Copyright 2003 The Post and Courier (Charleston, SC)
The Post and Courier (Charleston, SC)
September 26, 2003 Friday FINAL Edition
SECTION: SECTION A; Pg. 1A
LENGTH: 757 words
HEADLINE: Gulf vets face higher rate of ALS, local doctor finds

Military deployed during the first Gulf War are nearly twice as likely to develop the incurable nerve disease ALS, also known as Lou Gehrig's disease, as servicemen and women who were not sent to the Gulf region, according to a new study by a Charleston physician.

The rates were highest for the Air Force, second-highest for the Army, and lower but still elevated for the Navy, Reserves and National Guard.

"People may be frightened at the thought of getting the disease but should be reassured that it is extremely rare," said Dr. John R. Feussner, the chairman of the Medical University of South Carolina Department of Medicine.

A Neurology journal article this week on Feussner's study is attracting widespread national attention after years of concern about a possible link.

As for veterans in greater Charleston, "they're very aware," said Spike Roberts, Veterans Affairs service officer for Berkeley County.

The retired Marine Corps sergeant major doesn't know of any cases locally but remembers a captain at Camp Lejeune, N.C., who had served in the Gulf War and was diagnosed with ALS.

"It was very quick in progression. It affected his speech and mobility," Roberts said.

"It is a very devastating disease" that affects nerves in the spinal cord that control muscles, said Dr. William Tyor, the chief of neurology at the Veterans Administration Medical Center in Charleston. "The weakness is progressive for a few years, and it results in death. There is no good treatment; one medicine slows the progress slightly."

The cause is largely unknown, Tyor said, although the immune system and a few genes may be involved.

As chief research officer at the Department of Veterans Affairs in Washington, D.C., Feussner initiated the study in 1999 because he had patients who were Gulf War veterans and were upset about the possibility of developing ALS, amyotrophic lateral sclerosis. He assembled an expert panel, which initially found no increase in ALS deaths or occurrence, and then a research group.

The group studied the nearly 2.5 million people on active duty or activated Reserve during the Gulf War, of whom nearly 700,000 were deployed to the Gulf region.

The group found 107 confirmed cases of ALS, but the rate or risk was twice as high for those sent to the Gulf. The risk ranged from 2.7 times as high in the Air Force and 2.0 in the Army to 1.5 in the Navy and 1.1 in the Marine Corps.

The disease affects about 30,000 Americans at any given time.

Feussner and his colleagues have not identified a cause, just as the cause of ALS is not known.

He said he sees no reason to think that troops recently deployed to Iraq also might face a greater risk of ALS, but it may remain latent and not be diagnosed for 10 years.

The federal government has spent nearly $250 million on about 250 studies in the past 10 years to research problems that veterans experience after war, Feussner said.

"This is the first study to find a relationship ... the first to show a direct causal link between service and developing a condition," he said.

When servicemen and women returned from the first Gulf War from Aug. 2, 1990, to July 31, 1991, some reported diverse symptoms that came to be known as Gulf War Syndrome or Gulf War Veterans Illness. The symptoms include fatigue, skin disorders, headache, muscle pain, sleep disorders, respiratory and cardiovascular problems and neurological problems.

"ALS does not resemble Gulf War Syndrome," Tyor said.

ALS first appears as weakness in the extremities and usually begins slowly, said Tyor, who treats local veterans who have ALS.

Only one of his ALS patients served in the Gulf War, and that patient has died, he said.

Exposure to burning oil wells, chemical warfare agents and protective inoculations have been mentioned as possible causes of Gulf War Syndrome.

In ALS, Feussner virtually rules out inoculations because rates of ALS vary so much among the active military branches, Reserves and National Guard.

With so few cases, Feussner said, "you can't tease out the causes."

A second part of the study involves interviewing patients about such things as exposure to toxins in the Gulf, where they slept, what they ate and other exposure, the doctor said.

Earlier this year, the VA established a national ALS registry to identify and track vets who have ALS. Feussner hopes the registry will show whether ALS increases as Gulf War vets age.

FOR INFORMATION

The national ALS registry can be reached at (877) DIAL-ALS