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 I certainly believe that the
pyridostigmine bromide is an issue that we need to look at in
conjunction with some of the other exposures. There are several
reasons why I say that. One is that pyridostimine bromide does
exactly the same thing that nerve gas does. It's called an esterase
inhibitor. It does it, ostensibly, in a reversible fashion.
Theoretically, it doesn't penetrate the blood-brain barrier. But
a recent study by some Israeli doctors has found
that, at least in laboratory animals under stress - in
this case, physiological stress - that, in fact, the pyridostigmine
can penetrate the blood-brain barrier.
 It's true that you can't rule
it out. I don't regard it myself as one of the more likely factors.
I don't believe that, in the dosages that it was used, it
would have the kinds of health effects that people report.
Well, pesticide exposure would
be part of this sort of complex chemical mix that we're talking
about. It is true that pesticides were used in the Gulf to spray
areas where troops were bivouacking and things of that nature.
I'm not aware of any evidence that would tie it in any way to
the health experiences of the troops.
Again, looking at it in isolated
cases, are there five or six soldiers who were in an area where
pesticides were misused, and they might have symptoms very similar
to what we're seeing here as a result of those exposures? Certainly
that's possible. Do we have the kind of global use of pesticides
that would explain this phenomenon? I don't think we have the
global exposure to anything except for the oil smoke and to the
fall-out from the nerve agents if, in fact, one ascribes to that
particular exposure. So I think that, yes, you cannot exclude
it as a suspect, but I don't think it will end up being
the answer to what's causing Gulf War Syndrome.
Again, given the fact that many
soldiers who are sick didn't take the PB. Given the fact that
when the soldiers developed these preliminary symptoms, during
the air and ground war, was during the winter in Saudi Arabia,
and insects weren't a big problem at the time, as big a problem
as they might have been in March, April, or May. And given the
fact that follow-on studies by Dr. Abou-Donia with sarin also indicate this synergism, I don't know how
you can separate them. Certainly, it's one of the suspects or
one of the factors that you need to consider in individual cases.
The kinds of exposures you're
talking about now are ones for which there's very poor data.
Who actually used pyridostigmine bromide? Who used Deet (insect
repellent)? How much Deet did they use? Where were the pesticides
sprayed? Who got exposed to those pesticides? These are things
we'll probably never know. And, so, only over time will we be
able to discover whether epidemiologic research can, in fact,
untangle and come to any firm conclusion.
Two of those we can rule out kind
of quantitatively, depleted uranium dust and infectious agents.
In the one case, you know something about their prevalence, in
the depleted uranium dust. And in the case of the infectious
agents, if someone has leishmania, you can diagnose it. It's not that no one had either of those problems, but
those are not an important contributor.
With the vaccines, again, you
know, it would be very surprising if the vaccines played a role,
unless there were something like this complex chemical interaction,
which one can't rule out but for which there's no real evidence.
I shouldn't say no real evidence. There are a couple of interesting
"...the evidence that the oil fires are
the critical factor is not there." ...
Ware
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studies. But there's not a very strong body of evidence that
would pull that together. As far as the oil fires, it doesn't
either. It's amenable to more study, but thus far, the evidence
that the oil fires are the critical factor is not there.
Yes, with the exception of the
vaccines. And I'm not talking about anthrax or botulinum toxin.
I'm talking about other vaccines that may have been administered
in this dynamic. I think that you will see clusters of individuals
or groups of individuals who, for example, have leishmaniasis.
I think there are 35 or so individuals who have been diagnosed
with leishmaniasis. Some hydrogen sulfide was detected by the
Fox vehicles during the oil fires, and certainly there are some
people who might have been particularly susceptible and may be
ill as a result of that. And depleted uranium dust, again, you're
going to see clusters. People who were in areas where this stuff
was used. I mean, if you're going to see depleted uranium, it
will be among the tankers who were using it, upclose and personal
and then climbing over the Iraqi tanks. But that phenomena should
not be manifesting itself yet. Most medical research says that
inhalation of radioactive particles or radioactive dust usually
takes anywhere from eight to ten years to cause the kind of chronic
illnesses that we're seeing in the soldiers.
With the exception of, again,
some of the dynamics of the vaccines, I would agree with that
as well. There may be some unknown dynamic with some of the vaccines
that we're not aware of. I think it would probably be more of
the common vaccines rather than the anthrax or the botulinum toxin.
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