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News Release


IMMEDIATE RELEASE

Release No: 694-94
December 13, 1994

NEW INITIATIVES ANNOUNCED FOR GULF WAR VETERANS AND FAMILIES

"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.

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