I have been considering my onset and history. I grew up in the Middle East and was there (KSA) during Gulf War I. I am astounded by the similarities between Gulf War Illness and ME/CFS, especially considering the atypical and classic subsets in the latest Hornig/Lipkin study (I believe they had one Gulf War Veteran who placed in the atypical group). Papers state that 25-32% of Gulf War I veterans have been diagnosed with Gulf War Illness, which is essentially ME/CFS (although more prevalence of MCS and neurological symptoms in this cohort, which is in line with "atypical ME/CFS"). Statistics show that 17.6% of Gulf War II (i.e. Iraq War) veterans have been diagnosed with Gulf War Illness. Furthermore, Gulf War Illness has been declared a real disease...not psychosomatic. When we want to discuss etiology, do these figures not astound others? Are there others on this forum with links to the Gulf War/Middle East? I don't think this aspect has been vetted and discussed considering the subtypes in the Hornig/Lipkin paper. My onset has been gradual. During Gulf War I, I was about 200 miles from the Kuwait border. We did experience scud missile attacks to my camp and oil well fire smoke for weeks. I had multiple contacts with bases, soldiers, and their equipment...including taking materials home with me. I was a teenager and had my bedroom decked with "tokens." This inquest could be spurious, but given the statistics, I cannot negate an environmental/toxic insult that set me up for ME/CFS...and maybe others have some history too?