nobel prizes are awarded annually by the nobel foundation in sweden, for achievements in physics, chemistry, physiology or medicine, literature, peace and economic sciences. the work of lmb scientists has been awarded 9 nobel prizes, shared amongst 13 individuals, in the fields of chemistry and physiology or medicine. these prizes celebrate key advances in primary scientific research and for developing pioneering techniques for molecular biology. the award of 2 nobel prizes in the same year, 1962, established the laboratory ’ s reputation as a leading international research centre. you can also download a pdf of the printed brochure – this is recommended if you want to print the information yourself. 2009 chemistry prize “ for studies of the structure and function of the ribosome ” 2002 physiology or medicine prize sydney brenner, bob horvitz & john sulston “ for their discoveries concerning the ‘ genetic regulation of organ development and programmed cell death ’ in c. elegans ” 1997 chemistry prize “ for their elucidation of the enzymatic mechanism underlying the synthesis of adenosine triphosphate ( atp ) ” 1984 physiology or medicine prize cesar milstein & georges kohler “ for theories concerning the specificity in control and development of the immune system and the discovery of the principle for production of monoclonal antibodies ” 1982 chemistry prize “ for his development of crystallographic electron microscopy and his structural elucidation of biologically important nucleic acid - protein complexes ” 1980 chemistry prize “ for their contributions concerning the determination of base sequences in nucleic acids ” 1962 chemistry prize john kendrew & max perutz “ for their studies of the structures of globular proteins ” 1962 physiology or medicine prize francis crick & jim watson “ for their discoveries concerning the molecular structure of nucleic acids and its significance for information transfer in living material ” 1958 chemistry prize “ for his work on the structure of proteins, especially that of insulin ” nobel fast facts “ in 1962, the lmb was awarded 2 separate nobel prizes : francis crick and jim watson ( physiology or medicine ), and max perutz and john kendrew ( chemistry ) ” ribosomes : bringing dna to life venki ramakrishnan started work on the structure of the ribosome at the university of utah, before moving to the mrc laboratory of molecular biology in 1999. using x - ray crystallography to determine the position of the hundreds of thousands of atoms that make up a ribosome, the structure of the entire ribosome was solved. it is the most complex atomic - resolution


molecular biology in 1999. using x - ray crystallography to determine the position of the hundreds of thousands of atoms that make up a ribosome, the structure of the entire ribosome was solved. it is the most complex atomic - resolution structure determined to date. this research shed light on the role of the ribosome in the decoding of mrna and on antibiotic function, showing how different antibiotics bind to ribosomes. this information is critical in developing new antibiotics to combat infection and disease. modern antibiotics work by blocking the function of bacterial ribosomes : if the ribosomes cannot work, bacteria cannot survive. the knowledge about ribosomes opens up the possibilities of more medical advances and applications in the future. venki ’ s group continue their studies on ribosomes, at the lmb, to further understand the detailed mechanisms involved in the process of protein synthesis. venki shared the nobel prize with thomas steitz from yale university and ada yonath from the weizman institute. “ the idea of supporting long - term basic research like that at lmb does lead to breakthroughs. the ribosome is already starting to show its medical importance. ” venki ramakrishnan control of cell growth & programmed cell death sydney brenner, bob horvitz and john sulston, studied how genes regulate organ development and how cells are programmed to die. by studying the life cycle of the adult nematode worm, which has just 959 cells, a short lifetime, and is transparent, it was possible to follow cell division as it happened, and ‘ map ’ these cells to identify the origin of the worm ’ s components during development. it was also possible to see what effects gene mutations had on organ development. studying programmed cell death is important in understanding how viruses and bacteria invade cells and cancer changes them. inducing such death is a key goal of cancer therapy. collaborating with bob waterston, john then moved onto sequencing the worm ’ s genome, reading the dna code that determines the characteristics of the worm. this work led to the sequencing of the human genome, with john leading the uk team at the wellcome trust sanger institute. using sequencing techniques developed by fred sanger, the human genome was completed in 2003. this is now being studied in order to improve the diagnosis of disease, develop new therapies and improve healthcare. the more we learn about the human genome the more there is to explore. “ i just loved watching the cells. it ’ s a beautiful thing to


being studied in order to improve the diagnosis of disease, develop new therapies and improve healthcare. the more we learn about the human genome the more there is to explore. “ i just loved watching the cells. it ’ s a beautiful thing to do and a challenge in the jigsaw - puzzling sense to get it all. ” john sulston energy conversion in cells in the late 1970s, john walker began his studies of atp synthase, a molecular machine that is the key enzyme in cellular energy conversion. he realized that a detailed knowledge was required in order to understand how it works. therefore, he isolated the molecular machine involved in the production of atp from the mitochondria, the power - houses in our cells. he characterized its many component parts and showed how it is constructed from them. this work led to the realization that the machine is driven by a mechanical rotary mechanism, a new principle in enzyme function. this discovery opened up new areas of chemical research as well as providing the basis for biomedical applications for the benefit of mankind. the study of the process of energy conversion in biology continues at the mrc mitochondrial biology unit, on the addenbrooke ’ s site. here, john walker and other researchers are focused on understanding the biochemical and biological processes which occur in mitochondria, studying energy conversion in man and its involvement in human conditions such as aging, obesity and neuromuscular and neurodegenerative diseases, with the aim of eventually producing new therapies. john shared the nobel prize with paul boyer from the university of california, los angeles, and jens skou from aarhus university. “ we ’ re not asked to find cures for diseases, but to provide the background that allows disease processes to be better understood. ” john walker cesar milstein and georges kohler were trying to understand the mechanisms responsible for the remarkable diversity of antibodies. through this research, they invented a way to stimulate cells to provide unlimited production of a specific antibody – a monoclonal antibody. it was recognized that monoclonal antibodies had the potential to diagnose and treat a wide array of diseases, but it would take twenty years before this approach could be applied to humans, following research led by greg winter and michael neuberger at the mrc laboratory of molecular biology. one of the most successful ways in which monoclonal antibodies have been used is in diagnostics – “ tagging ” a monoclonal with a fluorescent dye to see if it has attached to a specific antigen. this method can be


molecular biology. one of the most successful ways in which monoclonal antibodies have been used is in diagnostics – “ tagging ” a monoclonal with a fluorescent dye to see if it has attached to a specific antigen. this method can be used to diagnose cancers and aids. monoclonal antibodies are now also being used for therapies to treat diseases including rheumatoid arthritis, multiple sclerosis, some forms of cancer and viral infections. it has sparked an international multi - billion pound biotechnology industry : monoclonal antibodies are the basis of a third of all biotech products in clinical development. cesar and georges shared the nobel prize with niels jerne from the basel institute, switzerland. “ the development of a method to produce monoclonal antibodies against a defined antigen has had a profound impact in many branches of research and signalled a shift in the analysis of biological problems. ” cesar milstein & georges kohler biological structure in 3d aaron klug overcame this limitation by taking images in different directions and combining them mathematically, using computers, to produce the 3d structure. he initially used this to determine the structure of viruses before studying the combination of protein and dna in chromatin, of which chromosomes are made. chromatin was broken into small fragments that could be examined. a model for chromatin was then proposed based on this knowledge of the structure of the fragments. the exact structure of chromatin affects how the genetic code along the dna is read. this investigation is crucial in the understanding of cancer, in which the control of growth and division of cells by the genetic material no longer works. since the invention of 3d reconstruction, improvements in electron microscopes, in specimen preparation and in computers have led to huge advances in 3d microscopy and suitable specimens, such as viruses, can now be visualised in atomic detail. sub - cellular structures can now be imaged by electron tomography and similar approaches have revolutionised medical imaging, where ct scanning is now used routinely in the diagnosis of neurological diseases and cancers. “ i like to think i would have achieved something elsewhere, but i could not have done what i have without so many able and gifted colleagues. ” aaron klug fred initially developed methods to find out the genetic sequence of a virus, which had just over 5000 base pairs and was the first fully sequenced genome. this method was then extended to determine the much larger sequence of human dna, and this was the most widely used analysis method from the early 1980s. fred ’ s method relies


which had just over 5000 base pairs and was the first fully sequenced genome. this method was then extended to determine the much larger sequence of human dna, and this was the most widely used analysis method from the early 1980s. fred ’ s method relies on copying the dna sequence, but it stops copying every time it hits a particular dna base – of which there are only four types – a, c, g and t. by measuring the length of the incomplete copies, you can determine where that base occurs in the dna. this sequence is read off an autoradiograph, a photographic record of a biological specimen, and gives a characteristic ‘ striped ’ pattern. fred ’ s method shaped the way that genomics and biomedicine were explored and was key to the human genome project, an international collaboration to identify all the approximately 20, 000 - 25, 000 genes in human dna. this has increased the understanding of many genetically based diseases including cancer. knowledge about the effects of dna variations among individuals can lead to revolutionary new ways to diagnose, treat, and eventually prevent the thousands of disorders that affect us. differences at the dna level between people are also the basis of dna fingerprinting. fred shared the nobel prize with walter gilbert, at harvard university, and paul berg at stanford university. “ … with people like francis crick around it was difficult to ignore nucleic acids or to fail to realize the importance of sequencing them. ” fred sanger the structure of proteins inspired to start work on protein structure, max perutz, at the mrc unit for research on the molecular structure of biological systems ( now the mrc laboratory of molecular biology ) chose haemoglobin, the red pigment of blood whose major function is the transport of oxygen from the lungs to the tissues. consisting of four chains, it is, at the molecular level, a large protein. it took 25 years for its structure to be determined. john kendrew joined max at the unit and started work on a related, but smaller protein, myoglobin. myoglobin consists of just one chain, and is present in the muscle of mammals such as whales and seals, where it acts as an oxygen store during diving. in 1959 it became the first protein to have its three - dimensional structure determined. the haemoglobin structure followed just a few months later. max and john developed the technique of protein crystallography, which uses the way that crystals of proteins cause x - rays to change direction to produce unique patterns from which their


determined. the haemoglobin structure followed just a few months later. max and john developed the technique of protein crystallography, which uses the way that crystals of proteins cause x - rays to change direction to produce unique patterns from which their structures can be established. this technique is now used worldwide to determine the structure of large molecules. determining the structure and function of proteins helps us to understand malfunctioning proteins, which cause illnesses, such as sickle cell anaemia, and helps develop treatments for these. the mrc laboratory of molecular biology has major programmes on protein structure, harnessing techniques that rely on complex technologies. “ i think we pushed knowledge of living matter down to the atomic level and this enormously increased our depths of understanding of the nature of life. ” max perutz the structure of dna francis and jim were working on solving the structure of dna in the mrc unit for research on the molecular structure of biological systems ( now the mrc laboratory of molecular biology ). using experimental data, especially x - ray diffraction photographs from rosalind franklin and maurice wilkins at king ’ s college, london, they began the process of model building. they showed how the different components of dna interact in three dimensions to form a long spiraling molecule, with a double ‘ backbone ’ of sugar and phosphates. nitrogen - containing compounds, called bases, protrude from the two halves of the backbone and link together in pairs, so the whole molecule is like a zip. this is known as the double helix. the four types of bases form a sequence along the dna, and this is the ‘ genetic code ’ from which the whole body develops. the discovery immediately suggested the way in which dna is replicated : the two strands are ‘ unzipped ’ to allow the ‘ code ’ of bases to be copied. “ it is this specific pairing between bases that is the heart of the replication process ”. the unraveling of the helical structure of dna is hailed as one of the most significant landmarks of the 20th century. scientists have been able to build on this basic knowledge of dna, by applying it to issues of health and medicine, e. g. identifying ‘ faulty ’ genes, such as the cystic fibrosis gene and the brca1 and brca2 genes implicated in some breast cancers. francis and jim shared the nobel prize with maurice wilkins. “ it ’ s so beautiful, you see, so beautiful! ” jim watson for the first of his two nobel prizes in chemistry, fred sang


brca2 genes implicated in some breast cancers. francis and jim shared the nobel prize with maurice wilkins. “ it ’ s so beautiful, you see, so beautiful! ” jim watson for the first of his two nobel prizes in chemistry, fred sanger determined the entire sequence of the 51 amino acids in the protein insulin, and showed how they are linked together. insulin is an important natural hormone, which controls the level of glucose ( sugar ) in the blood, and is used in the treatment of diabetes. fred ’ s method involved separating the different fragments of the protein on filter paper and moving them with an electric current according to their electric charge. this created a distinct pattern on the paper, which fred called a ‘ fingerprint. ’ the information about these fragments then had to be reconstructed – like a puzzle – in the correct order to give the sequence or ‘ chemical structure. ’ after 12 years of dedicated research, this was the first time the chemical structure of a protein had been deduced. it demonstrated that the sequence of amino acids in protein chains determines the individual and physiological properties of the protein. fred ’ s methods could now be applied to proteins in general to explore their role as key substances for life. today, it is still necessary to use chemical means to determine protein sequences. “ in spite of the many difficulties and set - backs that one encounters i ’ m sure that scientific research must be one of the most fascinating and exciting occupations. ” fred sanger nobel quick facts 9 nobel prizes shared amongst 13 individuals fred sanger is the only person to have won 2 nobel prizes for chemistry a number of lmb alumni have also received nobel prizes ( lmb dates in italics ) : - john gurdon ( physiology or medicine ) scientific staff 1972 - 1983 - tom steitz ( chemistry ) postdoctoral fellow 1967 - 1970 - elizabeth blackburn ( physiology or medicine ) phd student 1971 - 1974 - martin chalfie ( chemistry ) postdoctoral staff 1977 - 1982 - andrew fire ( physiology or medicine ) postdoctoral fellow 1983 - 1986 - roger kornberg ( chemistry ) postdoctoral visitor 1972 - 1975 - richard roberts ( physiology or medicine ) visitor 1970, 1978 - 1979 - michael smith ( chemistry ) postdoctoral visitor 1975 - 1976 - sidney altman ( chemistry ) postdoctoral visitor 1969 - 1971 in 1962, the lmb was awarded 2 separate nobel prizes : francis crick and jim watson ( physiology or medicine ), and max perutz and john kendrew ( chemistry )


“ people first thought of having long - term survivor clinical programs about 20 years ago primarily because it wasn ’ t even until the late 1970s that you started to see an increasing number of children who were treated for various malignancies become survivors, ” says stuart toledano, m. d., who heads the clinic and is director of the division of pediatric hematology / oncology in the department of pediatrics at the miller school of medicine. “ we started to recognize a unique set of problems and late effects of their treatment, both medical as well as psychosocial, in this group of children and young adults who had survived cancer. and frankly there was no information in the literature about this group of patients because before long - term survival was rare. these kids would be the first generation to survive in large numbers, and they would go on to teach us everything we know, and their experiences impact how we treat children diagnosed today with cancer. ” the current treatment for hodgkin ’ s disease resulted directly from the lessons of this first generation of childhood survivors. mediastinal radiation, or radiation to the chest, was once considered the gold standard for treating children with hodgkin ’ s. but years later physicians at long - term survivors programs started seeing young men with shorter - than - normal torsos. “ we found radiation in kids has a very specific side effect and that ’ s the effect on growth. a lot of these kids received their radiation before puberty and their chests stopped growing, ” toledano says. “ i would have to explain to them, ‘ you can work out all you want, but because of the radiation, your chest is not going to expand. ’ it seems so simple now, but we had no way of knowing before, because so few lived long enough for us to find out. “ with girls we saw the same sort of thing, but it took longer. ten to 15 years after radiation they were developing a lot of breast cancer, but only in the middle part of the breast, where they received the radiation for their hodgkin ’ s. because of these experiences, today we use chemotherapy for hodgkin ’ s and avoid radiation altogether in most patients, with the same survival rate. ” a study recently published in the journal pediatrics by steven lipshultz, m. d., professor and chairman of the um department of pediatrics, found that long - term cancer survivor clinics are among the best places to conduct studies on the late effects of childhood cancers,


the journal pediatrics by steven lipshultz, m. d., professor and chairman of the um department of pediatrics, found that long - term cancer survivor clinics are among the best places to conduct studies on the late effects of childhood cancers, particularly cardiovascular complications caused by cancer treatments. “ doing these kinds of studies on long - term survivors helps us pick up not only serious medical problems, but trends as well, issues such as employment, psychological problems, and even insurance concerns, ” says lipshultz. “ these programs, if run properly, are very effective at helping us identify a multitude of potential physical, psychosocial, and economic problems among cancer survivors. ” children who come to toledano ’ s survivors program hear pretty much the same story, from the first day. “ i always tell them, ‘ i don ’ t know why you got cancer, but you did. ’ but the point is, there are very few alive today who had childhood leukemia in the 1950s and ’ 60s, and we are just now seeing a large number of people who have survived more than 20 years, so we have no idea what you can expect when you reach your 40s and 50s. it ’ s uncharted territory. “ so i tell them to do what they can to live a healthy lifestyle. avoid risks, avoid heavy drinking, absolutely do not smoke — whatever it is that makes you pre - disposed to cancer, avoid. for example, if you ’ ve survived a myeloid cancer, it ’ s probably not a good idea to become a house painter and be around a lot of fumes. why would you want to work around those kinds of things when you don ’ t know what caused your cancer the first time? ” s children survived longer and longer, more late effects of their cancer treatment became evident. one of the biggest areas of concern has been the impact of treatment on how a child learns. daniel armstrong, ph. d., associate chair of the department of pediatrics and director of the mailman center for child development, has been at the forefront internationally of studying the cognitive effects of cancer treatment. “ we knew when we looked at the first leukemia survivors in the late ’ 70s and early ’ 80s, virtually all had significant learning problems, and very few were over 5 feet tall because the radiation stunted their growth and interfered with growth and development of their brain, ” remembers armstrong. “ most of these first kids, over time, would have a decline of 20 to 70 iq points. it was disastrous


were over 5 feet tall because the radiation stunted their growth and interfered with growth and development of their brain, ” remembers armstrong. “ most of these first kids, over time, would have a decline of 20 to 70 iq points. it was disastrous. ” it was imperative for researchers to figure out how the treatments were affecting the developing brain. they began to see that the parts of the brain and functions that developed before treatment were relatively intact, but it was a different story for the part of the brain that developed after treatment. “ we did a study in babies under 3 who received high dose radiation for brain tumors, and they had problems in all areas — almost all were in the mentally retarded range, some severely, with lifelong severe disabilities, ” explains armstrong. “ but what we found is if we could give chemotherapy and delay radiation until age 4, we got about a 20 - point increase in their iq, and that makes the difference between a child who can learn and one who cannot. ” this work led armstrong ’ s team to develop a model that ’ s been reliably predictive of the impact treatment at a specific age would have on future learning. the most sensitive time for the brain is before birth, while the first three years are the second most crucial time, when gross motor ability and language develop. that ’ s why radiating a child before age 3 has such devastating effects. the primary development between ages 3 and 7 is in the frontal part of the brain, which is involved in attention, visual memory, speed of processing, and ability to organize and plan. after age 7 the impact of treatment on the brain is not as severe, but the front part of the brain does continue developing into the mid - 20s. “ by about 1990 we could identify the impact of treatment on learning, but there were no interventions, ” armstrong remembers. “ we could delay radiation, reduce some chemotherapy, but those treatments were associated with good survival, so most parents believed it was better to have a child with a learning problem than a dead child. “ i started working with a series of children having school - related problems and they are really the ones who get the credit — i just recognized the pattern. what i began to see is that these children treated before age 7 for brain tumors could learn when the information was going in their ears and coming out their mouths. but school is a read / write world, not a listen / speak world. ” armstrong ’ s team started developing an accommodation plan for these children that shifted them to a listen /


when the information was going in their ears and coming out their mouths. but school is a read / write world, not a listen / speak world. ” armstrong ’ s team started developing an accommodation plan for these children that shifted them to a listen / speak way of learning : books on tape, dictating their assignments on a tape recorder, voice - recognition software, and other technology. of the ten children they initially worked with, who at the time met the criteria for special education and mental retardation, nine have graduated from high school with a regular diploma, five have been american cancer society college scholarship recipients, and one has graduated cum laude from florida atlantic university. “ what we are working on now is a cognitive rehabilitation model that we can utilize during treatment, when the injury is happening, and drive through the injury by exercising the brain, ” armstrong says. “ where a child with cancer is today, the child of tomorrow won ’ t be there. they ’ ll be better. all of our concern when we first started was acute care : how do we keep these kids from dying? now the shift is clearly how do we lessen the late effects, how do we treat the consequences of our successes? we don ’ t know the answers, but we ’ re going to find them because we have the chance to. ” as with many things in medicine, the first hint of late effects of cancer treatment in children came through observation. “ i was taking care of children as a cardiologist in the mid - 1980s, and i started seeing kids with serious heart problems, and i would look back and see they had been treated with chemotherapy, ” recalls lipshultz. he published the first large study to show a link between late cardiac effects in children treated with doxorubicin ( adriamycin® ) for all in childhood. lipshultz estimates there are now more than 2, 000 papers on late cardiac effects that show increasing rates of heart failure, cardiac transplantation, and cardiac death in young adults previously treated for childhood cancer. but much like the cognitive late effects, the focus is now shifting to how to prevent the problem in the first place. a study published in the new england journal of medicine by lipshultz last summer could have huge implications for the thousands of children diagnosed with cancer every year. more than 200 children newly diagnosed with high - risk all were enrolled in this multicenter, randomized, controlled trial, conducted out of dana - farber cancer institute in boston. half of the children were


of children diagnosed with cancer every year. more than 200 children newly diagnosed with high - risk all were enrolled in this multicenter, randomized, controlled trial, conducted out of dana - farber cancer institute in boston. half of the children were treated using the standard multi - agent protocol for all, which includes doxorubicin. the other half were treated with an infusion of dexrazoxane ( zinecard® ) 30 minutes before receiving doxorubicin. dexrazoxane is a free - radical scavenger that has been found to protect the heart of adults receiving the same type of chemotherapy. “ the dexrazoxane therapy was associated with a large and statistically significant reduction in heart damage in the children who received it before their chemotherapy, ” lipshultz says. “ receiving the dexrazoxane had no impact on the effectiveness of the chemotherapy in the short term ; longer follow - up will determine the influence of dexrazoxane on survival and heart function. ” wenty - three - year - old meital cohen of miami received high doses of adriamycin when diagnosed with high - risk leukemia just before her 7th birthday. just over a year off treatment, she relapsed. she would come very close to death before a bone marrow transplant saved her life after a seven - year struggle. cohen visits the survivors clinic, but she doesn ’ t dwell on the possibility of cardiac problems down the road. “ i watch myself, i get my annual checkups, but i don ’ t worry about it. everyone ’ s life has problems, but i live a normal life like everyone else, ” says cohen. “ cancer doesn ’ t mean death — there is life after cancer, and i intend to enjoy it. ” a key area of new research is finding ways to keep kids with heart damage healthy. one way is through exercise, but it is not known which cancer patients would benefit from it most. tracie miller, m. d., director of clinical pediatric research at the miller school of medicine, is looking at genetic mutations of mitochondrial dna that may have been damaged in children undergoing chemotherapy. “ the mitochondria is the powerhouse that produces energy and is found in every cell in the body, ” explains miller. “ if you damage the dna you could actually impair the mitochondria from producing energy. so if you ’ re asking a muscle to work, with not enough power you could do more harm than good. ” miller ’ s


explains miller. “ if you damage the dna you could actually impair the mitochondria from producing energy. so if you ’ re asking a muscle to work, with not enough power you could do more harm than good. ” miller ’ s research team has been looking at children who received an anthracycline, such as adriamycin, to see if they have more genetic mutations in their mitochondria, then determine if those with more mutations don ’ t excel as well with exercise. “ our work has shown that childhood cancer survivors are at risk for a sedentary lifestyle, cholesterol problems, decreased bone density and obesity, so we want to promote exercise in some regard, but not at the risk of hurting their heart. ” on another warm summer day, 20 - year - old seth fishman goes for his six - month checkup at the long - term survivors comprehensive program just before returning to indiana university for the fall semester. at 15 he was diagnosed with hodgkin ’ s disease, but because of the children who came before him, he received no radiation, only chemotherapy. he ’ s new to survivorship — but as part of the second generation of childhood survivors, he ’ s grateful to those who came before him and knows he has a role to play. “ you worry that something might go wrong, it ’ s always in the back of your mind, and you ’ re certainly not ever going to forget it, ” says fishman. “ that ’ s why it ’ s important to come back and get checked and help stay on top of any problems that could crop up. cancer gives you a different outlook — you savor every moment of your life. ” aviel sanchez is making the most of his life. married for six years to his high school sweetheart, he ’ s just been promoted to sergeant in the miami - dade county police department, an agency he has served for more than ten years. meital cohen recently received her degree in architecture from the university of miami, and is already working on a development project. she hopes the doctors and nurses who cared for her never forget how grateful all the survivors are. “ they have a gift to help others, save others, ” cohen says, “ especially the children. ” jeanne antol krull is director of media relations in the office of communications at the miller school of medicine. photos by john zillioux and donna victor.


volume 5, number 1 — february 1999 campylobacter jejuni — an emerging foodborne pathogen campylobacter jejuni is the most commonly reported bacterial cause of foodborne infection in the united states. adding to the human and economic costs are chronic sequelae associated with c. jejuni infection — guillian - barre syndrome and reactive arthritis. in addition, an increasing proportion of human infections caused by c. jejuni are resistant to antimicrobial therapy. mishandling of raw poultry and consumption of undercooked poultry are the major risk factors for human campylobacteriosis. efforts to prevent human illness are needed throughout each link in the food chain. awareness of the public health implications of campylobacter infections has evolved over more than a century ( 1 ). in 1886, escherich observed organisms resembling campylobacters in stool samples of children with diarrhea. in 1913, mcfaydean and stockman identified campylobacters ( called related vibrio ) in fetal tissues of aborted sheep ( 1 ). in 1957, king described the isolation of related vibrio from blood samples of children with diarrhea, and in 1972, clinical microbiologists in belgium first isolated campylobacters from stool samples of patients with diarrhea ( 1 ). the development of selective growth media in the 1970s permitted more laboratories to test stool specimens for campylobacter. soon campylobacter spp. were established as common human pathogens. campylobacter jejuni infections are now the leading cause of bacterial gastroenteritis reported in the united states ( 2 ). in 1996, 46 % of laboratory - confirmed cases of bacterial gastroenteritis reported in the centers for disease control and prevention / u. s. department of agriculture / food and drug administration collaborating sites foodborne disease active surveillance network were caused by campylobacter species. campylobacteriosis was followed in prevalence by salmonellosis ( 28 % ), shigellosis ( 17 % ), and escherichia coli o157 infection ( 5 % ) ( figure 1 ). in the united states, an estimated 2. 1 to 2. 4 million cases of human campylobacter - iosis ( illnesses ranging from loose stools to dysentery ) occur each year ( 2 ). commonly reported symptoms of patients with laboratory - confirmed infections ( a small subset of all cases )


million cases of human campylobacter - iosis ( illnesses ranging from loose stools to dysentery ) occur each year ( 2 ). commonly reported symptoms of patients with laboratory - confirmed infections ( a small subset of all cases ) include diarrhea, fever, and abdominal cramping. in one study, approximately half of the patients with laboratory - confirmed campylobacter - iosis reported a history of bloody diarrhea ( 3 ). less frequently, c. jejuni infections produce bacteremia, septic arthritis, and other extraintestinal symptoms ( 4 ). the incidence of campylobacteriosis in hiv - infected patients is higher than in the general population. for example, in los angeles county between 1983 and 1987, the reported incidence of campylobacteriosis in patients with aids was 519 cases per 100, 000 population, 39 times higher than the rate in the general population. ( 5 ). common complications of campylobacteriosis in hiv - infected patients are recurrent infection and infection with antimicrobial - resistant strains ( 6 ). deaths from c. jejuni infection are rare and occur primarily in infants, the elderly, and patients with underlying illnesses ( 2 ). sequelae to infection guillain - barre syndrome ( gbs ), a demyelating disorder resulting in acute neuromuscular paralysis, is a serious sequela of campylobacter infection ( 7 ). an estimated one case of gbs occurs for every 1, 000 cases of campylobacteriosis ( 7 ). up to 40 % of patients with the syndrome have evidence of recent campylobacter infection ( 7 ). approximately 20 % of patients with gbs are left with some disability, and approximately 5 % die despite advances in respiratory care. campylobacteriosis is also associated with reiter syndrome, a reactive arthropathy. in approximately 1 % of patients with campylobacteriosis, the sterile postinfection process occurs 7 to 10 days after onset of diarrhea ( 8 ). multiple joints can be affected, particularly the knee joint. pain and incapacitation can last for months or become chronic. both gbs and reiter syndrome are thought to be autoimmune responses stimulated by infection. many patients with reiter syndrome carry the hla b27 antigenic marker ( 8 ). the pathogenesis of gbs ( 9 ) and reiter syndrome is not completely understood


syndrome are thought to be autoimmune responses stimulated by infection. many patients with reiter syndrome carry the hla b27 antigenic marker ( 8 ). the pathogenesis of gbs ( 9 ) and reiter syndrome is not completely understood. treatment of c. jejuni infections supportive measures, particularly fluid and electrolyte replacement, are the principal therapies for most patients with campylobacteriosis ( 10 ). severely dehydrated patients should receive rapid volume expansion with intravenous fluids. for most other patients, oral rehydration is indicated. although campylobacter infections are usually self limiting, antibiotic therapy may be prudent for patients who have high fever, bloody diarrhea, or more than eight stools in 24 hours ; immunosuppressed patients, patients with bloodstream infections, and those whose symptoms worsen or persist for more than 1 week from the time of diagnosis. when indicated, antimicrobial therapy soon after the onset of symptoms can reduce the median duration of illness from approximately 10 days to 5 days. when treatment is delayed ( e. g., until c. jejuni infection is confirmed by a medical laboratory ), therapy may not be successful ( 10 ). ease of administration, lack of serious toxicity, and high degree of efficacy make erythromycin the drug of choice for c. jejuni infection ; however, other antimicrobial agents, particularly the quinolones and newer macrolides including azithromycin, are also used. the increasing rate of human infections caused by antimicrobial - resistant strains of c. jejuni makes clinical management of cases of campylobacteriosis more difficult ( 11, 12 ). antimicrobial resistance can prolong illness and compromise treatment of patients with bacteremia. the rate of antimicrobial - resistant enteric infections is highest in the developing world, where the use of antimicrobial drugs in humans and animals is relatively unrestricted. a 1994 study found that most clinical isolates of c. jejuni from u. s. troops in thailand were resistant to ciprofloxacin. additionally, nearly one third of isolates from u. s. troops located in hat yai were resistant to azithromycin ( 11 ). in the industrialized world, the emergence of fluoroquinolone - resistant strains of c. jejuni illustrates the need for prudent anti


. troops located in hat yai were resistant to azithromycin ( 11 ). in the industrialized world, the emergence of fluoroquinolone - resistant strains of c. jejuni illustrates the need for prudent antimicrobial use in food - animal production ( 12 ). experimental evidence demonstrates that fluoroquinolone - susceptible c. jejuni readily become drug - resistant in chickens when these drugs are administered ( 13 ). after flouroquinolone use in poultry was approved in europe, resistant c. jejuni strains emerged rapidly in humans during the early 1990s ( 12 ). similarly, within 2 years of the 1995 approval of fluoroquinolone use for poultry in the united states, the number of domestically acquired human cases of ciprofloxacin - resistant campylobacteriosis doubled in minnesota ( 14 ). in a 1997 study conducted in minnesota, 12 ( 20 % ) of 60 c. jejuni isolates obtained from chicken purchased in grocery stores were ciprofloxacin - resistant ( 14 ). the pathogenesis of c. jejuni infection involves both host - and pathogen - specific factors. the health and age of the host ( 2 ) and c. jejuni - specific humoral immunity from previous exposure ( 15 ) influence clinical outcome after infection. in a volunteer study, c. jejuni infection occurred after ingestion of as few as 800 organisms ( 16 ). rates of infection increased with the ingested dose. rates of illness appeared to increase when inocula were ingested in a suspension buffered to reduce gastric acidity ( 16 ). many pathogen - specific virulence determinants may contribute to the pathogenesis of c. jejuni infection, but none has a proven role ( 17 ). suspected determinants of pathogenicity include chemotaxis, motility, and flagella, which are required for attachment and colonization of the gut epithelium ( figure 2 ) ( 17 ). once colonization occurs, other possible virulence determinants are iron acquisition, host cell invasion, toxin production, inflammation and active secretion, and epithelial disruption with leakage of serosal fluid ( 17 ). survival in the environment survival of c. jejuni outside the gut is poor, and replication does not occur readily ( 17 ). c. jejuni grows best at 37°c to 42°c ( 18 ), the approximate body temperature


survival in the environment survival of c. jejuni outside the gut is poor, and replication does not occur readily ( 17 ). c. jejuni grows best at 37°c to 42°c ( 18 ), the approximate body temperature of the chicken ( 41°c to 42°c ). c. jejuni grows best in a low oxygen or microaerophilic environment, such as an atmosphere of 5 % o2, 10 % co2, and 85 % n2. the organism is sensitive to freezing, drying, acidic conditions ( ph < 5. 0 ), and salinity. sample collection and transport if possible, stool specimens should be chilled ( not frozen ) and submitted to a laboratory within 24 hours of collection. storing specimens in deep, airtight containers minimizes exposure to oxygen and desiccation. if a specimen cannot be processed within 24 hours or is likely to contain small numbers of organisms, a rectal swab placed in a specimen transport medium ( e. g., cary - blair ) should be used. individual laboratories can provide guidance on specimen handling procedures ( 18 ). numerous procedures are available for recovering c. jejuni from clinical specimens ( 18 ). direct plating is cost - effective for testing large numbers of specimens ; however, testing sensitivity may be reduced. preenrichment ( raising the temperature from 36°c to 42°c over several hours ), filtration, or both are used in some laboratories to improve recovery of stressed c. jejuni organisms from specimens ( e. g., stored foods or swabs exposed to oxygen ) ( 19 ). isolation can be facilitated by using selective media containing antimicrobial agents, oxygen quenching agents, or a low oxygen atmosphere, thus decreasing the number of colonies that must be screened ( 18, 19 ). subtyping of isolates no standard subtyping technique has been established for c. jejuni. soon after the organism was described, two serologic methods were developed, the heat - stable or somatic o antigen ( 20 ) and the heat - labile antigen schemes ( 21 ). these typing schemes are labor intensive, and their use is limited almost exclusively to reference laboratories. many different dna - based subtyping schemes have been developed, including pulsed - field gel electrophoresis ( pfge ) and randomly amplified polymorphic dna ( rapd ) analysis ( 22 ). various typing schemes have been developed on the basis of the sequence of fl


526 | | 1982 - 1983 | | hmo patients | | washington state | | undercooked chicken | | animals with diarrhea | | 30, 34 | | 29 | | 42 | | 1990 | | residents of manchester | | england | | bottled milka | | 33 | | 53 | | 106 | | 1982 - 1983 | | rural children | | iowa | | raw milk | | 32 | | 40 | | 80 | | 1981 | | residents of denver ft. collins | | colorado | | untreated water, raw milk, undercooked chicken | | cats | | 29 | | 54 | | 54 | | 1982 | | residents of rotterdam | | netherlands | | chicken, pork, barbequed foods | | 28 | | 10 | | 15 | | 1982 | | residents of larimer county | | colorado | | preparing chicken | | 26 | | 55 | | 14 | | 1980 | | residents of goteborg | | sweden | | preparing chicken | | kitten dog with diarrhea | | 25 | abottle tops pecked by wild birds. in the united states, infants have the highest age - specific campylobacter isolation rate, approximately 14 per 100, 000 person years. as children get older, isolation rates decline to approximately 4 per 100, 000 person years for young adolescents. a notable feature of the epidemiology of human campylobacteriosis is the high isolation rate among young adults, approximately 8 per 100, 000 person years. among middle - aged and older adults, the isolation rate is < 3 per 100, 000 person years ( 2 ). the peak isolation rate in neonates and infants is attributed in part to susceptibility on first exposure and to the low threshold for seeking medical care for infants ( 2 ). the high rate of infection during early adulthood, which is pronounced among men, is thought to reflect poor food - handling practices in a population that, until recently, relied on others to prepare meals ( 2 ). the ecology of c. jejuni involves wildlife reservoirs, particularly wild birds. species that carry c. jejuni include migratory birds — ranes, ducks, geese ( 36 ), and seagulls ( 37 ). the organism is also found in other wild and domestic bird species, as well as in rodents ( 38 ). insects can carry the organism on their exoskeleton ( 39 ). the intestines of poultry are easily colonized with c. jejun


also found in other wild and domestic bird species, as well as in rodents ( 38 ). insects can carry the organism on their exoskeleton ( 39 ). the intestines of poultry are easily colonized with c. jejuni. day - old chicks can be colonized with as few as 35 organisms ( 40 ). most chickens in commercial operations are colonized by 4 weeks ( 41, 42 ). vertical transmission ( i. e., from breeder flocks to progeny ) has been suggested in one study but is not widely accepted ( 43 ). reservoirs in the poultry environment include beetles ( 39 ), unchlorinated drinking water ( 44 ), and farm workers ( 41, 42, 45 ). feeds are an unlikely source of campylobacters since they are dry and campylobacters are sensitive to drying. c. jejuni is a commensal organism of the intestinal tract of cattle ( 46 ). young animals are more often colonized than older animals, and feedlot cattle are more likely than grazing animals to carry campylobacters ( 47 ). in one study, colonization of dairy herds was associated with drinking unchlorinated water ( 48 ). campylobacters are found in natural water sources throughout the year. the presence of campylobacters is not clearly correlated with indicator organisms for fecal contamination ( e. g., e. coli ) ( 49 ). in temperate regions, organism recovery rates are highest during the cold season ( 49, 50 ). survival in cold water is important in the life cycle of campylobacters. in one study, serotypes found in water were similar to those found in humans ( 50 ). when stressed, campylobacters enter a " viable but nonculturable state, " characterized by uptake of amino acids and maintenance of an intact outer membrane but inability to grow on selective media ; such organisms, however, can be transmitted to animals ( 51 ). additionally, unchlorinated drinking water can introduce campylobacters into the farm environment ( 44, 48 ). campylobacter in the food supply c. jejuni is found in many foods of animal origin. surveys of raw agricultural products support epidemiologic evidence implicating poultry, meat, and raw milk as sources of human infection. most retail chicken is contaminated with c. jejuni ; one study reported an isolation rate of 98 % for retail


of raw agricultural products support epidemiologic evidence implicating poultry, meat, and raw milk as sources of human infection. most retail chicken is contaminated with c. jejuni ; one study reported an isolation rate of 98 % for retail chicken meat ( 52 ). c. jejuni counts often exceed 103 per 100 g. skin and giblets have particularly high levels of contamination. in one study, 12 % of raw milk samples from dairy farms in eastern tennessee were contaminated with c. jejuni ( 53 ). raw milk is presumed to be contaminated by bovine feces ; however, direct contamination of milk as a consequence of mastitis also occurs ( 54 ). campylobacters are also found in red meat. in one study, c. jejuni was present in 5 % of raw ground beef and in 40 % of veal specimens ( 55 ). control of campylobacter infection on the farm control of campylobacter contamination on the farm may reduce contamination of carcasses, poultry, and red meat products at the retail level ( 27 ). epidemiologic studies indicate that strict hygiene reduces intestinal carriage in food - producing animals ( 41, 42, 45 ). in field studies, poultry flocks that drank chlorinated water had lower intestinal colonization rates than poultry that drank unchlorinated water ( 42, 44 ). experimentally, treatment of chicks with commensal bacteria ( 56 ) and immunization of older birds ( 57 ) reduced c. jejuni colonization. because intestinal colonization with campylobacters readily occurs in poultry flocks, even strict measures may not eliminate intestinal carriage by food - producing animals ( 39, 41 ). slaughter and processing provide opportunities for reducing c. jejuni counts on food - animal carcasses. bacterial counts on carcasses can increase during slaughter and processing steps. in one study, up to a 1, 000 - fold increase in bacterial counts on carcasses was reported during transportation to slaughter ( 58 ). in studies of chickens ( 59 ) and turkeys ( 60 ) at slaughter, bacterial counts increased by approximately 10 - to 100 - fold during defeathering and reached the highest level after evisceration. however, bacterial counts on carcasses decline during other slaughter and processing steps. in one study, forced - air chilling of swine carcasses caused a 100 - fold reduction in carcass contamination ( 61 ). in texas turkey plants,


however, bacterial counts on carcasses decline during other slaughter and processing steps. in one study, forced - air chilling of swine carcasses caused a 100 - fold reduction in carcass contamination ( 61 ). in texas turkey plants, scalding reduced carcass counts to near or below detectable levels ( 60 ). adding sodium chloride or trisodium phosphate to the chiller water in the presence of an electrical current reduced c. jejuni contamination of chiller water by 2 log10 units ( 62 ). in a slaughter plant in england, use of chlorinated sprays and maintenance of clean working surfaces resulted in a 10 - to 100 - fold decrease in carcass contamination ( 63 ). in another study, lactic acid spraying of swine carcasses reduced counts by at least 50 % to often undetectable levels ( 64 ). a radiation dose of 2. 5 kgy reduced c. jejuni levels on retail poultry by 10 log10 units ( 65 ). c. jejuni, first identified as a human diarrheal pathogen in 1973, is the most frequently diagnosed bacterial cause of human gastroenteritis in the united states. sequelae including gbs and reactive arthritis are increasingly recognized, adding to the human and economic cost of illness from human campylobacteriosis. the emergence of fluoroquinolone - resistant infections in europe and the united states, temporally associated with the approval of fluoroquinolone use in veterinary medicine, is also a public health concern. the consumption of undercooked poultry and cross - contamination of other foods with drippings from raw poultry are leading risk factors for human campylobacteriosis. reinforcing hygienic practices at each link in the food chain — from producer to consumer — is critical in preventing the disease. dr. altekruse is a public health service epidemiology fellow with the food and drug administration, center for veterinary medicine. his current research interest is antimicrobial - resistant foodborne pathogens. - kist m. the historical background of campylobacter infection : new aspects. in : pearson ad, editor. proceedings of the 3rd international workshop on campylobacter infections ; ottawa ; 1985 jul 7 - 10. london : public health laboratory service ; 1985. p. 23 - 7. - tauxe rv. epidemiology of campylobacter jejuni infections in the united states and other industrial nations


; 1985 jul 7 - 10. london : public health laboratory service ; 1985. p. 23 - 7. - tauxe rv. epidemiology of campylobacter jejuni infections in the united states and other industrial nations. in : nachamkin i, blaser mj, tompkins ls, editors. campylobacter jejuni : current and future trends. washington : american society for microbiology ; 1992. p. 9 - 12. - blaser mj, wells jg, feldman ra, pollard ra, allen jr. the collaborative diarrheal disease study group. campylobacter enteritis in the united states : a multicenter study. ann intern med. 1983 ; 98 : 360 – 5. - peterson mc. clinical aspects of campylobacter jejuni infections in adults. west j med. 1994 ; 161 : 148 – 52. - sorvillo fj, lieb le, waterman sh. incidence of campylobacteriosis among patients with aids in los angeles county. j acquir immune defic syndr hum retrovirol. 1991 ; 4 : 598 – 602. - perlman dj, ampel nm, schifman rb, cohn dl, patton cm, aguirre ml, persistent campylobacter jejuni infections in patients infected with the human immunodeficiency virus ( hiv ). ann intern med. 1988 ; 108 : 540 – 6. - allos bm. association between campylobacter infection and guillain - barre syndrome. j infect dis. 1997 ; 176 : s125 – 8. - peterson mc. rheumatic manifestations of campylobacter jejuni and c. fetus infections in adults. scand j rheumatol. 1994 ; 23 : 167 – 70. - shoenfeld y, george j, peter jb. guillain - barre as an autoimmune disease. int arch allergy immunol. 1996 ; 109 : 318 – 26. - blaser mj. campylobacter species. in : principles and practice of infectious diseases. mandell gl, douglas rg, bennett je, editors. 3rd ed. new york : churchill livingstone, 1990 ; 194 : 1649 - 58. - murphy gs jr, echeverria p, jackson lr, arness mk,


mandell gl, douglas rg, bennett je, editors. 3rd ed. new york : churchill livingstone, 1990 ; 194 : 1649 - 58. - murphy gs jr, echeverria p, jackson lr, arness mk, lebron c, pitarangsi c. ciprofloxacin - and azithromycin - resistant campylobacter causing traveler ' s diarrhea in u. s. troops deployed to thailand in 1994. clin infect dis. 1996 ; 22 : 868 – 9. - piddock ljv. quinolone resistance and campylobacter spp. antimicrob agents chemother. 1995 ; 36 : 891 – 8. - jacobs - reitsma wf, kan ca, bolder nm. the induction of quinolone resistance in campylobacter bacteria in broilers by quinolone treatment. in : campylobacters, helicobacters, and related organisms. newell dg, ketley jm, feldman ra, editors. new york : plenum press ; 1996. p. 307 - 11. - smith ke, besser jm, leano f, bender j, wicklund j, johnson b, fluoroquinolone - resistant campylobacter isolated from humans and poultry in minnesota [ abstract ]. program of the 1st international conference on emerging infectious diseases ; atlanta, georgia ; 1998 mar 7 - 10. atlanta : centers for disease control and prevention ; 1998. - blaser mj, sazie e, williams lp jr. the influence of immunity on raw milk - associated campylobacter infection. jama. 1987 ; 257 : 43 – 6. - black re, levine mm, clements ml, hughes tp, blaser mj. experimental campylobacter jejuni infection in humans. j infect dis. 1988 ; 157 : 472 – 9. - ketley jm. pathogenesis of enteric infection by campylobacter. microbiology. 1997 ; 143 : 5 – 21. - nachamkin i. campylobacter and arcobacter. in : manual of clinical microbiology. 6th ed. washington : asm press ; 1995. p. 483 - 91. - humphrey tj. an appraisal of the efficacy of pre - enrichment for the isolation of campylobacter jejuni


clinical microbiology. 6th ed. washington : asm press ; 1995. p. 483 - 91. - humphrey tj. an appraisal of the efficacy of pre - enrichment for the isolation of campylobacter jejuni from water and food. j appl bacteriol. 1989 ; 66 : 119 – 26. - penner jl, hennessy jn, congi rv. serotyping of campylobacter jejuni and campylobacter coli on the basis of thermostable antigens. eur j clin microbiol infect dis. 1983 ; 2 : 378 – 83. - lior h, woodward dl, edgar ja, laroche lj, gill p. serotyping of campylobacter jejuni by slide agglutination based on heat - labile antigenic factors. j clin microbiol. 1982 ; 15 : 761 – 8. - hilton ac, mortiboy d, banks jg, penn cw. rapd analysis of environmental, food and clinical isolates of campylobacter spp. fems immunol med microbiol. 1997 ; 18 : 119 – 24. - meinersmann rj, helsel lo, fields pi, hiett kl. discrimination of campylobacter jejuni isolates by fla gene sequencing. j clin microbiol. 1997 ; 35 : 2810 – 4. - harrington cs, thomson - carter fm, carter pe. evidence for recombination in the flagellin locus of campylobacter jejuni : implications for the flagellin gene typing scheme. j clin microbiol. 1997 ; 35 : 2386 – 92. - norkrans g, svedhem a. epidemiologic aspects of campylobacter jejuni enteritis. journal of hygiene ( cambridge ). 1982 ; 89 : 163 – 70. - hopkins rs, scott as. handling raw chicken as a source for sporadic campylobacter jejuni infections [ letter ]. j infect dis. 1983 ; 148 : 770. - kapperud g, skjerve e, bean nh, ostroff sm, lassen j. risk factors for sporadic campylobacter infections : results of a case - control study in southeastern norway. j clin microbiol. 1992 ; 30 : 3117


microbiol. 1994 ; 18 : 333 – 6. - stern nj, line je. comparison of three methods for recovery of campylobacter spp. from broiler carcasses. j food prot. 1992 ; 55 : 663 – 6. - rohrbach bw, draughon fa, davidson pm, oliver sp. prevalence of listeria monocytogenes, campylobacter jejuni, yersinia enterocolitica, and salmonella in bulk tank milk : risk factors and risk of human exposure. j food prot. 1992 ; 55 : 93 – 7. - hudson pj, vogt rl, brondum j, patton cm. isolation of campylobacter jejuni from milk during an outbreak of campylobacteriosis. j infect dis. 1984 ; 150 : 789. - lammerding am, garcia mm, mann ed, robinson y, dorward wj, truscott rb, prevalence of salmonella and thermophilic campylobacter in fresh pork, beef, veal, and poultry in canada. j food prot. 1988 ; 51 : 47 – 52. - stern nj. mucosal competitive exclusion to diminish colonization of chickens by campylobacter jejuni. poult sci. 1994 ; 73 : 402 – 7. - widders pr, perry r, muir wi, husband aj, long ka. immunization of chickens to reduce intestinal colonization with campylobacter jejuni. br poult sci. 1996 ; 37 : 765 – 8. - stern nj, clavero mrs, bailey js, cox na, robach mc. campylobacter spp. in broilers on the farm and after transport. poult sci. 1995 ; 74 : 937 – 41. - izat al, gardner fa, denton jh, golan fa. incidence and levels of campylobacter jejuni in broiler processing. poult sci. 1988 ; 67 : 1568 – 72. - acuff gr, vanderzant c, hanna mo, ehlers jg, golan fa, gardner fa. prevalence of campylobacter jejuni in turkey carcasses during further processing of turkey products. j food prot. 1986 ; 49 : 712 – 7. - oosterom j, de


##lan fa, gardner fa. prevalence of campylobacter jejuni in turkey carcasses during further processing of turkey products. j food prot. 1986 ; 49 : 712 – 7. - oosterom j, de wilde gja, de boer e, de blaauw lh, karman h. survival of campylobacter jejuni during poultry processing and pig slaughtering. j food prot. 1983 ; 46 : 702 – 6. - li yb, walker jt, slavik mf, wang h. electrical treatment of poultry chiller water to destroy campylobacter jejuni. j food prot. 1995 ; 58 : 1330 – 4. - mead gc, hudson wr, hinton mh. effect of changes in processing to improve hygiene control on contamination of poultry carcasses with campylobacter. epidemiol infect. 1995 ; 115 : 495 – 500. - epling lk, carpenter ja, blankenship lc. prevalence of campylobacter spp. and salmonella spp. on pork carcasses and the reduction effected by spraying with lactic acid. j food prot. 1993 ; 56 : 536 – 7, 540. - patterson mf. sensitivity of campylobacter spp. to irradiation in poultry meat. lett appl microbiol. 1995 ; 20 : 338 – 40. suggested citation : altedruse sf, stern nj, fields pi, swerdlow dl. campylobacter jejuni — an emerging foodborne pathogen. emerg infect dis [ serial on the internet ]. 1999, feb [ date cited ]. available from http : / / wwwnc. cdc. gov / eid / article / 5 / 1 / 99 - 0104. htm


a ring of radiation previously unknown to science fleetingly surrounded earth last year before being virtually annihilated by a powerful interplanetary shock wave, scientists say. nasa ' s twin van allen space probes, which are studying the earth ' s radiation belts, made the cosmic find. the surprising discovery — a new, albeit temporary, radiation belt around earth — reveals how much remains unknown about outer space, even those regions closest to the planet, researchers added. after humanity began exploring space, the first major find made there were the van allen radiation belts, zones of magnetically trapped, highly energetic charged particles first discovered in 1958. " they were something we thought we mostly understood by now, the first discovery of the space age, " said lead study author daniel baker, a space scientist at the university of colorado. these belts were believed to consist of two rings : an inner zone made up of both high - energy electrons and very energetic positive ions that remains stable in intensity over the course of years to decades ; and an outer zone comprised mostly of high - energy electrons whose intensity swings over the course of hours to days depending primarily on the influence from the solar wind, the flood of radiation streaming from the sun. [ how nasa ' s twin radiation probes work ( infographic ) ] the discovery of a temporary new radiation belt now has scientists reviewing the van allen radiation belt models to understand how it occurred. radiation rings around earth the giant amounts of radiation the van allen belts generate can pose serious risks for satellites. to learn more about them, nasa launched twin spacecraft, the van allen probes, in the summer of 2012. the satellites were armed with a host of sensors to thoroughly analyze the plasma, energetic particles, magnetic fields and plasma waves in these belts with unprecedented sensitivity and resolution. unexpectedly, the probes revealed a new radiation belt surrounding earth, a third one made of super - high - energy electrons embedded in the outer van allen belt about 11, 900 to 13, 900 miles ( 19, 100 to 22, 300 kilometers ) above the planet ' s surface. this stable ring of space radiation apparently formed on sept. 2 and lasted for more than four weeks. " the feature was so surprising, i initially foolishly thought the instruments on the probes weren ' t working properly, but i soon realized the lab had built such wonderful instruments that there wasn ' t anything wrong with them, so what we saw must be true, " baker said. this newfound radiation belt then abruptly and almost completely disappeared on oct. 1. it was apparently disrupted by


realized the lab had built such wonderful instruments that there wasn ' t anything wrong with them, so what we saw must be true, " baker said. this newfound radiation belt then abruptly and almost completely disappeared on oct. 1. it was apparently disrupted by an interplanetary shock wave caused by a spike in solar wind speeds. " more than five decades after the original discovery of these radiation belts, you can still find new unexpected things there, " baker said. " it ' s a delight to be able to find new things in an old domain. we now need to re - evaluate them thoroughly both theoretically and observationally. " a radiation mystery it remains uncertain how this temporary radiation belt arose. van allen mission scientists suspect it was likely created by the solar wind tearing away the outer van allen belt. " it looks like its existence may have been bookended by solar disturbances, " baker said. future study of the van allen belts can reveal if such temporary rings of radiation are common or rare. " do these occur frequently, or did we get lucky and see a very rare circumstance that happens only once in a while? " baker said. " and what other unusual revelations might come now that we are really looking at these radiation belts with new, modern tools? " the scientists detailed their findings online feb. 28 in the journal science. - nasa ' s radiation belt storm probe mission in pictures - how nasa ' s twin radiation belt storm probes work ( infographic ) - earth quiz : do you really know your planet?


common names in english : nodding groundsel, nodding ragwort the largest family of flowering plants, the compositae ( asteraceae ), comprising about 1, 100 genera and more than 20, 000 species and characterized by many small flowers arranged in a head looking like a single flower and subtended by an involucre of bracts. a head may consist of both ray flowers and disk flowers, as in the sunflower, of disk flowers only, as in the burdock, or of ray flowers only, as in the dandelion. the senecioneae are a tribe of closely related genera that can be recognized most readily by the nature of the pappus and the involucral bracts or phyllaries. the phyllaries are basically in one well developed, often partially or wholly connate series of equal length that closely envelope the head. frequently there are a few, very much smaller and mostly randomly distributed, often necrotic - tipped bracts near the base of the main series. the pappus is of fine, soft, often pure white capillary hairs. heads may be either discoid or radiate. - - gerald carr., biennials, perennials, or shrubs, 5 - 100 ( - 250 + ) cm ( perennating taprooted, fibrous - rooted, branched caudices, or suberect to creeping, seldom branched ; herbage, often glabrescent at flowering ). stems single or clustered, erect or branched ). leaves basal and / or cauline ; alternate ; petiolate or sessile ( bases sometimes clasping ) ; blades subpalmately to pinnately nerved, mostly ovate or deltate to oblanceolate, lanceolate, linear, or filiform ( and most intermediate shapes ), rarely suborbiculate ( sometimes palmately or pinnately lobed to 2 - 3 - pinnatifid ), ultimate entire or denticulate to serrate or toothed ( sometimes with relatively many callous or teeth ), faces glabrous or hairy ( usually arachnose to tomentose, often glabrescent ). heads ( sometimes nodding ) usually radiate ( rarely quasi - disciform ), usually in corymbiform to cymiform, sometimes paniculiform, arrays ( sometimes from axils of distal leaves ), sometimes borne singly. calyculi usually of 1


usually radiate ( rarely quasi - disciform ), usually in corymbiform to cymiform, sometimes paniculiform, arrays ( sometimes from axils of distal leaves ), sometimes borne singly. calyculi usually of 1 - 8 + bractlets ( bractlets often intergrading with distal peduncular bracts, mostly 1 / 5 - 1 / 2 + times phyllaries ), sometimes 0. involucres mostly cylindric, 5 - 15 ( - 40 ) mm diam. phyllaries persistent, usually ± 5, 8, 13, or 21 in ( 1 - ) 2 series, distinct ( margins interlocking ), erect ( often reflexed in fruit ), mostly oblong to lanceolate or linear, subequal or equal, margins usually scarious. receptacles flat to convex, foveolate, epaleate. ray florets usually ± 5, 8, 13, or 21, pistillate, sometimes 0 ; corollas usually yellow, sometimes ochroleucous or white, rarely reddish to purplish ( laminae sometimes barely surpassing phyllaries ; peripheral pistillate florets usually 0, sometimes 1 - 8 + ; corollas usually yellow, sometimes ochroleucous or white ). disc florets ( 5 - ) 13 - 80 +, bisexual, fertile ; corollas usually yellow, rarely ochroleucous, white, reddish, or purplish, tubes shorter than to equaling campanulate throats, lobes 5, erect to recurved, usually ± deltate ; style branches stigmatic in 2 lines, apices usually truncate - penicillate. cypselae cylindric or prismatic, usually 5 - ribbed or - angled, glabrous or hairy ( especially on ribs sometimes myxogenic ) ; pappi usually persistent ( fragile ), sometimes readily falling, of 30 - 80 +, white to stramineous. x = 10. species 1000 + : nearly worldwide, mostly in warm - temperate, subtropical, and tropical regions at mid and upper elevations. the concept of senecio in traditional north american floristics stems from nineteenth century botanists who saw the genus as a diverse assemblage held together by similar morphologies of the heads and florets. studies in the past two decades have shown senecio in the broad sense to be a collection


from nineteenth century botanists who saw the genus as a diverse assemblage held together by similar morphologies of the heads and florets. studies in the past two decades have shown senecio in the broad sense to be a collection of separate lineages ; a better taxonomy is to be had by treating the lineages as genera. some of the lineages were recognized in the past as infrageneric assemblages. a treatment of senecio by t. m. barkley ( 1978 ) reflected the traditional circumscription of the genus ; a narrower circumscription is used here. present concepts, plus a catalogue of genera, were presented by barkley ( 1999 ). the " species - groups " recognized here are given names purely as a matter of convenience ; the groups and their names are intentionally given no formal taxonomic status ( t. m. barkley 1978 ). some of the groups may represent natural evolutionary alliances ; that remains to be clarified. the following taxa are not established members of the flora but are nonetheless noteworthy : senecio brasiliensis ( sprengel ) lessing var. tripartitus ( de candolle ) baker is a south american weed of disturbed sites, introduced on the gulf coast near pensacola, florida, in 1893 - 1894. its presence was discussed by j. m. greenman ( 1917 ) and by l. j. uttal ( 1982 ), both of whom treated it as senecio canabinaefolius hooker & arnott. it is toxic to livestock ; it seems not to have persisted in the flora. senecio bicolor ( willdenow ) viviani ( s. cineraria de candolle ) is one of the plants called " dusty miller " in the horticultural trade. it occasionally persists in the flora after cultivation. species of the african genus euryops are commonly cultivated in california and florida and, to a lesser extent, in other warm areas of the flora. they would key here to senecio. they are shrubs with leaves dissected or prominently toothed, phyllaries connate for the proximal third of their lengths, and yellow corollas. apparently none persist for long after cultivation. relatively recent collections from low - lying ( 50 - 100 m ), seasonally wet, disturbed areas in orange and san diego counties, california, have included semi - weedy perennial herbs or subshrubs 100 - 200 cm that are initially arachnose


from low - lying ( 50 - 100 m ), seasonally wet, disturbed areas in orange and san diego counties, california, have included semi - weedy perennial herbs or subshrubs 100 - 200 cm that are initially arachnose to tomentose, soon glabrescent, and have oblanceolate to linear or filiform leaves ( 2 - 7 cm ), notably small heads in corymbiform arrays, ± 13 phyllaries 3 - 4 mm, and 7 - 8 ray florets with corolla laminae 2 - 3 mm. g. l. nesom ( pers. comm. ) has suggested that these plants are senecio linearifolius a. richard, a native of australia and tasmania. references to shapes, sizes, bases, margins, induments, etc., of " leaves " in keys and descriptions refer to principal ( largest, most conspicuous ) leaves at flowering unless otherwise indicated. species senecio bigelovii, ( 20 - ) 40 - 80 ( - 120 ) cm ( caudices fibrous - rooted ). herbage usually floccose - tomentose to glabrescent. stems single or loosely clustered. leaves progressively reduced distally ; petiolate ) ; blades to lanceolate, 7 - 15 × ( 1 - ) 2 - 5 cm, bases or serrate to dentate ( mid and distal leaves similar, sessile, bractlike, often clasping ). heads nodding when young ), ( 1 - ) 3 - 12 ( - 20 ) in racemiform often largest ). calyculi of 4 - 10 linear mostly 1 / 3 - 1 / 2 phyllaries, sometimes 1 or 2 equaling phyllaries ). phyllaries ± 13 or ± 21, 6 - 12 mm, green. ray florets 0. cypselae glabrous. 2n = 40. [ source ] the two varieties of senecio bigelovii are distinguished by morphologic tendencies and by geography. [ source ] flowers : bloom period : june, july, august. • flower color : yellow size : 12 - 18 " tall. culture : space 9 - 12 " apart. soil : prefers light, rich, moist organic soil. sunlight : sun exposure : sun to partial shade. temperature : cold hardiness : 4a, 4b, 5a, 5b, 6a, 6b, 7a


12 " apart. soil : prefers light, rich, moist organic soil. sunlight : sun exposure : sun to partial shade. temperature : cold hardiness : 4a, 4b, 5a, 5b, 6a, 6b, 7a, 7b, 8a, 8b. ( map ) - whittaker & margulis, 1978 - haeckel, 1866 - cavalier - smith, 1981 - sinnott, 1935 ex cavalier - smith, 1998 - vascular plants - brongniart, 1843 - takhtajan, 1967 - takhtajan ex reveal, 1992 - lindley, 1833 - giseke, 1792, nom. cons., nom. alt. - c. linnaeus, 1753 - groundsel, ragwort, butterweed [ reputedly from latin senex, old man or woman, alluding to the white pappus bristles resembling the white hair of an elderly person ] - specific epithet : - botanical name : - senecio bigelovii a. gray - specific epithet : bigelovii - a. gray - genus : senecio ( ) - c. linnaeus, 1753 - groundsel, ragwort, butterweed [ reputedly from latin senex, old man or woman, alluding to the white pappus bristles resembling the white hair of an elderly person ] - subtribe : senecioninae ( ) - tribe : senecioneae ( ) - subfamily : asteroideae ( ) - family : compositae ( ) - giseke, 1792, nom. cons., nom. alt. - order : asterales ( ) - lindley, 1833 - superorder : campanulanae ( ) - takhtajan ex reveal, 1992 - subclass : asteridae ( ) - takhtajan, 1967 - class : magnoliopsida ( ) - brongniart, 1843 - dicotyledons - subphylum : euphyllophytina ( ) - phylum : tracheophyta ( ) - sinnott, 1935 ex cavalier - smith, 1998 - vascular plants - subkingdom : viridaeplantae ( ) - cavalier - smith, 1981 - kingdom : plantae ( ) - haeckel, 1866 - plants ligularia bigelovii ( a. gray ) w. a. weber status : accepted name comment : data providers : ipni, tropicos


, 1981 - kingdom : plantae ( ) - haeckel, 1866 - plants ligularia bigelovii ( a. gray ) w. a. weber status : accepted name comment : data providers : ipni, tropicos. gcc lsid : urn : lsid : compositae. org : names : 6c2db06d - 0bdf - 4267 - beec - 926899453eda last scrutiny : 16 - aug - 09 members of the genus senecio zipcodezoo has pages for 174 species, subspecies, varieties, forms, and cultivars in this genus. here are just 100 of them : myrica pennsylvanica ( northern bayberry ) · myrica pensylvanica ' morton ' ( silver sprite bayberry ) · s. acaulis ( senecio ) · s. actinella ( flagstaff ragwort ) · s. amplectens ( alpine groundsel ) · s. amplectens holmii ( holm ' s groundsel ) · s. amplectens var. amplectens ( showy alpine ragwort ) · s. amplectens var. holmii ( holm ' s groundsel ) · s. ampullaceus ( texas groundsel ) · s. angulatus ( climbing groundsel ) · s. anteuphorbium ( senecio ) · s. aphanactis ( chaparral ragwort ) · s. aquaticus ( water ragwort ) · s. arborescens ( estrella ) · s. arizonicus ( arizona ragwort ) · s. aronicoides ( rayless ragwort ) · s. articulatus ( candle plant ) · s. aschenborianus ( senecio ) · s. astephanus ( san gabriel ragwort ) · s. atratus ( tall blacktip ragwort ) · s. aurea ( golden groundsel ) · s. ballyi ( senecio ) · s. bellidioides ( alpine groundsel ) · s. bicolor ( silver ragwort ) · s. bicolor cineraria ( dusty miller ) · s. bigelovii ( nodding groundsel ) · s. bigelovii gray var. hallii gray ( nodding ragwort ) · s. bigelovii var. bigelovii ( biglow ' s


) · s. bigelovii ( nodding groundsel ) · s. bigelovii gray var. hallii gray ( nodding ragwort ) · s. bigelovii var. bigelovii ( biglow ' s ragwort ) · s. bigelovii var. hallii ( hall ' s ragwort ) · s. blochmaniae ( dune ragwort ) · s. bolanderi var. bolanderi ( bolander ' s ragwort ) · s. californicus ( california ragwort ) · s. cannabifolius ( aleutian ragwort ) · s. cannabinifolius ( hempleaf ragwort ) · s. cineraria ' cirrus ' ( cirrus dusty miller ) · s. cineraria ' silver dust ' ( dusty miller ) · s. clarkianus ( clark ' s ragwort ) · s. clivorum ( summer ragwort ) · s. confusus ' sao paulo ' ( mexican flame vine ) · s. congestus ( clustered marsh ragwort ) · s. crassifolius ( senecio ) · s. crassissimus ( vertical leaf senecio ) · s. crassulus ( meadow groundsel ) · s. cristobalensis ( senecio ) · s. cylindricus ( senecio ) · s. dangarensis ( largescaled rasbora ) · s. deflersii ( pickle plant ) · s. dimorphophyllus var. dimorphophyllus ( splitleaf groundsel ) · s. dryadens ( longnose tapirfish ) · s. elegans ( purple groundsel ) · s. elmeri ( elmer ' s ragwort ) · s. eremophilus ( desert groundsel ) · s. eremophilus var. eremophilus ( desert ragwort ) · s. eremophilus var. kingii ( ragwood groundsel ) · s. eremophilus var. macdougalii ( macdougal ' s groundsel ) · s. ertterae ( ertter ' s ragwort ) · s. erucifolius ( hoary ragwort ) · s. erucifolius erucifolius ( hoary groundsel ) · s.


. ertterae ( ertter ' s ragwort ) · s. erucifolius ( hoary ragwort ) · s. erucifolius erucifolius ( hoary groundsel ) · s. eurycephalus torr. & a. gray var. eurycephalus torr. & a. gray ex a. gray ( widehead groundsel ) · s. eurycephalus var. eurycephalus ( siskiyou ragwort ) · s. ficoides ( senecio ) · s. flaccidus ( douglas senecio ) · s. flaccidus var. douglasii ( douglas ' groundsel ) · s. flaccidus var. flaccidus ( threadleaf groundsel ) · s. flaccidus var. monoensis ( green groundsel ) · s. fremontii ( dwarf mountain ragwort ) · s. fremontii var. blitoides ( dwarf mountain ragwort ) · s. fremontii var. fremontii ( dwarf mountain ragwort ) · s. fremontii var. inexpectatus ( dwarf mountain ragwort ) · s. fremontii var. occidentalis ( dwarf mountain ragwort ) · s. glastifolius ( holly - leaved senecio ) · s. gunnii ( mountain fireweed ) · s. haworthii ( senecio ) · s. herreanus ( string of beads cactus ) · s. herreianus ( gooseberry ) · s. hispidulus ( hispid fireweed ) · s. hybridus ( common ragwort ) · s. hydrophiloides ( tall groundsel ) · s. hydrophilus ( alkali marsh groundsel ) · s. hypoleucus ( pale groundsel ) · s. inaequidens ( narrow - leaved ragwort ) · s. integerrimus ( columbia ragwort ) · s. integerrimus nutt. var. exaltatus ( nutt. ) cronq. ( columbia groundsel ) · s. integerrimus var. exaltatus ( columbia groundsel ) · s. integerrimus var. integerrimus ( lambstongue ragwort ) · s. integerrimus var. major ( lambstongue groundsel ) · s. integerrimus var. ochroleucus ( pale


) · s. integerrimus var. integerrimus ( lambstongue ragwort ) · s. integerrimus var. major ( lambstongue groundsel ) · s. integerrimus var. ochroleucus ( paleyellow ragwort ) · s. integerrimus var. scribneri ( scribner ' s ragwort ) · s. jacobaea ( ragwort ) · s. jacobaea dunensis ( ragwort ) · s. jacobaea jacobaea ( ragwort ) · s. jacobsenii ( trailing jade ) · s. kirkii ( tree daisy ) · s. kleinia ( mountain grass ) · s. kleiniaeformis ( spear head ) · s. kleiniiformis ( spearhead ) · s. lamarckianus ( bois de ch ) · s. lemmonii ( lemmon groundsel ) · s. linearifolius ( fireweed ) · s. littoralis ( woolly ragwort ) - search for pictures : images. google. com - search for scholarly articles : google scholar - search using scientific name and vernacular names : all the web | altavista canada | altavista | excite | google | hotbot | lycos - search using specialized databases : genbank | medline | scirus | cisti / cal | agricola periodicals | agricola books - catalog of hymenoptera in america north of mexico / prepared cooperatively by specialists on the various groups of hymenoptera under the direction of karl v. krombein... [ et al. ]. washington : smithsonian institution press, 1979 - url. - contributions from the united states national herbarium 13 1909 - 1912 washington, d. c. : smithsonian institution press, 1890 - url p. 224, p. 744. - flora of new mexico / by e. o. wooton and paul c. standley. washington : g. p. o., 1915. url p. 744. - flora of new mexico. by e. o. wooton and paul c. standley. washingtongovt. print. off. 1915 url p. 744. - great basin naturalist memoirs. 1987 [ provo, utah ] brigham young university, 1976 - 1992. url p. 223. - the great basin naturalist. 43 1983 provo, utah : m. l. bean life science museum, brigham


- great basin naturalist memoirs. 1987 [ provo, utah ] brigham young university, 1976 - 1992. url p. 223. - the great basin naturalist. 43 1983 provo, utah : m. l. bean life science museum, brigham young university, 1939 - 1999. url p. 330, p. 332, p. 63. - the university of colorado studies. boulder, university of colorado. url p. 178. - the university of kansas science bulletin. 42 1961 [ lawrence ] : university of kansas, 1902 - 1996. url p. 469. - ediger, r. i. 1970. revision of section suffruticosi of the genus senecio ( compositae ). sida 3 : 504 - 524. - brands, s. j. ( comp. ) 1989 - present. the taxonomicon. universal taxonomic services, zwaag, the netherlands. accessed january 10, 2012. accessed through gbif data portal february 02, 2008 : - missouri botanical garden, missouri botanical garden - school of life sciences, arizona state university, arizona state university vascular plant herbarium - school of life sciences, arizona state university, the deaver herbarium, northern arizona university - usda plants, usda plants database - university of colorado museum, zoological specimens - utah state university, usu - utc specimen database - biodiversity heritage library namebankid : 2657670 - catalogue of life accepted name code : ast - 11463 - grin nomen number : 452810 - integrated taxonomic information system ( itis ) taxonomic serial number ( tsn ) : 36103 - mobot nameid : 2703112 - u. s. d. a. plant symbol : libih sebi - zipcode zoo species identifier : 62426


historically, albertans have elected governments with large majorities and kept them in power for a long time. this political tradition began during the first provincial election in 1905. alberta ' s first premier, alexander c. rutherford and his liberals took 22 of 25 seats. in 1979, the progressive conservatives won 74 out of 79 seats. after the 2012 provincial election, the progressive conservatives held 61 out of 87 seats. the liberal party formed the first government in alberta from 1905 - 1921. the united farmers of alberta party overcame the liberals in 1921 and stayed in power until 1935. the social credit party formed the next provincial government for 35 years from 1935 - 1971. the progressive conservative party has been in government from 1971 to present. how is government formed? the province is divided into 87 constituencies, or ridings. each riding has a number of candidates from different parties. the candidate in each riding that wins the highest number of votes in an election becomes the member of the legislative assembly ( mla ) for that riding. this person represents the constituency in the legislative assembly. the leader of the political party with the most seats in the legislative assembly becomes the premier of alberta. the premier and ministers form the government. elections and by - elections by law, a provincial general election must be held every five years, though it can be held sooner. in a general election albertans from across the province vote on who they want to represent them in the legislative assembly. sometimes a seat in the legislative assembly is vacated well before the next provincial election will be held. when this happens, a by - election is called. a by - election is an election held in one riding only. the winner of the by - election becomes the new mla for that riding until the next general election. how are laws made? laws are passed by mlas. laws are introduced as bills, and debated in the legislative assembly before being put to a vote. if the assembly passes a bill, it goes to the lieutenant governor for royal assent, at which point it becomes law. alberta facts - governence - provincial governance : 83 seat elected legislative assembly, executive power exercised by cabinet and premier - federal representation : 26 members of parliament, 6 senators - representative of the crown : lieutenant governor, appointed by the governor general, on the advice of the prime minister of canada


traditional chinese medicine ( tcm ) for nausea and morning sickness morning sickness affects well over half of all pregnant women, and often it is the first sign of pregnancy. symptoms of morning sickness include nausea and vomiting, usually beginning around the sixth week of pregnancy and abating sometime after the twelfth week of pregnancy. morning sickness is a normal reaction by the body to the increased hormone levels of pregnancy. traditional chinese medicine ( tcm ) can help alleviate the discomfort of morning sickness and encourage a healthier pregnancy. how can traditional chinese medicine help nausea and morning sickness? traditional chinese medicine ( tcm ) includes a well - developed system of diagnosis and pathology based upon several thousand years of observation and study. from this foundational knowledge of oriental medicine comes the theory of qi ( vital energy ) and the pathways through which qi flows, called meridians. good health is based upon the proper flow of qi throughout all the meridians in the body. several treatment methods to balance the body and alleviate symptoms of nausea and morning sickness are used by traditional chinese medicine ( tcm ), including acupuncture, chinese herbal medicine, and acupressure. often, a combination of these treatments provides the most effective relief of nausea and morning sickness. what causes nausea and morning sickness according to traditional chinese medicine ( tcm )? when a woman becomes pregnant, the vital substances of her body, including the essence, blood and kidney qi, collect together to form the new life within her body. often, this change causes an obstruction within the penetrating vessel ( chong mai ) meridian of the body, leading to rebellious qi of the stomach rising up and causing nausea. from this pathological sequence, several patterns of disharmony can result within the body, liver qi stagnation attacking the stomach causes severe nausea and spleen and stomach qi deficiency are the cause of mild nausea. depending on which pattern the practitioner observes within the body will determine the course of treatment. acupuncture for nausea and morning sickness acupuncture is considered the most useful form of traditional chinese medicine ( tcm ) treatment for nausea and morning sickness. depending on your specific presentation of symptoms, the acupuncturist will select the most effective points to relieve the nausea. the most commonly used points for nausea and morning sicknes include the following : - pericardium 6 ( p6 ) – neiguan - is located in the first depression that falls between the two tendons running from your wrist to your elbow, approximately three fingerbreaths from the wrist crease. numerous


: - pericardium 6 ( p6 ) – neiguan - is located in the first depression that falls between the two tendons running from your wrist to your elbow, approximately three fingerbreaths from the wrist crease. numerous studies have been conducted to show the effectiveness of this point for nausea of all causes, and it is commonly used for self - treatment with acupressure. a consumer product made of wristbands that apply pressure to these points are available and commonly marketed for sea sickness prevention ; however, the bands ’ usefulness for morning sickness has been reported in numerous placebo - controlled studies. - stomach 36 ( st 36 ) – zusanli - is also another acupuncture point commonly used to calm the stomach and relieve nausea. this point is located four fingerbreaths beneath the kneecap, one fingerbreath beside the edge of the tibia bone on the shin. this point is effective for all disorders of the stomach and is useful to strengthen digestion and promote the generation of qi within the body. one of the st 36 ’ s functions is to descend the stomach qi, which is the primary cause of nausea. - gallbladder 34 ( gb 34 ) – yanglingquan – is an effective acupuncture point for alleviate patterns of morning sickness related to liver qi stagnation invading the stomach. the acupuncture point is located on the lateral side of the lower leg, just below and in front of the head of the fibula bone. the point strongly moves stagnation in the abdomen and calms rebellious qi affecting the stomach, relieving nausea. - ren 12 ( rn 12 ) – zhongwan – is another useful points for treating nausea. located on the midline along the abdomen, midway between the meeting point of the ribs and the navel. ren 12 is effective for deficient conditions of the stomach and is commonly treated with moxibustion, a form of warming therapy. while there are several acupuncture points that are contraindicated during pregnancy, licensed acupuncturists are properly trained to avoid the use of these points. always inform your practitioner if you think you are pregnant. acupuncture and traditional chinese medicine have a long history and success rate in treatment a variety of woman ’ s disorders, including morning sickness. chinese herbal medicine for nausea and morning sickness chinese herbal medicine is one of the most popular forms of traditional chinese medicine ( tcm ) treatment used today. several hundred herbs are part of


in treatment a variety of woman ’ s disorders, including morning sickness. chinese herbal medicine for nausea and morning sickness chinese herbal medicine is one of the most popular forms of traditional chinese medicine ( tcm ) treatment used today. several hundred herbs are part of the chinese pharmacopeia and are used to create thousands of different formulas for the treatment of disease. however, when treating morning sickness, many of these formulas are difficult to use. this is not due to endangering the pregnancy, but primarily due to the fact that during morning sickness many of the herbal decoctions are too unpleasant to drink. that said, several chinese herbs and formulas are contra - indicted or cautioned during pregnancy ; so always inform your practitioner if you are pregnant and only consume herbal medicine prescribed by an experienced practitioner. several chinese herbs can be safely used during pregnancy, commonly used as food, widely available, and thankfully are more acceptable to the palate : - ginger – sheng jiang – fresh ginger is a common herb used in chinese medicine to help digestion, though it functions of warming the stomach, and reducing the toxicity of other herbs. it is commonly used in cooking throughout the world and it can help alleviate symptoms of morning sickness. ginger can be drunk as a tea or taken in concentrated capsule form. readily available are ginger snap cookies or biscuits and ginger ale that contain ginger and may help with the nausea of morning sickness. - cardamon seed – sha ren – cardamon is a very effective herb for treating morning sickness due to its function of calming the stomach, transforming phlegm, circulating the qi, and stopping vomiting. sha ren is an ideal herb for morning sickness due to the additional function of “ calming the fetus ”, which means it is used for the prevention of miscarriage. cardamon can also be ground and made into a tea, along with ginger, to alleviate nausea. what is morning sickness? well over half of all women experience morning sickness during pregnancy, usually beginning around the 6th week and ending after the twelfth week of pregnancy. hyperemesis gravidarum is an extreme form of morning sickness that occurs in about 1 % of all pregnancies and is marked by excessive vomiting that can lead to dehydration. if you are experiencing significant nausea, always inform you primarily care physician immediately. what is traditional chinese medicine ( tcm )? traditional chinese medicine ( tcm ) has been in practice for over 5, 000 years and includes herbal medicine, acupuncture, acupressure, dietary therapy, shia


care physician immediately. what is traditional chinese medicine ( tcm )? traditional chinese medicine ( tcm ) has been in practice for over 5, 000 years and includes herbal medicine, acupuncture, acupressure, dietary therapy, shiatsu massage, and other practices such as qigong. tcm is highly complex and based upon theories devised through observation of nature, the human body, and the cosmos. according to traditional chinese medicine, all phenomena in the world are related by the opposing concepts of yin and yang. yin and yang must be in a harmonious, dynamic balance to achieve optimal health. yang refers to maleness, the bowels, heat, light, upward / outward movement, surface, and agitation. yin refers to the opposite — femaleness, bones, organs, coldness, darkness, heaviness, downward / inward movement, and calmness. both are necessary for life, yet the relationship between the two is in a constant state of flux. the vital substances of traditional chinese medicine ( tcm ) physiology that affect the yin and yang include : - blood : blood underlies the nourishment of the functions of qi and is the physical manifestation of the woman. - bodily fluids : this includes all fluids in the body. they moisten the skin, hair, tissues, joints, and organs, and allow for smooth movement of joints and other body parts. yin fluids are thick, lining the internal organs and cushioning the brain and spinal cord. yang fluids are thinner, such as sweat, saliva and urine. - essence : this is the vital physical presence or spirit of the body and all physical elements that are responsible for determining physical growth and development. - qi : this refers to energy that propels all bodily functions and is responsible for the movement, transformation, warmth, and restraint of the blood. what risks are associated with traditional chinese medicine ( tcm )? patients should be aware that chinese herbs are not without possible side effects, including allergic reactions, direct toxic reactions, and interactions with other medicines. while there have recently been efforts to regulate dosages and use of chinese herbs by some governments, the active ingredients of these medicines often have not been measured precisely. this can lead to variations among formulations and adds to the difficulties in evaluating and comparing trial results of these medicines. consult a physician and / or a chinese herbalist before taking any herbal formula. “ morning sickness and chinese medicine. ” askanase, aaron, m. ac., lic. ac. “ gynecological


mary swander gives a demonstration on making sauerkraut during extending the season in your kitchen, which was part of the practical farmers annual conference jan. 13, 2012, in ames. that packet of tomato seeds laying on the kitchen counter may seem like just a gardener ’ s dream right now. but food preservation experts say that advance planning on what to do with the 70 pounds of tomatoes that will be sitting on that same kitchen counter in august is a good idea. many gardeners — novices and experts alike — discover home canning and other food preservation methods by natural extension of growing their own food. angela laury, assistant professor of food science and human nutrition and extension food safety specialist at iowa state university, advises hobby gardeners and home cooks interested in canning and freezing to study up on food safety basics before starting. she recommends the “ usda complete guide to home canning ” as the “ bible ” of home food preservation, whether one is interested in jams and jellies, pickles, tomatoes or other vegetables. “ this resource tells you step by step by step what you should do ; no one should be scared of home food preservation if you do it properly, ” laury said. “ it also provides basic recipes with plenty of variations, so you have room to be creative within the bounds of food safety precautions. ” lonna nachtigal, a local food grower and owner of onion creek farm, has been doing home food preservation for almost 20 years. she gave demonstrations of food preservation methods and tips for practical farmers of iowa ’ s annual conference in ames in january. nachtigal said being prepared is a good idea — learn the basics and purchase equipment and jars now before produce floods the kitchen. “ first of all, do not despair, ” nachtigal said. “ all the work you put in now really pays off in the long run. ” long after the garden is done for the year, families can be eating from it, she said. laury said the primary food safety concern of home food canning is clostridium botulinum, a foodborne bacteria that can cause serious neurological problems. “ it ’ s able to grow in anaerobic environments, or with no oxygen, ” laury said. “ that basically means a sealed jar. ” laury said canning food at the proper ph ( acidity ), water content and heat processing levels will reduce the likelihood of contaminated food. proper sanitation of jars is also a must, she said. with freezing foods, laury