well as evaluation process
modifications.
Other findings from this first group indicate that infectious diseases
accounted for very few diagnoses, about 4 percent.
Some patients have
psychologically related medical conditions, such as depression, anxiety,
tension headache and related stress disorders.
All patients have been provided
prompt treatment and many have responded well already.
The Comprehensive Clinical Evaluation Program provides an in-depth medical
evaluation of Department of Defense beneficiaries who are experiencing
illnesses which may be related to their service in the Persian Gulf War.
Based
on the CCEP experience to date, the Department of Defense doctors, so far, have
found no clinical evidence for a single or unique agent causing a "Gulf War
Illness." Our results, from this very large number of patients evaluated, are
consistent with those of a previously-reported NIH Technology Workshop Panel
and of the Defense Science Board Task Force on Persian Gulf War Health Effects,
that concluded many veterans suffer from not a single disease or apparent
syndrome, but rather "multiple illnesses with overlapping symptoms and
causes."
Categories Primary Diagnosis
Circulatory System 3%
Digestive System 7%
Endocrine 3%
Genitourinary System 2%
Healthy1 8%
Infectious Disease 4%
Injury and Poisoning 0%
Musculoskeletal 16%
Neoplasm 1%
Nervous System 6%
Other2 Headache/CNS/Memory 3% 3% 3% 2% 1% 2%
Loss Fatigue Sleep Disorders
Respiratory Related GI /
Abdomen Misc.
Psychological Conditions 8% 5% 4% 2% 2% 3%
Depression Tension Headache
Post Traumatic Stress Disorder
Somatization Anxiety Misc.
Respiratory System 6%
Skin & Subcutaneous 5%
1 Persons seeking consultation without complaint or sickness.
2 Includes "Symptoms, Signs & Other Ill Defined Conditions" as categorized
according to International Classification of Diseases (ICD-9) nomenclature
consisting of cases for which no diagnosis is classifiable elsewhere; no more
specific diagnosis can be made; signs or symptoms that prove to be transient;
and, cases in which a more precise diagnosis was not available for any other
reason.
