1. Gulf War Issues Starring Your Host Ian Welch

2. Topics of discussion Leishmaniasis Leishmaniasis Brain Cancer Brain Cancer ALS ALS Undiagnosed Illnesses Undiagnosed Illnesses

3. Leishmaniasis (Sand Fleas) What is Leishmaniasis? What is Leishmaniasis? What are the signs and symptoms? What are the signs and symptoms? Other information Other information

4. Leishmaniasis What is Leishmaniasis? Leishmaniasis is a parasitic disease spread by the bite of infected sand flies.Leishmaniasis is a parasitic disease spread by the bite of infected sand flies. 3 types3 types Visceral Visceral Mucocutaneous Mucocutaneous Cutaneous Cutaneous

5. Visceral Leishmaniasis What are the signs and symptoms? Enlarged Spleen and Liver Enlarged Spleen and Liver Fever Fever Weight loss Weight loss Swollen glands Swollen glands Possible low blood counts, including a low red blood cell count, low white blood cell count, and low platelet count. Possible low blood counts, including a low red blood cell count, low white blood cell count, and low platelet count.

6. Visceral Leishmaniasis Of the 21 Cases in Afghanistan that were reported, all were in the 1980’s Of the 21 Cases in Afghanistan that were reported, all were in the 1980’s According to the CDC, Only 2 American Service Members cases have been reported since According to the CDC, Only 2 American Service Members cases have been reported since

7. Cutaneous Leishmaniasis? What are the signs and symptoms? Have one or more sores on the skin.Have one or more sores on the skin. The sores can change in size and appearance over time.The sores can change in size and appearance over time. Often look somewhat like a volcano, with a raised edge and central crater.Often look somewhat like a volcano, with a raised edge and central crater. The sores can last for months or years.The sores can last for months or years. Can take weeks or months to develop.Can take weeks or months to develop. Can be diagnosed using a blood smear.Can be diagnosed using a blood smear.

8. Leishmaniasis Other information Treatment – Usually heals on its own Treatment – Usually heals on its own Can leave scar after healing Can leave scar after healing 1.5 Million new cases each year 1.5 Million new cases each year Is common in Iraq and Afghanistan Is common in Iraq and Afghanistan

9. Leishmaniasis Questions?

10. Brain Cancer Is Brain cancer caused by Sarin gas exposure? Is Brain cancer caused by Sarin gas exposure? Study posted in the American Journal for Public Health. Study posted in the American Journal for Public Health. Statistical link only. Statistical link only. The study was criticized and continues to be studied. The study was criticized and continues to be studied. Any Gulf War veteran with brain cancer should still file a claim. Any Gulf War veteran with brain cancer should still file a claim.

11. Amyotrophic Lateral Sclerosis Aka - Lou Gehrig’s disease Gulf War veteran’s who served from 1990 to 1991. Gulf War veteran’s who served from 1990 to 1991. VA and DoD Research shows these veterans have a nearly two-fold risk than those veterans who did not serve in the Gulf. VA and DoD Research shows these veterans have a nearly two-fold risk than those veterans who did not serve in the Gulf. Any Gulf War veteran with ALS should file a claim immediately. Any Gulf War veteran with ALS should file a claim immediately.

12. Amyotrophic Lateral Sclerosis Signs and Symptoms Weakness – begins more so in the hands than the feet. May progress on one side of the body more than the other. Weakness – begins more so in the hands than the feet. May progress on one side of the body more than the other. Muscle cramping, twitching, spasms. Muscle cramping, twitching, spasms. Tremors Tremors Weakness of the throat muscles causing speech difficulties, swallowing, even breathing. Weakness of the throat muscles causing speech difficulties, swallowing, even breathing. Many times it takes 10 or more years to develop. Many times it takes 10 or more years to develop.

13. Amyotrophic Lateral Sclerosis There is no cure but there is treatment. There is no cure but there is treatment. The VA is using sodium phenylbutyrate and other medications to slow the progress of the disease. The VA is using sodium phenylbutyrate and other medications to slow the progress of the disease.

14. Amyotrophic Lateral Sclerosis Questions?

15. Undiagnosed illnesses What is an undiagnosed illness? What is an undiagnosed illness? What are the conditions most commonly associated? What are the conditions most commonly associated?

16. Undiagnosed illnesses What is an undiagnosed illness? Veteran must have served in the Persian Gulf War. Veteran must have served in the Persian Gulf War. Redefined – medically unexplained chronic multisymptom illness (MUCMI ® ). Redefined – medically unexplained chronic multisymptom illness (MUCMI ® ). Disability that manifested itself to a degree of 10% or more not later than December 31, 2011. (extended) Disability that manifested itself to a degree of 10% or more not later than December 31, 2011. (extended) Disability must be chronic for no less than 6 months. (proven with medical or lay statements) Disability must be chronic for no less than 6 months. (proven with medical or lay statements)

17. Undiagnosed illness What are the disabilities most commonly associated? MUCMI ® MUCMI ® Chronic fatigue syndromeChronic fatigue syndrome FibromyalgiaFibromyalgia Irritable bowel syndromeIrritable bowel syndrome

18. What are the disabilities most commonly associated? (cont) Fatigue Fatigue Headache Headache Muscle pain Muscle pain Joint pain Joint pain Sleep disturbances Sleep disturbances Abnormal weight loss Abnormal weight loss Menstral disorders Menstral disorders Signs or Symptoms of the following: Skin Skin Neurological Neurological Neuropsychological Neuropsychological Respiratory system Respiratory system Gastrointestinal Gastrointestinal Cardiovascular Cardiovascular

19. What does all this mean? Any veteran who served in the Persian Gulf War that is suffering from a disability (especially one that is listed) should file a claim immediately.

20. Questions??