Gulf War Illness Caused by Bacteria, Doctors Say Disease: Some claim to have caught the ailment from veterans. Others say theory lacks hard evidence.
By J.R. MOEHRINGER, TIMES STAFF WRITER

Los Angeles Times Sunday March 9, 1997
Home Edition Part A, Page 1 Type of Material: Top Story

IRVINE--A number of medical professionals, who say they've become ill while treating Gulf War veterans, claim the mysterious disease afflicting tens of thousands of soldiers is contagious and could pose a public health threat.

Doctors, nurses, laboratory researchers, as well as others who come in casual contact with Gulf War veterans, say they've contracted the same symptoms--fatigue, fever, aches, rashes and respiratory problems--that are generally associated with "Gulf War syndrome."

Government investigators as well as some prominent scientists express deep skepticism about such theories, and they find little evidence to support the claim that Gulf War illnesses are contagious.

But despite failing to find favor with official Washington and colleagues, many remain convinced that the cause of Gulf War illness is an infectious microbe, either native to the Middle East or produced by Iraq's infamous biological weapons program. Whatever the cause, they say, it's spreading.

As proof, they cite themselves.

"Everyone in this office has had Gulf War illness," said Garth Nicolson, an Irvine biochemist at the nonprofit Institute for Molecular Medicine, which he founded to investigate Gulf War syndrome and other chronic conditions. "I lost four teeth and had part of my lower jaw removed."

The inspiration for Nicolson's Irvine institute, which opened its doors to Gulf War veterans in August, was his daughter-in-law, a 101st Airborne Division soldier who became ill after her unit penetrated deep into Iraq during the 1991 conflict

"Practically everyone in her unit came down with Gulf War illness," said Nicolson, who at that time was heading the tumor biology department at the renowned M.D. Anderson Cancer Center in Houston. "We found out a lot of people in the service were becoming sick, and we'd seen similar illnesses before."

After intense clinical research and thorough examinations of his daughter-in-law, Nicolson and his biophysicist wife, Nancy, concluded that Gulf War illness could be treated with massive doses of antibiotics.

"She's fully recovered," he said of his daughter-in-law. "She's going to be entering medical school."

Until recently, many suspected that Gulf War illnesses were caused by chemical weapons. Nicolson and others, however, say chemical weaponry has been a red herring. He argues that the leading culprit may be a bacterium, such as mycoplasma fermentans, which he claims to have found in the blood of 45% of the ailing veterans he's tested.

Perhaps genetically altered by the Iraqis or their weapons suppliers, mycoplasma fermentans might have been a biological warfare agent used in warheads that exploded above allied troop positions during the Persian Gulf conflict, Nicolson contends. Or it may have been dispersed in some other way by the Iraqis.

Such theories have circulated among investigators for some time, but have failed to win many converts in Washington.

"We saw [mycoplasma fermentans] as a highly unlikely candidate for biological warfare," said Dr. Shyh-Ching Lo, chief of the Division of Molecular Pathology at the Armed Forces Institute of Pathology in Washington. He recently studied Nicolson's data and found it inconclusive.

. "If 50% of veterans were infected, we anticipate they would have a much higher incidence of antibody response, but we did not really see that," Lo said.

In its final report two months ago, the Presidential Advisory Committee on Gulf War Veterans' Illnesses also discounted Nicolson's arguments about the likely source of Gulf War syndrome.

"Clinical evidence seems to indicate that mycoplasma is not a source of widespread illness in Gulf War veterans," said Mark Brown, a senior policy analyst on the committee, which will continue to oversee Pentagon investigations into Gulf War illnesses.

"What clinical evidence?" Nicolson asked. "They've never presented any clinical evidence that mycoplasma wasn't involved, because all signs and symptoms of Gulf War illness can be caused by mycoplasmal infections."

Despite the committee's findings, doctors at Walter Reed Army Medical Center near Washington recently agreed to work with Nicolson.

"A protocol for evaluating Dr. Nicolson's work is being developed now," said Walter Reed spokesman Ben Smith. "Everybody involved with Gulf War illness, all the folks here at Walter Reed and elsewhere, have said we'll look at anything that'll help patients"

The Senate Veterans Affairs Committee, after hearing testimony from many worried veterans, has vowed to investigate the contagion question.

"We've had lot of veterans testify that they are concerned they are passing on these illnesses to their wives and children," said Charles Battaglia, the committee's staff director. "It's one of the things we'll be looking at as part of the investigation this committee is conducting."

Joyce Riley, a former Air Force flight nurse in Houston, testified before the committee that she became ill while treating soldiers who returned from the Gulf War.

Though she never left the United States during her tour of duty, she quickly began to show symptoms identical to those of her patients, including the debilitating chronic fatigue that now afflicts many veterans. At one point, Riley said, she was too weak to brush her teeth.

." When Riley recovered--thanks, she says, to intravenous antibiotics similar to those used on Nicolson's daughter--she founded the American Gulf War Veterans Assn., a Texas-based organization that answers veterans' questions and collects data on their health.

She was lucky, she says, because she received prompt medical attention. Thousands of veterans have died, she believes, because their conditions went unrecognized and misdiagnosed

Among the veterans who have contacted her organization, Riley says, 80% report that they've transmitted their illness to at least one other person, including children, neighbors and co-workers. Many veterans even describe bizarre symptoms in their household pets.

"Here's the scary part," she said. "When I talk to veterans, I ask, 'How're the children doing?' And they say, 'Well, my little boy cries at night because his muscle aches are so bad.' And I say, 'Tell me about your pets.' And they tell me, 'Well, our pets died.' "

"A doctor called me the other day, and he's been treating Gulf War veterans," she said. "Both his prize dogs are dragging their back legs, and he's sick too."

Dr. Kathy Leisure, of Lebanon, Pa., has no doubt that the illness is an infectious disease. She has treated 600 Gulf War veterans, and one day noted a Gulf War-type rash on her nose.

"Even now people are getting the illness," she said.

Frequently, Riley hears from physicians who are sick. And scared. Said Nicolson: "Saddam Hussein threatened to carry the war back to America. This is one way he could do that."

One of Nicolson's supporters is Dr. Edward S. Hyman, a New Orleans physician who has treated nearly a dozen Gulf War veterans without becoming ill himself--though he checks himself regularly for unusual bacteria he believes responsible for Gulf War illness.

Hyman, who has testified before Congress about Gulf War illness, has warned that the nation's blood supply, much of which is donated by active duty military personnel, may be unsafe.

"It's conceivable," said Hyman, who added that Gulf War illness behaves like the bacterial infections he has studied for 30 years. "I'm not the kind of guy who screams 'germ warfare' when there's no evidence for it. Though I have better evidence than most anybody."

Dr. Charles Hinshaw, of Wichita, Kan., agrees. A former president of the American Academy of Environmental Medicine, he hasn't become sick treating Gulf War veterans, but he believes that many of their illnesses are contagious. He handles their blood with great care.

"If I was running the Red Cross," he said, "or I was part of the Department of Defense, I'd say, 'Let's don't take any more blood from veterans until we answer this question.' "

"We make sure before we collect blood from anybody that they feel well, that they're in good health, and have normal temperature and pulse," said Dr. Peter L. Page, senior medical officer for biomedical services at the American Red Cross. "Those practices have protected transfusions very well over the decades from bacterial contamination."

Officials at the American Red Cross, which collects 50% of the nation's blood supply, dismiss such concerns. More than five years after the war's end, "we're just now beginning to see secondhand exposures in physicians and nurses," said Nicolson, adding: "This is not going to go away, just slowly spread."

But Nicolson and others charge that because mycoplasma fermentans and some other bacteria have long incubation periods, carriers may not always display outward symptoms of illness.

It spread like wildfire through his office. Besides himself and his wife, five staffers came down with classic symptoms of Gulf War illness.

"There's 123 different possible symptoms," said Blake Hale, 22, a member of Nicolson's staff, which includes physicians and chemists. "I've experienced probably three-quarters of those."

Some of Hale's friends had trouble believing that his recent sickness was in any way connected to the Gulf War, since he's never spent a day in the military.

But such skeptics have an even harder time believing the recovery he's made. Along with everyone else in Nicolson's office, he feels just fine after receiving treatment with antibiotics. The drugs don't cure the disease, doctors say, but they do control the symptoms.

Among Nicolson's most dramatic treatment successes is Dr. Larry Goss, of Walters, Okla.

When Goss and his wife began suffering from severe chronic fatigue several years ago, they couldn't imagine the cause. Gulf War syndrome never occurred to them since neither had served in the military.

As his wife's condition deteriorated into something resembling multiple sclerosis--a common diagnosis, Goss said, among Gulf War veterans who are sick--Goss heard about Nicolson's research. It was only then that Goss began to wonder if his volunteer work with local Gulf War veterans had caused his illness and that of his wife.

At Nicolson's suggestion, the Gosses took massive doses of an antibiotic called doxycycline. Almost instantly, both felt better.

"She threw away her cane," Goss said, "and no longer needed her wheelchair."

Since his dramatic recovery, and especially his wife's, Goss has become a firm believer in Nicolson's theories. For little or no money, he examines hundreds of Gulf War veterans, many of whom come long distances, all of whom seem terribly frightened.

"I'm just a country doctor who got sick and saw a lot of my patients sick and didn't know what was going on," he said. "I'm no expert. I don't think anyone is. We need to learn more."

Said Riley: "It's startling. We're sitting on top of a contagious disease and doing nothing about it."