Sickness and Secrecy

By Paul M. Rodriguez

A synthetic substance an experimental adjuvant banned for use in humans has been found in the trial blood tests of Persian Gulf War veterans. The federal government says it can't be so, but what if it is?

Accounts of the mystery sickness called Gulf War Syndrome or Persian Gulf Illness read like chapters in a story that could have been written by Michael Crichton, Tom Clancy -- or the Three Stooges. Unlike Joe Klein, the authors of this human tragedy may remain anonymous. Even the ending may never be known.
. . . . But current and former soldiers are getting sicker by the day. Treatment systems in military and other government facilities are being called inadequate, and confusion down the chain of command is adding to the misery of thousands of American veterans and their families.
. . . . Backpedaling by the Department of Defense, or DoD, about whether soldiers were exposed to biological- and chemical-warfare agents during the Persian Gulf War, and the disappearance of 700,000 service-related immunization records add story lines reeking of conspiracies, cover-ups and top-secret intrigue.
. . . . Meanwhile, the sick become sicker, and more join their ranks daily. By the hundreds.
. . . . Doctors, nurses, medics, immunologists and toxicologists, both military and civilian, have come to Insight with tales of outrage, anguish, guilt, suspicion and previously undisclosed information that provides new and deeply puzzling data that all hope will lead to answers and treatment for America's gulf-war veterans. Most puzzling is the fact that the sick involve soldiers who were deployed in the Persian Gulf -- as well as those who never left U.S. soil or entered any theater of conflict.
. . . . It is from this last clue -- sickness among both deployed and nondeployed -- that we begin. If unwritten chapters of this mystery confirm the suspicions of the health-care specialists, covert medical experiments such as the Tuskegee syphilis studies and the nuclear-radiation tests on U.S. servicemen could pale in comparison. This is no outer-space Andromeda Strain, but there is grave concern it could involve a mad-scientist experiment gone awry.
. . . . Before proceeding, however, bear in mind the first maxim of investigative journalism and research science: Never leap to conclusions. So we begin with a small but important element of an unfolding mystery that provides startling new information about where to look and what to look for, who is responsible and what to do to help sick veterans get better.
. . . . This new information emerges after a four-month investigation by Insight into origins of gulf-war sickness and subsequent laboratory tests conducted on hundreds of blood samples taken from soldiers -- those sick and those showing no signs of sickness. The analysis of these results, some of which have been separately reconfirmed (though tests continue), show peculiar antibody levels for an experimental adjuvant compound known as squalene. This compound, which is not approved for internal human use other than in highly controlled experiments, has been studied on animals and humans in recent years as a promising tool to help boost the body's immune system against such illnesses as influenza, herpes simplex ... and HIV. In fact, it is from the experimental HIV clinical trials run by private firms -- and in conjunction with high-level government research projects including those by the U.S. military -- that the presence of squalene in the bodies of the sick gulf-war veterans takes on the potentially fiendish qualities of a nightmare.
. . . . It is important to note that no such connection has been made by any reputable medical, scientific or government official. In fact, it vehemently has been denied that experimental HIV immunization tests ever were expanded either to a general population of sick people or a general population of military personnel. The reason for such caution is evident: Just because squalene antibodies have been found to exist in test samples of a few hundred gulf-war veterans suffering from Persian Gulf War syndrome does not mean they correlate to currently known HIV experimental-vaccine tests using the same adjuvant compound.
. . . . That said, questions posed by Insight to top officials at the Pentagon; the Army, Navy, Air Force and Marine Corps; the military reserves; the National Guard; Walter Reed Army Medical Center; the Veterans Administration, or VA; and the National Institutes of Health (including the National Institute of Allergy and Infectious Diseases) remain unanswered. Such questions have included the following:
. . . . * Why do antibodies for the experimental immune-system-affecting adjuvant known as squalene -- not approved for human use beyond highly controlled experimental settings -- show up in the bloodstreams of gulf-war veterans who are sick with a variety of illnesses seemingly unrelated thus far to any known biological or chemical agent?
. . . . * What inoculation was administered to gulf-war veterans that may have contained squalene as an adjuvant for an immunization program?
. . . . * Why have thousands of gulf-war veterans told investigators that they had been administered shots the contents of which have not been identified?
. . . . * Why have hundreds of military doctors, nurses and medics told investigators that they were ordered to administer shots of secret contents to soldiers and then ordered to destroy the records?
. . . . * Where are the hundreds of thousands of pages of shot records -- and invoices for the secret contents -- that must be kept and maintained by the military as a matter of law?
. . . . Failure to answer such questions is certain to raise concerns about conspiracies and secret operations gone haywire. When answers are evasive, transparently dishonest or stone-walled, even bigger trouble is on the way. In this case, the obfuscation by authorities has fed growing mistrust among veterans and congressional investigators who have found it all but impossible to pierce the military and intelligence smoke screens surrounding the unusual illnesses suffered by gulf-war veterans.
. . . . Perhaps because they have no hard answers, the DoD and the VA have been responding to mounting complaints from many quarters about what appears to many to be a containment operation. This has raised concern about the integrity of these institutions among veterans, congressional leaders and even the top brass.
. . . . Insight also has encountered considerable obstruction within the bureaucracy at the VA and the DoD, but once top officials were tracked down, they seemed genuinely concerned and earnest. Nonetheless, key questions that drive so many of the conspiracy theories remain unanswered. Chief among these: Where are the shot records, and why are so many soldiers adamant about having received secret shots to which nobody officially will admit? And when asked how and why squalene has appeared in the blood of the sick veterans, DoD and VA officials say they have no clue. They also say the compound should not be there, and that if it proves to be present they'll be surprised. Nonetheless, Timothy Gerrity, one of the leaders of the investigation into the gulf-war illnesses, tells Insight the government will investigate. Such a move no doubt would be wise, since congressional oversight panels plan full and open hearings on the squalene revelations in this Insight report.
. . . . That might be more impressive if it were the first time the squalene theory had been called to the attention of the highest levels of government -- including the Clinton White House and the top echelons of U.S. military and civilian brass. In fact, the theory first was advanced publicly by Pamela Asa, a Tennessee immunologist specializing in autoimmune diseases and symptomatology. The military and civilian authorities dismissed the "concept" that soldiers were given a secret immunization as unfounded pending independent analysis -- which never was ordered. Why neither the DoD nor the VA took the initiative to explore this theory, advanced by Dr. Asa and several other well-known specialists, is difficult to determine.
. . . . Asa has treated hundreds of gulf-war veterans showing signs of autoimmune-like diseases and suggested such symptoms could be due to something called "adjuvants disease." Testing this theory only required evidence that such an adjuvant was present and, if so, determining how it got there. For example, had there been an immunization using squalene for some unknown medical threat; perhaps even some chemically or biologically engineered HIV-like bug that might attack the immune system in ways similar to those being reported from vets by the tens of thousands.
. . . . Working with toxicologists, cardiologists, oncologists, AIDS specialists, immunologists and military and civilian specialists treating gulf-war veterans, Insight has discovered the something that wasn't supposed to be there -- the telltale something that the government officially has denied.
. . . . Indeed, Air Force Col. Ed Koenigsberg, director of the DoD's Persian Gulf War Veterans' Illness Investigation Team, testified in October 1995 before the President's Advisory Committee on Persian Gulf Veterans Disease that the Asa theory was not plausible because 1), no adjuvant other than aluminum adjuvants (also called alum-based adjuvants) had been used on U.S. soldiers; and 2), there is no such thing as adjuvants disease.
. . . . Although the only U.S.-approved adjuvant is alum-based, others -- such as squalene -- have been developed and used on laboratory animals ... and experimentally on humans in government-approved tests. Since adjuvants act to rev up the immune arsenals, they have been of special interest, for example, in searching for a way to deal with HIV.
. . . . A drawback of adjuvants, and a matter of concern and debate within scientific and medical circles for years, is that they can trigger immune responses that go out of control or generate immune reactions that attack the patient from within. Notwithstanding the debate, science has determined that only in the most careful experimental tests may adjuvants such as squalene -- and a related polymer compound known as squalane -- be used on human test subjects.
. . . . Except for work with a few cutting-edge pharmaceuticals (and then only with approval from federal authorities), only government agencies are involved in human experimental tests using adjuvants. Agencies authorized to conduct human experiments include National Institutes of Health Infectious Diseases and Allergy Center and the Walter Reed Army Medical Center, to name but two. In fact, the NIH and the Walter Reed facilities have been experimenting since at least the late eighties with immunizations that might combat the scourge of HIV. Typically, the experimental "immunizations" are mixed with adjuvants -- such as alum, squalene and squalane liquids -- to provide a boost to the experimental vaccines.
. . . . When the theory first was raised that one of the immunizations could be causing gulf-war sickness, the military said it was impossible -- as did medical authorities at the VA and civilians at the White House. But, curiously, the military commissioned a study to review adjuvants disease, which supposedly does not exist, and immunizations. The results were released in March 1996 -- six months after Koenigsberg testified before the President's advisory committee. In this report, prepared by the U.S. Army Medical Research and Material Command, or USAMRMC, the "investigation team" concluded that the only vaccines and immunizations administered to soldiers were publicly known and were alum-based, that nothing but alum was used as an adjuvant and, therefore, the theory was faulty.
. . . . "The basic hypothesis and supporting evidence presented ... are flawed or inaccurate. Available information strongly argues against [this] hypothesis:
. . . . "1) All vaccines used during the GW have a long history of safety and all, except BotTox [botulism toxoid] which was used under an IND [investigational new-drug permit], were licensed by the FDA at the time of the Gulf War.
. . . . "2) Since the standard immunization series is given to individuals in basic and advanced training, only a relatively small number of additional vaccines were given during deployment to the Persian Gulf, and the previous use of these vaccines has not resulted in problems similar to those reported by GW veterans.
. . . . "3) All vaccine lots are individually licensed for safety and efficacy. The vaccines used, therefore, are unlikely to be contaminated or of low quality.
. . . . "4) The only adjuvant used in the vaccines given to GW personnel was alum. Alum is an FDA-approved adjuvant with a long history of safety. It has been given to millions of people world-wide without significant problems. No experimental adjuvants were used by the military.
. . . . "5) There are no reports of alum causing HAD [human adjuvants disease] or any other chronic disease.
. . . . "6) There are no reports of chronic inflammatory responses at the sites of immunization with vaccines containing alum as would be expected if HAD were to occur.
. . . . "7) Several recent studies [13 reports to date] have failed to show any association between silicone-gel implants and increased -incidence of connective-tissue disease. There is little supporting evidence, other than anecdotal reports, that silicone-gel implants cause an increase in connective tissue diseases or HAD."
. . . . The last item -- No. 7 -- refers to theories advanced by several scientists, including Asa, that symptoms experienced by gulf-war veterans appear strikingly similar to those experienced by women who have had breast augmentation with silicone-gel implants. Autoimmune-like illnesses have been reported -- but contested -- at higher rates in women with breast implants than those without silicone-gel augmentation.
. . . . The theoretical connection is simple: Silicone possesses adjuvant-like qualities and thus could be causing or at least contributing to illnesses reported by women with breast implants. Because symptomatologies experienced by gulf-war vets in peculiarly high numbers resemble similar medical maladies associated with silicone-gel implants, this theory goes, perhaps what veterans are experiencing is an adjuvant-like reaction to something introduced into their bodies.
. . . . In an appendix to the USAMRMC report, an immunologist at Johns Hopkins University in Baltimore hired by the military rejected the adjuvant theory as flawed because, the claims go, there is no such thing as HAD and nothing but alum-based vaccines were administered to the veterans. An excerpt from this unknown immunologist's report reads, in part:
. . . . "Veterans returning from the Persian Gulf area have manifested a number of symptoms and illnesses. They include both physical and psychological disorders. There is no evidence and no reason to believe, however, that all of these diseases have a single etiology. Persuasive evidence, such as that assembled by the Institute of Medicine, shows that this syndrome represents a number of unrelated disorders with no evidence of common origin. Studies have not yet shown that these illnesses, separately or collectively, are more prevalent among Gulf War veterans than appropriate controls." As such, the military contractor concluded, the concept of an unknown adjuvant causing the gulf-war vets' illnesses "is based on a series of erroneous assumptions and unsupported conjectures."
. . . . Yes, a theory remains a theory until it is proved. But so broad and dismissive a conclusion based on so little evidence sounds like propaganda to many scientists -- especially from an unnamed contract source in a footnote. Little wonder that dozens of health-care professionals interviewed by Insight during a four-month investigation have expressed deep distrust and frustration with the military and the VA. "I just got fed up with the lies and the deceit," says one. "They [the government] are refusing to deal with these people and instead of doing their jobs and finding out what in the hell is medically wrong, they are letting them go or forcing them out by saying it's all in their heads or they're making it up."
. . . . This source, who remains in government service at a senior level and thus refuses to be further identified, is far from alone in expressing anger and fear about how the DoD and the VA have handled both the investigation and treatment of suffering gulf-war personnel. The frustration centers on an alleged systemic failure in the U.S. government to explore not just the causes of the symptoms but also the treatment of the sick. The fear revolves around censure and sanctions imposed on those who have spoken out -- either publicly or through the chain of command -- and who, in turn, have been punished. Spokesmen for the DoD and VA deny such charges, say they have been addressed openly and deny there is a coverup or conspiracy to silence anyone who may know of one or believes one exists.
. . . . But as the General Accounting Office, or GAO, recently concluded in an exhaustive study -- the third in an ongoing series by that investigative watchdog agency of Congress, the government has failed its soldiers. And this despite more than $40 million spent or allocated, nearly 100 studies (four-fifths of which are incomplete or not scheduled for completion until after the year 2000) and hundreds of personnel assigned to probe the gulf-war syndrome.
. . . . "Six years after the war, little is conclusively known about the causes of Gulf War veterans' illnesses," according to the GAO. "None of the comments we received provide evidence to challenge our principal findings and conclusions that (1) DoD and VA have no means to systematically determine whether symptomatic Gulf War veterans are better or worse today than when they were first examined and (2) ongoing epidemiological research will not provide precise, accurate, and conclusive answers regarding the causes of the Gulf War veterans' illnesses."
. . . . And, according to the GAO, in most cases, examinations of any significance did not occur until after 1994 -- and then only because of public and congressional pressures to prod a lethargic bureaucracy into action.
. . . . Besides criticizing the DoD and VA, the GAO also blasted the President's Advisory Committee on Gulf War Veterans' Illnesses, impaneled with much fanfare a year ago, for failing critically to examine information supplied to it by military, intelligence and other government medical sources and adopted without much review in the December final report. And, GAO said of criticisms, "All of the comments we received seek to shift the onus of identifying and substantiating the causes of Gulf War illnesses to us, when in fact we merely reviewed the sufficiency and persuasiveness of the evidence behind the administration's conclusions. In some instances, we found it to be weak or open to alternative interpretation. We believe the burden of proof is still on those who have made the assertions about the likely and unlikely causes of the illnesses."
. . . . For example, GAO investigators found that much research had been conducted on exposure to stress, but other hypotheses received scant support. "In its Final Report, IOM [the Institute of Medicine] discusses the evidence for a number of disease hypotheses, including multiple-chemical sensitivity and organophosphate-induced delayed neuropathy. IOM found the evidence for none of the hypotheses to be highly compelling when it conducted the review, but it nevertheless highlighted the importance of exploring 'all possible avenues to increase our knowledge of such illnesses and to reduce suffering and disability.' Nonetheless, aside from studies examining stress-related symptoms, relatively few studies have been supported to evaluate alternative-disease hypotheses. For example, prior to October 1996, only one study focused on the health effects of potential exposure to chemical-warfare agents. While multiple studies of the role of stress in the veterans' illnesses have been supported with federal research dollars, some other hypotheses have been pursued largely outside the federal research program," said the GAO.
. . . . In fact, it is just such outside research, conducted almost exclusively without federal tax dollars and in private laboratories at prestigious university hospitals, that the concerns -- or call them theories -- involving the illnesses of the gulf-war soldiers may have made some breakthroughs. Besides Asa, Garth and Nancy Nicolson, two highly respected and widely published scientists known for their medical studies into a broad range of immunological, cancerous and auto-immune diseases, have advanced a separate theory of what may be contributing to the ill health of some of the veterans.
. . . . Specifically, the Nicolsons believe that some vets suffer from diseases of biological, not chemical or radiological, origins. This theory centers on the presence of an uncommon infection of a microorganism known as mycoplasma fermentans (incognitus strain). It is a slow-growing mycoplasma discovered deep inside white blood cells of about one-half of sick gulf-war soldiers. Such mycoplasmas, according to the Nicolsons, may produce unusual autoimmune-like signs that could account for symptoms experienced by many sick vets. The origin of this mycoplasma could be from vaccines (multiple vaccination immunosuppression), overseas sand and water, plumes from bombing chemical and biological depots, oil fires and plumes, biological sprayers or Iraqi Scud-B skyburst warheads.
. . . . Interestingly, the Nicolsons' tests also have discovered the presence of HIV-1 envelope genes in a number of sick vets. This aspect -- if borne out by further testing -- again raises that scientifically troubling question: How could gulf-war veterans show signs of HIV-like indicators in their blood regardless of whether they have myco-plasmas in their systems? (Mycoplasmas occur naturally and the Nicolsons believe that the HIV-1 gene envelope they have discovered could signify that mycoplasmas were "engineered" in some way for a military purpose. The U.S. government has denied knowledge of such engineering either in the United States or elsewhere, including Iraq.)
. . . . To the scores of veterans and their families Insight interviewed at length, along with their military and civilian doctors, how these soldiers became ill is not the most important issue. "I just want to get well," says one decorated Army doctor who is sick but continues to search for answers on behalf of his patients and comrades. "I just keep getting the same nonanswers. I'm told to go away. I'm told I'm crazy. I'm told to shut up. I'm told I'll ruin my career.... What the hell difference does it make to me? I'm dying," he says, "and they are too," he adds, referring to dozens of his patients.
. . . . It is important to note that as a percentage of the general population in civilian and military groups, the rate of death for gulf-war vets is about the same, but reports from other military medical doctors confirm beyond a reasonable doubt that tens of thousands of these soldiers are sick or getting sick with mysterious illnesses.
. . . . Katherine Leisure, M.D., a doctor who agreed to speak to Insight on the record, says she is transitioning out of the VA because of extreme conflicts she has with the way the agency treats patients and doctors seeking answers to what ails these gulf-war vets. She cites the refusal to provide shot records from the war, the stopping of discharges based on psychiatric evaluations that peoples' problems are mental and ignoring the requests of medical specialists to explore alternative theories concerning what caused or contributed to the illnesses of the vets.
. . . . "It's a huge scandal," says Leisure, who works in Pennsylvania. "The VA and DoD are acting like the worst of any health-maintenance organizations you could think of; they're not working for the vets but covering up for themselves." Leisure, who says it was her outspokenness that forced her resignation from the VA, believes "fraud and perjury" have been committed in these matters by senior officials at the VA and the DoD and that part of the reason is that "the bureaucrats don't want to pay" for medical services "caused by something we did or exposed our vets to."
. . . . "It's a crime what's happening. This is a terrible time for federal medicine. We need to help these vets now, but that's not on the agenda," she says, citing failure to study Leshmeysis tropica as a possible cause of some (but not all) of the sicknesses. And, Leisure echoes what many medical personnel have told Insight, that something happened before and/or after the troops were deployed and returned -- and somebody or some institution is covering it up. "The inoculations were given in good faith. I'm confident of that," Leisure emphasizes when asked if secret shots were administered or could have been. "I wouldn't be surprised to find out that something just like that occurred," she says, adding that she has no such knowledge.
. . . . It is a familiar suspicion among the professionals. "I wouldn't be surprised to find out that there was something bad given to these men," says a private medical researcher in the field of AIDS therapy. Another nationally known medical doctor says, "We have found many instances where people, these human guinea pigs, have been told one thing -- and they're so desperate for help -- but wind up back in our clinics worse off because of what they were given. And we can't find out the truth of what happened to them because of so much secrecy involved. If there's nothing up, why are those [military] shot records classified and where are those records?"
. . . . Most with whom Insight spoke believe there probably is no single cause for the gulf-war sicknesses --that the illnesses probably are due to multiple interactions linked to the medical cocktails administered soldiers, variations in genetic makeup, exposure to chemical and/or biological weapons and maybe even pesticides. Even so, to zero in on what treatments to give -- and to study how to avoid such illnesses in the future -- requires that doctors know what soldiers may have been exposed to and what they were given by way of immunizations for real or perceived health threats. The declassification and release of their medical records would be a good starting point. But because of the disappearance of the service-related shot records -- probably criminal in nature, according to federal law-enforcement authorities investigating this issue -- the most elementary checking cannot occur.
. . . . Little wonder there are furies of suspicion. Unscientific denials by the authorities only make those suspicions worse -- especially those regarding the adjuvant squalene which the government says it never used but which has appeared in the blood of hundreds of sick vets. Even the merest tyro must wonder whether this may have been part of a secret government project that was intended to help protect American soldiers, but didn't.
. . . . "I want to know how squalene, an adjuvant that's not supposed to be in these vets, got into these vets," says a leading medical specialist who studied lab results on blood samples taken from gulf-war personnel that were drawn by military as well as by civilian medical personnel for use in a series of controlled tests to determine the presence of adjuvants in the patients' systems.
. . . . In both series of tests, samples of the militarily drawn blood and the civilian-drawn blood showed positive reactions for squalene antibodies. Moreover, samples of blood drawn from human test subjects involved in federal experimental HIV and sexually transmitted disease studies also showed positive reactions for antibodies of squalene. In the cases of the experimental test subjects, it should be noted that the medications administered these civilians contained the adjuvant squalene. Moreover, these test subjects never served in the military.
. . . . "We have found soldiers who are not sick that do not have the antibodies," says one of the laboratory re-searchers contacted by Insight. "We found soldiers who never left the United States, but who got shots, who are sick -- and they have squalene in their systems. We found people who served overseas in various parts of the desert that are sick who have squalene. And we found people who served in the desert but were civilians who never got these shots [administered by the United States] who are not sick and do not have squalene."
. . . . In short, says one of only a few senior government officials familiar with the blood tests for squalene: "I can't tell you why it's there, but there it is. And I can tell you this, too: The sicker an individual, the higher the level of antibodies for this [squalene] stuff." Echoing similar comments, a high-level DoD official who is involved in investigating gulf-war illnesses, says: "I'm not telling you that squalene is making these people sick, but I am telling you that the sick ones have it in them. It's probably whatever was used with the squalene that's doing it, or in combination with the squalene. You find that, and you may be on to something."
. . . . And according to government sources, the Nicolsons' theory about mycoplasmas appears to have compelled the DoD and the VA to adopt some of their methods of detection and therapies to help the sick soldiers. The Nicolsons don't know how the HIV-like microorganisms got into the soldiers, but because they have discovered it there, they're convinced its presence proves something bizarre has occurred.
. . . . So, is the presence of squalene, HIV-like mycoplasmas and unusual sicknesses in these vets that are not tied to known biological and chemical agents coincidental? Or is there a common factor, such as an experiment or experiments gone awry?
. . . . Spokesmen from the VA, NIH, Walter Reed, Fort Detrick, Md. (home of the Army's Medical Research Institute of Infectious Diseases), the DoD and various branches of the armed services say no such experiments -- for AIDS, say -- were conducted on military personnel. But when asked why squalene is showing up in the blood of the sick, they either clam up or say they cannot explain it.
. . . . As GAO investigators and concerned congressmen are saying, if there's nothing to hide, then why hasn't the government explored the laboratory tests that are finding something that isn't supposed to be there?

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