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From page 205... ... , 105, 127�128 Acute leishmaniasis, 120�121 Acute malaria, 125 Acute motor axonal neuropathy (AMAN) , 105 Acute nontyphoidal Salmonella infection, 109 diagnosis, 109 Salmonella bacteremia, 109 Salmonella gastroenteritis, 109 treatment, 109 Acute Q fever, 130�131 atypical presentations, 131 Coxiella burnetii hepatitis, 130�131 Coxiella burnetii pneumonia, 130 treatment for, and related long-term toxicity, 131 Acute respiratory distress syndrome (ARDS) Read the entire page →
From page 206... ... See Acute respiratory distress syndrome Armed Forces Institute of Pathology, 85, 182 Army Medical Surveillance Activity, 61, 82 Arthritis in chronic brucellosis, 116 sufficient evidence of an association involving, 5, 116 Attributions to military service in southwest and south-central Asia, 24�26 B Background, 9�16 charge to the Committee on Gulf War and Health: Infectious Diseases, 13, 15�16 identifying infectious diseases to study, 13�14 Bacterial diseases, 2, 21�22, 25�26, 36�44 antibiotic-resistant or common nosocomial infections, 44 endemic to southwest and south-central Asia that have long-term adverse health outcomes, 36�44 more prevalent in southwest and south-central Asia than in the US, 36�41 not more prevalent in southwest and south-central Asia than in the US, 42�44 of special concern to US troops or veterans, 41 against which all military personnel were immunized and vaccines are highly or fully protective, 41 against which all military personnel were immunized and vaccines are partly protective, 42 BAMC. See Brooke Army Medical Center Benign intracranial hypertension, 131 Biologic-warfare (BW) Read the entire page →
From page 207... ... , 61, 110 Chicken pox (varicella) , diagnosis in US troops serving in the Gulf War, OEF, or OIF, 85 Choroiditis, multifocal, 6, 117 Chronic brucellosis, 115�118 arthritis, 116 cardiovascular system infections, 117 diagnosis, 115 genitourinary tract manifestations, 117 hepatic involvement, 116 major manifestations, 115�118 neurologic involvement, 116�117 ophthalmologic involvement, 117 other symptoms, 118 respiratory system infections, 118 Chronic hepatitis, sufficient evidence of an association involving, 5, 134 Chronic osteomyelitis, 187 Chronic sequelae of Coxiella burnetii infection, 132�135 chronic hepatitis, 134 endocarditis, 133 osteomyelitis, 134 post-Q fever fatigue syndrome, 134�135 vascular infection, 134 CL. Read the entire page →
From page 208... ... , 7, 61, 88, 91, 145 Deployment Health Support, 15 medical databases, 28, 91�93, 191 policies on tuberculin skin testing, 7 policy regarding predeployment and postdeployment serum collection, 7, 93�94 Read the entire page →
From page 209... ... INDEX 209 Serum Repository, 93 Department of Veterans Affairs (VA) , 1, 11, 19, 61, 155, 187 Occupational and Environmental Health Strategic Healthcare Group, 15 Depression, limited or suggestive evidence of an association involving, 6 Desert Storm pneumonitis, 181 Detection, of tuberculosis transmission, 136 Development of conclusions, 3�4 of inclusion criteria, 2�3 Diagnosis active TB, 140�141 acute brucellosis, 114�115 acute Campylobacter infection, 104 acute nontyphoidal Salmonella infection, 109 acute Shigella infection, 111 chronic brucellosis, 115 latent tuberculosis infection, 136 leishmaniasis, 121 Q fever, 131 West Nile fever, 151�152 Diarrheal diseases, 1, 62�73, 103�112 Campylobacter infection, 103�107 diagnosis in US troops serving in the Gulf War, OEF, or OIF, 62�73 enteric infections in the Gulf War, 62�69 gastroenteritis in OEF and OIF, 69�73 nontyphoidal Salmonella infection, 108�110 Shigella infection, 110�112 Diseases, unreported, 25 Diseases and etiologic agents considered by the Committee for evaluation, 21�24 bacterial diseases, 21�22 fungal diseases, 22 helminthic diseases, 22�23 miscellaneous diseases, 23�24 protozoan diseases, 23 viral diseases, 23 Diseases and etiologic agents of special interest to Gulf War, OEF, and OIF veterans, 181�194 Al Eskan disease, 181�183 bacterial diseases, 41 biologic-warfare agents, 193�194 comments on, 28�29 idiopathic acute eosinophilic pneumonia, 183�184 mycoplasmas, 190�193 sexually transmitted diseases, 57�58 wound and nosocomial infections, 184�185 Diseases excluded from in-depth study Escherichia coli, 28 Read the entire page →
From page 210... ... See Enzyme-linked immunosorbent assay testing Encephalitis St. Louis, 149 West Nile, 151 Endemicity in southwest and south-central Asia, 2, 15, 25�26, 120 brucellosis, 113�114 Campylobacter infection, 103 malaria, 124�125 nontyphoidal Salmonella infection, 109 Q fever, 130 Shigella infection, 111 tuberculosis, 137 West Nile virus infection, 150 Endocarditis, 117 sequelae of Coxiella burnetii infection, 133 sufficient evidence of an association involving, 5, 133 Enteric Disease Research Program (US Navy) Read the entire page →
From page 211... ... , 127�128 in acute Campylobacter infection, 104�105 limited or suggestive evidence of an association involving, 6, 117, 128 sufficient evidence of an association involving, 5, 105 Gulf War, 1�3, 11, 15, 103 instance of leishmaniasis, 78�80 malaria in, 82 nosocomial infections in, 85 Q fever contracted during, 89 severe acute respiratory disease in, 76 West Nile fever in, 84 Gulf War and Health series, 4, 11, 101 "Gulf War Illness" (GWI) , 13 and mycoplasmas, 191�193 H Helminthic diseases, 2, 22�23, 25 endemic to southwest and south-central Asia that have long-term adverse health outcomes, 53�55 Hematologic complications of infection with Plasmodium spp., 126 sufficient evidence of a causal relationship involving, 4, 126 Hemolytic uremic syndrome (HUS) Read the entire page →
From page 212... ... , 85 and Department of Defense Medical Databases, 91�93 and Department of Defense policy regarding predeployment and postdeployment serum collection, 93�94 diarrheal diseases, 62�73 insect-borne diseases, 78�84 meningococcal disease, 85 nosocomial infections, 85�88 Q fever, 88�90 respiratory disease, 73�78 tuberculosis, 90�91 viral hepatitis, 90 Infectious diseases endemic to southwest and south-central Asia that have long-term adverse health outcomes, 20�24, 35�60 bacterial diseases, 36�44 helminthic diseases, 53�55 protozoan diseases, 50�52 sexually transmitted diseases, 56�58 viral diseases, 45�49 Infectious diseases identified for study, 13�14, 19�29 direct attribution to military service in southwest and south-central Asia, 24�26 diseases and agents of special interest to Gulf War, OEF, and OIF veterans, 28�29 Read the entire page →
From page 213... ... , 86�88, 186 Late manifestations of active tuberculosis, 142�144 extrapulmonary tuberculosis, 143�144 pulmonary tuberculosis, 143 relapse of active TB, 144 spinal tuberculosis and long-term neurologic disability, 144 tuberculosis meningitis and long-term neurologic disability, 143�144 Latent tuberculosis infection (LTBI) , 7, 137, 142, 145 diagnosis, 136 Leishmaniasis, 3, 13, 78�82, 118�123 acute, 120�121 coinfection with HIV, 122 diagnosis, 121 endemicity in southwest and south-central Asia, 120 in the Gulf War, 78�80 long-term adverse health outcomes, 122�123 Read the entire page →
From page 214... ... 214 GULF WAR AND HEALTH in OEF and OIF, 80�82 transmission, 119�120 treatment for, and related long-term toxicity, 121�122 Levels of association between select diseases and long-term adverse health outcomes, 101�155 brucellosis, 112�118 diarrheal diseases, 103�112 leishmaniasis, 118�123 malaria, 123�129 Q fever, 129�135 tuberculosis, 135�149 West Nile virus infection, 149�155 Limited or suggestive evidence of an association, 6, 31 involving amnesia, 6 involving brucellosis, 6, 117 involving Campylobacter infection, 6, 107 involving Coxiella burnetii infections, 6, 135 involving deafness, 6, 117 involving demyelinating meningovascular syndromes, 6, 117 involving demyelinating polyneuropathy, 6, 128 involving depression, 6 involving episcleritis, 6, 117 involving fatigue and inattention, 6 involving Guillain-Barr� syndrome, 6, 117, 128 involving multifocal choroiditis, 6, 117 involving myelitis-radiculoneuritis, 6, 117 involving neurologic and neuropsychiatric complications, 6, 128 involving nummular keratitis, 6, 117 involving optic neuritis, 6, 117 involving papilledema, 6, 117 involving Plasmodium falciparum infections, 6, 128 involving Plasmodium vivax infections, 6, 128 involving post-Q fever fatigue syndrome, 6, 135 involving sensorineural hearing loss, 6, 117 involving uveitis, 6, 107 Limited or suggestive evidence of no association, 7, 31 Literature amassing, 29 review and evaluation of, 3�4, 29�30 selection of, 29 Long-term adverse health outcomes, 24 of acute Campylobacter infection, 104�107 of Al Eskan disease, 182 of brucellosis, 115�118 definition, 2 of idiopathic acute eosinophilic pneumonia, 183�184 of infection with Plasmodium spp., 126�129 Read the entire page →
From page 215... ... , 1, 3, 82�84, 123�129 acute, 125 coinfection with HIV, 126 endemicity in southwest and south-central Asia, 124�125 in the Gulf War, 82 long-term adverse health outcomes, 126�129 in OEF and OIF, 82�84 relapse and recrudescence, 128�129 sufficient evidence of a causal relationship involving, 4, 126, 128�129 transmission, 124 treatment for, and related long-term toxicity, 125�126 Meningitis sufficient evidence of an association involving, 5, 117 tuberculosis and long-term neurologic disability, 143�144 West Nile, 151 Meningococcal disease, diagnosis in US troops serving in the Gulf War, OEF, or OIF, 85 Meningoencephalitis, 152 sufficient evidence of an association involving, 5, 117 Methodology, 1�4, 19�31 categories of strength of association, 30�31 development of conclusions, 3�4 identifying the infectious diseases to study, 19�29 identifying the pathogens to study, 2�3 reasons for excluding two diseases from in-depth study, 28 review and evaluation of the literature, 29�30 MFS. See Miller-Fisher syndrome Mild acute respiratory disease in the Gulf War, 73�76 among ground troops, 74�75 among shipboard military personnel, 76 Miller-Fisher syndrome (MFS) Read the entire page →
From page 216... ... See Nuclear gene tracking Nontyphoidal Salmonella infection, 1, 108�110 acute illness, 109 coinfection with nontyphoidal Salmonellae and HIV, 109�110 endemicity in southwest and south-central Asia, 109 long-term adverse health outcomes, 110 sufficient evidence of an association involving, 5, 110 transmission, 108 Norovirus (NV) , 71 among ground troops in the Gulf War, 67 Nosocomial infections, 85�88, 184�185 antibiotic-resistant or common, 44 diagnosis in US troops serving in the Gulf War, OEF, or OIF, 85�88 Nuclear gene tracking (NGT) Read the entire page →
From page 217... ... , 1�3, 11, 19, 35, 61, 78, 86�88, 90, 103 Brooke Army Medical Center, 86�87 Landstuhl Regional Medical Center, 87�88 leishmaniasis in, 80�82 malaria in, 82�84 nosocomial infections in, 86�88 Q fever contracted during, 89�90 Walter Reed Army Medical Center, 87�88 West Nile fever in, 84 Ophthalmologic complications of chronic brucellosis, 117 of infection with Plasmodium spp., 126�127 sufficient evidence of a causal relationship involving, 4, 127 Optic neuritis, limited or suggestive evidence of an association involving, 6, 117 Orchioepididymitis, sufficient evidence of an association involving, 5, 117 Osteomyelitis, 189 chronic, 187 sequelae of Coxiella burnetii infection, 134 sufficient evidence of a causal relationship involving, 4, 134 P Papilledema, limited or suggestive evidence of an association involving, 6, 117 Pathogenesis of Al Eskan disease, 182 of idiopathic acute eosinophilic pneumonia, 184 Pathogens, identified for study, 2�3 Persian Gulf War. See Gulf War Persian Gulf War Veterans Act, 1, 11�12, 24 PFTs. Read the entire page →
From page 218... ... , 3, 88�90, 129�135 acute, 130�131 coinfection with HIV, 131�132 diagnosis in US troops serving in the Gulf War, OEF, or OIF, 88�90, 131 endemicity in southwest and south-central Asia, 130 long-term adverse health outcomes, 132�135 transmission of Coxiella burnetii, 129�130 R ReA. See Reactive arthritis Reactivation TB, vs primary TB, 140 Reactive arthritis (ReA) Read the entire page →
From page 219... ... , 114 Severe acute respiratory disease in the Gulf War, 76 Sexually transmitted diseases, 56�58 Shigella infection, 1, 3, 13, 71, 110�112 acute illness, 111 among ground troops in the Gulf War, 66�67 endemicity in southwest and south-central Asia, 111 long-term adverse health outcomes, 111�112 sufficient evidence of an association involving, 5, 112 transmission, 110 Shipboard military personnel enteric infections in the Gulf War among, 68�69 mild acute respiratory disease in the Gulf War among, 76 Silicosis, 182�183 Southwest and south-central Asia. See also Endemicity in southwest and south-central Asia; Prevalence in southwest and south-central Asia map of, 20 Special interest diseases. Read the entire page →
From page 220... ... See Treatments with related long-term toxicity Transmission of brucellosis, 113�114 of Campylobacter infection, 103 of Coxiella burnetii, 129�130 of leishmaniasis, 119�120 of malaria, 124 Read the entire page →
From page 221... ... , 1, 3, 135�149 active, 140�142 diagnosis in US troops serving in the Gulf War, OEF and OIF, 90�91 endemicity in southwest and south-central Asia, 137 late manifestations, 142�144 potential relationships with military service, 144�149 risk of progression from latent tuberculosis infection to active tuberculosis, 137�140 transmission, 135�136 treatment for latent tuberculosis infection to prevent active tuberculosis, 140 U Unreported diseases, 25 US Navy Forward Laboratory, 83 US Senate Committee on Veterans Affairs, Special Investigation Unit on Persian Gulf War Illness, 192 US troops levels of, 10, 14 living conditions of, 61 personal hygiene among, 66 USNS Comfort, 186 USNS Mercy, 62, 68, 76 Uveitis Read the entire page →
From page 222... ... , 150�151, 153 West Nile virus (WNV) infection, 1, 3, 84, 149�155 acute, 151 diagnosis, 151�152 endemicity in southwest and south-central Asia, 150 in the Gulf War, 84 long-term adverse health outcomes, 152�154 in OEF and OIF, 84 sufficient evidence of an association involving, 6, 154 transmission, 150 treatment, 152 WHO. Read the entire page →
From page 223... ... See West Nile virus infection World Health Organization (WHO) , 30, 149 Wound infections, 29, 184�187 concerns regarding Acinetobacter baumannii, 185�186 regional experiences in non-Americans, 188�190 Wounded-to-killed ratios, 184 WRAMC. Read the entire page →

From page 205...

... , 105, 127�128 Acute leishmaniasis, 120�121 Acute malaria, 125 Acute motor axonal neuropathy (AMAN) , 105 Acute nontyphoidal Salmonella infection, 109 diagnosis, 109 Salmonella bacteremia, 109 Salmonella gastroenteritis, 109 treatment, 109 Acute Q fever, 130�131 atypical presentations, 131 Coxiella burnetii hepatitis, 130�131 Coxiella burnetii pneumonia, 130 treatment for, and related long-term toxicity, 131 Acute respiratory distress syndrome (ARDS)

Index Pages 205-224

Index
Pages 205-224