Bast, Elizabeth, Jester, Dylan J, Palacio, Ana et al. · Military medicine · 2026 · DOI
Gulf War Illness (GWI) is a chronic condition affecting 30-40% of veterans deployed during the 1990-1991 Gulf War, causing fatigue, pain, memory problems, digestive issues, and other symptoms similar to ME/CFS and long COVID. This review examines whether GWI might be caused by a viral infection, similar to how long COVID develops after SARS-CoV-2 infection. The authors suggest that veterans may have been exposed to a coronavirus related to MERS during their deployment, and they call for more research to explore this possibility.
This study is important because it proposes a testable mechanistic framework for understanding GWI by drawing parallels with long COVID and ME/CFS, potentially identifying shared pathogenic pathways across these debilitating post-infectious conditions. If GWI is indeed post-viral, lessons learned from investigating its cause could accelerate understanding of ME/CFS etiology. Furthermore, the hypothesis offers a specific research direction—examining MERS-related coronavirus exposure—that could unify understanding of multiple post-viral syndromes affecting millions of people globally.
This review does not establish that GWI is definitively caused by a viral infection; it presents a hypothesis requiring direct investigation. The paper does not provide serological or virological data proving MERS or MERS-related coronavirus exposure in Gulf War veterans. The symptomatologic similarities between GWI, ME/CFS, and long COVID suggest possible shared mechanisms but do not prove identical etiology across these conditions.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Bast, Elizabeth, Jester, Dylan J, Palacio, Ana, Krengel, Maxine, Reinhard, Matthew, & Ashford, J Wesson (2026). Gulf War Illness: A Historical Review and Considerations of a Post-Viral Syndrome.. Military medicine. https://doi.org/10.1093/milmed/usaf092
BibTeX
@article{mecfsatlas-bast-2026-gulf-war,
author = {Bast, Elizabeth and Jester, Dylan J and Palacio, Ana and Krengel, Maxine and Reinhard, Matthew and Ashford, J Wesson},
title = {Gulf War Illness: A Historical Review and Considerations of a Post-Viral Syndrome.},
journal = {Military medicine},
year = {2026},
doi = {10.1093/milmed/usaf092},
note = {PubMed: 40117126},
url = {https://www.mecfsatlas.com/evidence/bast-2026-gulf-war},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/bast-2026-gulf-war
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