Gulf related illness--current perspectives.

In the years after Operation Desert Storm and Operation Granby, some 4-8% of veterans of the conflict began to report symptoms of illness. Common complaints included fatigue, impaired cognition, joint pain, sleep disturbances, and chest pains. Between 1992 and 1994 in the USA, and later in the UK, governments set up medical assessment programmes to define the scope of the problem in qualitative and quantitative terms. Initial efforts moved to extensive epidemiological assessment and a search for causative mechanisms of what became termed "Gulf War Syndrome". Eventually significant sums of money were invested in medical and investigative research in an attempt to relate symptoms to causes. This paper presents the historical background and context to the problem of Gulf and war related illnesses, summarises the findings of relevant epidemiological studies and discusses some of the hypotheses that have been generated to explain the clusters of symptoms reported by veterans. Finally, the current UK research programme and its underlying rationale is presented. The aim is to provide an overview of the current position and assist in the interpretation of a diagnostically difficult area.