CDC Formally Recognizes Gulf War Illness
November 12, 2025
Nearly 700,000 men and women served in the Persian Gulf during Operation Desert Shield and Operation Desert Storm (August 1990 – February 1991). A prominent condition affecting Gulf War Veterans is a cluster of medically unexplained chronic symptoms that can include: fatigue, headaches, joint pain, indigestion, insomnia, dizziness, respiratory disorders, skin problems, and memory impairment. VA refers to these symptoms as chronic multi-symptom illness, medically unexplained illnesses, and Gulf War Veterans' illnesses—all commonly known as Gulf War Illness (GWI).
According to a 2020 Department of Defense report, GWI is estimated to affect 175,000 to 250,000 Veterans who were deployed to the Gulf War theater of operations. GWI affects Veterans who served in the Army and Marine Corps at higher rates than those who served in the Navy and Air Force, and enlisted personnel are affected more than others. GWI rates also differ by where Veterans were located during deployment, with the highest rates among troops who served in areas that were close to combat.
On October 1, 2025, the Centers for Disease Control and Prevention (CDC) announced a medical diagnostic code for Gulf War Illness (GWI). This code will finally allow doctors and scientists to more effectively track, document, and treat a cluster of chronic symptoms that affect approximately 25-32% of Gulf War Veterans. Symptoms of GWI can include fatigue, fibromyalgia (widespread muscle pain), gastrointestinal disorders, respiratory disorders, skin rashes, as well as memory and concentration difficulties.
VA research is dedicated to learning more about GWI in order to provide optimal care for Veterans experiencing this illness. Toward that goal, VA and the National Institutes of Health (NIH) launched a study in 2023 that aimed to describe the clinical and biological characteristics of GWI that may pave the way to treatments. “VA and NIH’s collaboration will bring together experts who will meticulously investigate the underlying causes of symptoms. With the help of Veterans who volunteer for the study, researchers will lay the groundwork for care that will meaningfully improve the lives of hundreds of thousands of Veterans living with Gulf War Illness,” said Dr. Rachel Ramoni, former VA Chief Research and Development Officer.
Recent HSR Studies on Gulf War Illness Include:
- Collaborative Specialty Care for Gulf War Illness. This HSR-funded study (June 2020 – May 2026) will determine the effectiveness of tele-Collaborative Specialty Care (CSC) as compared to e-consultation. In tele-CSC, the specialty provider team delivers health coaching and problem-solving treatment to Veterans with GWI – and recommends the PACT optimize the use of analgesics. In e-consultation, the specialty provider team will make a one-time recommendation to the PACT that the Veterans receive local health coaching, problem-solving treatment, and analgesic optimization. Throughout this study, an advisory committee of operations partners works to ensure the findings are used to directly and immediately improve care.
- Co-PIs: Lisa Marie McAndrew, PhD, VA New Jersey Healthcare; Justeen Hyde, PhD, VA Bedford Healthcare; and Scott Sherman, MD, VA New York Harbor Healthcare.
- Listening to Gulf War Vets: This HSR-funded study (September 2018 – March 2024) will yield significant insights into the features of effective care models and treatment, as well as satisfaction with care. Rather than relying on focus groups or questionnaires, researchers conducted extensive interviews with Veterans and caregivers. This will amplify patient and caregiver voices in Gulf War-related research and clinical care to improve our understanding of experiences of illness and illuminate patient preferences that will contribute to the design and conduct of patient-centered research. PI: Shannon Nugent, PhD, VA Portland Healthcare.
- Evaluation of a Mindfulness-based Intervention for Gulf War Illness. Conducted from April 2017 to September 2023, this randomized controlled trial evaluated the effectiveness of an 8-week program called Mindfulness-based Stress Reduction (MBSR) – and whether it produced better outcomes than another self-management program called Chronic Disease Self-Management (CDSMP). Investigators compared outcomes between 154 Gulf War Veterans with Chronic Multi-symptom Illness (CMI) and 154 non-Gulf War Veterans with CMI. Contrary to expectations, study investigators did not find Gulf War Veterans randomized to receive MBSR had better outcomes on pain, fatigue, or cognitive failures than Gulf War Veterans randomized to receive CDSMP. Study results showed that although Gulf War Veterans generally reported finding both interventions acceptable, investigators found little to suggest that either intervention was associated with much improvement over time. Investigators concluded that although it is possible that MBSR would be helpful to some Gulf War Veterans, it is not an intervention that should be widely disseminated or recommended for this population of Veterans. PI: Tracy Simpson, PhD, VA Puget Sound Healthcare.
- Systematic Review Evaluates Interventions for GWI. In 2020, investigators with VA’s Evidence Synthesis Program (ESP) Center in Portland, OR, conducted a systematic review to evaluate the effectiveness and harms associated with therapeutic interventions for GWI and its related symptoms. After reviewing more than 4,600 citations, they included 45 studies that discussed 12 randomized controlled trials (RCTs), each of which examined a different intervention for GWI. Their findings showed moderate strength of evidence that a combination of cognitive behavioral therapy (CBT) and exercise – or exercise alone improved several GWI symptoms (i.e., fatigue and overall mental health). Moderate strength evidence also suggested that doxycycline is likely to be an ineffective treatment and is associated with harms.
