Re: WHO | Melamine contaminated powdered infant formula in China
<TABLE class=formlayout id=apex_layout_271110100662109808 summary=""><TBODY><TR><TD noWrap align=right>
Published Date</TD><TD noWrap align=left>19-SEP-2008</TD></TR><TR><TD noWrap align=right>
Subject</TD><TD noWrap align=left>PRO/EDR> Infant kidney stones - China (04): WHO, international recall</TD></TR></TBODY></TABLE>
INFANT KIDNEY STONES - CHINA (04): WHO, INTERNATIONAL RECALL************************************************************A ProMED-mail post<
http://www.promedmail.org>ProMED-mail is a program of theInternational Society for Infectious Diseases<
http://www.isid.org>
In this update:[1] WHO[2] Hong Kong recall dairy products, international recall infant milk[3] South Korea testing plans[4] Singapore, EU responses[5] Subscriber observation - prior melamine pet food contamination******
[1] WHODate: 18 Sep 2008Source: WHO Epidemic and Pandemic Alert and Response (EPR) [edited]<http://www.who.int/csr/don/2008_09_19/en/index.html>Melamine-contaminated powdered infant formula in China [18 Sep 2008]--------------------------------------------------------------------More than 6240 cases of kidney stones in infants with 3 deaths have been reported from across China as of 17 Sep 2008. Kidney stones in infants are very rare. The Ministry of Health of China has confirmed that these cases are related to melamine-contaminated powdered infant formula consumed by the infants. While the exact onset date of illness resulting from contamination is unknown,
a manufacturer received a complaint of illness in March 2008.Following inspections conducted by China's national inspection agency, at least 22 dairy manufacturers across the country were found to have melamine in some of their products (levels varied between 0.09mg/kg and 2.560 mg/kg).
Two companies exported their products to Bangladesh, Burundi, Myanmar, Gabon and Yemen. While contamination in those exported products remains unconfirmed, a recall has been ordered from China.A recall is also ongoing for all contaminated products in China.The World Health Organization (WHO) is in close communication with the Ministry of Health of China to monitor the situation. The WHO has also been disseminating information on the situation to WHO Member States through the International Food Safety Authorities Network (INFOSAN). INFOSAN has also specifically alerted the 5 countries importing potentially contaminated products from China.The WHO recommends breastfeeding as the ideal way of providing young infants with the nutrients they need for healthy growth and development. Exclusive breastfeeding is recommended up to 6 months of age.For more information--------------------- Questions and Answers on melamine <
http://www.who.int/csr/media/faq/QAmelamine/en/index.html>- WHO page on breastfeeding <
http://www.who.int/topics/breastfeeding/en/index.html>- Guidelines for the safe preparation, storage and handling of powdered infant formula<
http://www.who.int/foodsafety/publications/micro/pif2007/en/index.html>--Communicated by

RO/MBDS<
promed-mbds@promedmail.org>******[2] Hong Kong recall dairy products, international recall infant milkDate: 18 Sep 2008Source: New Scientist [edited]<
http://www.newscientist.com/article/dn14754-chinese-dairy-contamination-sc=>Chinese dairy contamination scandal grows-----------------------------------------
Hong Kong ordered the recall of a Chinese company's products on Thursday [18 Sep 2008] after tests found 8 out of 30 of its dairy offerings, including milk, ice cream and yoghurt, were contaminated with melamine -- an organic base usually found in plastics and resins, and banned in food. The tests by Hong Kong's food safety watchdog are the 1st verification by an independent food safety watchdog that the melamine contamination health scandal had now spread to such a large range of other dairy products.Inner Mongolia Yili Industrial Group Co Ltd is one of 22 Chinese firms implicated in China's growing milk-powder contamination scandal. Milk powder containing melamine has killed 4 infants in China and made more than 6000 ill.
The company was a Beijing Olympic games sponsor."We are recalling the Yili products, and the importer is also recalling all Yili products," said Constance Chan, the controller of Hong Kong's Centre for Food Safety, after the latest round of test results of 30 samples of milk products.Pet-food scandal----------------"That would involve milk, milk beverages, yoghurt, ice cream and ice bar," she added.
"8 out of 30 products of Yili company contain melamine."The announcement by the Hong Kong authorities could prove an embarrassment for China, which has so far failed to identify melamine contamination in dairy products other than milk powder. Last year [2007] domestic animals in the US died as a result of eating pet food imported from China, also contaminated by melamine.There were reports at the time of the pet food scandal that Chinese factory owners had been adding melamine to their products to boost nitrogen content, and so make it appear that they contain more protein that they actually do.
This practice was banned last year [2007].Hong Kong authorities said they would now systematically test all other China-produced dairy products made by other Chinese brands before deciding if further recalls might be necessary.Export worries--------------"In the next few days, we will test all other mainland Chinese (dairy) products," Chan added. "Any Chinese milk powder no matter where it is made on the mainland, will be tested."Meanwhile China tried to calm jitters about exports of tainted baby milk powder to 5 poor developing nations, saying no problems had been reported so far and that the government was working hard to address the issue. The government has already announced that 5 countries Yemen, Bangladesh, Myanmar, Gabon and Burundi -- have imported milk powder made by 2 Chinese firms whose products were found to be contaminated."Though there has been no bad reaction,:magnify: the quality watchdog has demanded that these companies take action to recall the products," said Chinese Foreign Ministry Spokeswoman Jiang Yu.--Communicated by

RO/MBDS<
promed-mbds@promedmail.org>******[3] South Korea testing plansDate: 19 Sep 2008Source: Financial Times [edited]<
http://www.ft.com/cms/s/0/96406392-85e2-11dd-a1ac-0000779fd18c.html>
HK and Seoul act on China baby milk worries-------------------------------------------
China's tainted infant formula scandal yesterday spread beyond the country's borders as food safety officials in South Korea and Hong Kong said they would investigate or recall Chinese products. The Chinese government, which is scrambling to reduce damage to the image of "Made in China," announced more arrests in connection with the milk powder crisis, which claimed its 4th victim yesterday.Hong Kong ordered the recall of dairy products including milk, ice-cream and yogurt made by Yili, one of China's biggest dairy groups and an official sponsor of the Beijing Olympics. Hong Kong's food safety watchdog said 8 out of 30 Yili products had failed a test for contamination with melamine, a chemical that can boost the apparent protein content of milk diluted with water. Shares in Inner Mongolia Yili Industrial Group tumbled by the 10 percent daily maximum for a 2nd straight day.South Korea's food protection agency said it would test whether processed foods from China contained poisonous chemicals. The Korea Food and Drug Administration said it had collected samples of 615 imported Chinese products that might contain tainted milk powder, the Yonhap news agency said. The Chinese government has said milk powder was exported by Yili and Sanlu, the 1st company whose products were cited for melamine contamination, only to Yemen, Bangladesh, Burma, Gabon and Burundi."Though there has been no bad reaction, the quality watchdog has demanded that [Yili and Sanlu] take action to recall the products," the Chinese foreign ministry said yesterday [18 Sep 2008].The government's product safety watchdog website said tests on livestock feed would be stepped up to prevent the use of melamine. Meanwhile worried parents continued to bring infants to hospitals across the country to have them tested for kidney stones, which can be caused by melamine contamination.At Shanghai Children's Hospital yesterday, nurses said they had tested more than 200 children. One worried mother said her 18-month-old daughter had fallen ill after drinking one of the brands of milk powder on a government list of those failing a safety test.The Chinese government said on Wednesday that 6000 more children had fallen ill after being fed tainted milk powder. Melamine-contaminated pet food from China was blamed last year [2007] for the deaths of thousands of pets in the US.[Byline: Patti Waldmeir, additional reporting by Teresa Yan]--Communicated by

RO/MBDS<
promed-mbds@promedmail.org>******[4] Singapore, EU responsesDate: 19 Sep 2008Source: Reuters AlertNet [edited]<
http://www.alertnet.org/thenews/newsdesk/PEK113930.htm>
Singapore bans China dairy imports, EU wants answers----------------------------------------------------
Singapore banned all dairy imports from China on Friday [19 Sep 2008] and the European Union demanded answers from Beijing as the baby formula scandal that has left thousands of infants ill across China spread to liquid milk. A government food quality watchdog in China said nearly 10 percent of milk and drinking yoghurt samples from 3 major dairy companies were contaminated with potentially deadly melamine.
Panicked parents have crowded hospitals and demanded redress since officials and the Sanlu Group, China's biggest maker of infant milk powder, said last week that babies were sick with kidney stones and complications after drinking toxic milk powder. At the latest count, 6244 children have become ill.
A total of 4 have died and 158 are suffering "acute kidney failure." The tide of sick children is overwhelming some doctors, the official Xinhua agency said, quoting a man who was turned away by hospitals in his hometown.Singapore said on Friday [19 Sep 2008] it had banned the import and sale of all milk and dairy products from China after tests found melamine contamination in 2 brands of China-made milk products. Beijing has already recalled some milk powder exported by 2 firms whose products were found to be contaminated, and although it said "there has been no bad reaction" to those goods, many countries are fretting about their citizens' health.On Thursday [18 Sep 2008], Hong Kong recalled dairy products of one Chinese company.Robert Madelin, director-general for health and consumer protection at the European Commission, said the European Union did not import Chinese infant milk powder and there had been no EU reports of illness from other imported Chinese dairy products.
But with foreign consumers watching China again struggle with toxic food and claims of delays and cover-ups, Madelin told reporters in Beijing he expected an account of what went wrong."We are trying to establish the facts," Madelin said. "On the governance aspects, we are also asking questions, and we will learn the truth probably about the same time you do."After a nationwide check, China's General Administration of Quality Supervision, Inspection and Quarantine named two of China's top dairy producers, Xinhua news agency has reported. Almost one-tenth of liquid milk and yoghurt batches from Mengniu Dairy and Inner Mongolia Yili Industrial Group Co Ltd contained melamine, which is banned in food.
Several samples of milk from the Bright dairy group also had the substance. Used in making plastics, melamine is rich in nitrogen, an element often used to measure protein levels. By adding melamine to watered-down milk, dealers can fool quality checks.Starbucks---------Starbucks Corp said its 300-plus cafes in mainland China had pulled milk supplied by Mengniu. Starbucks said no employees or customers had fallen ill from the milk.

Yili, a Beijing Olympic Games sponsor, already faced a recall in Hong Kong, where authorities found 8 of its 30 products, including ice-cream and yoghurt ice bars, contained melamine. Mengniu and Yili apologised to shaken consumers and investors and vowed to recall and destroy problem products."Anyone who must step down will step down, anyone who must bear legal responsibility will bear legal responsibility," Yao Tongshan, Mengniu executive director and chief financial officer, told reporters in Hong Kong, where the company is listed.Quality officials stressed that most Chinese milk was safe, trying to shore up public trust already shaken by a litany of food scares involving eggs, pork and seafood in recent years. The Chinese quality watchdog also said melamine-tainted milk would not make adults sick unless they drank more than 2 litres a day. But consumers sounded far from reassured.China launched reforms to clean up food and product safety after a wave of scandals last year [2007], including melamine found in pet food ingredients sent to the United States. It has again vowed to punish errant businesses and officials and there have already been dismissals and detentions linked to Sanlu, 43 percent owned by New Zealand dairy giant Fonterra.[Byline: Chris Buckley]--Communicated by

RO/MBDS<
promed-mbds@promedmail.org>******[5] Subscriber observation -- prior melamine pet food contaminationDate: 18 Sep 2008From: Tony Ross<
tonyross@illinois.edu>The 2007 petfood contamination in the USA associated with melamine had an additional twist to its pathogenesis. Melamine is not particularly toxic to cats and dogs. Neither is cyanuric acid. But put them together in contaminated petfood and you get a nephrotoxic crystaluria which killed large numbers of cats and dogs.A similar large incident occured in 2004 affecting cats and dogs in several Asian countries. It would be interesting to know whether the current infant urolith [kidney stones] problem is due to the melamine-cyanuric acid polymer or melamine alone.--Tony Ross BVSc MSc PhDUniversity of Illinois<
tonyross@illinois.edu>
[The numbers of affected infants (6244) have not changed since yesterday's posting, but there has been a report of an additional death attributable to the melamine contamination of baby milk powder in China, bringing the total of fatalities up to 4. From the above newswires and reports, it appears as though there has been international distribution of melamine contaminated dairy products. While the Chinese authorities have stated that the implicated contaminated baby milk powder has been distributed to only 5 countries (Yemen, Bangladesh, Burma, Gabon and Burundi), testing of other dairy products including yoghurt and ice-cream exported to Hong Kong and Singapore have identified the presence of melamine in these products.
Other countries are now beginning to test dairy products imported from China to see if these products are also contaminated with melamine.The list of countries known to have imported baby milk products from producers with documented melamine contamination includes 5 developing countries with limited resources, reduced public health infrastructures and limitations in access of the general population to secondary and tertiary medical care.
Identification of infants with renal problems related to the ingestion of melamine contaminated milk products may be challenged in some of these countries. This moderator attempted to find information on the coverage of breastfeeding in the 5 mentioned countries, to attempt an estimate on the possible number of infants and young children potentially at risk (those not presently being breastfed and those being supplemented by infant formula/powder),
but unfortunately the database on the WHO website is currently under revision (see<
http://www.who.int/nutrition/databases/infantfeeding/en/index.html>)In part [4] above, Dr. Ross raises some interesting observations. ProMED-mail did not cover a similar incident in 2004, and would like to thank Dr. Ross for bringing this to our attention. In a probably related incident in China, on 22 Feb 2006, Xinhua reported at least 38 cats dying shortly after being fed with Xiduoyu, a brand of a "Tianjin-based cat food manufacturer." A veterinarian referred to in the story said "test results from Beijing Animal Hospital showed the dead cats had suffered from kidney exhaustion and that the sick ones have kidney damage." Suspicions at that time focused on lead poisoning though Gu Junhua, a chief engineer from China's "national feedstuff quality check centre under the Ministry of Agriculture," was reported as saying: "But at present, he said it was difficult to draw any conclusions because the country has not drafted any food safety criteria for pets in terms of the quality and quantity of each element of the ingredients." No mention of melamine was made in that article.(<
http://english.sina.com/china/1/2006/0221/66443.html>, information gotten originally from Wikipedia<
http://en.wikipedia.org/wiki/2007_pet_food_recalls#cite_note-Xinhua_English-45>). The Wikipedia site also had the following information: "A 2004 outbreak involving pet foods sickened more than 6000 dogs and a lesser number of cats in Asia. Kidney failure in the animals was linked to foods manufactured in Thailand by Mars Inc. Veterinarians in Asia initially blamed the 2004 problems on fungal toxins, but pathology tests conducted in 2007 found melamine and cyanuric acid present in renal tissue from both outbreaks.
According to pathologists: "These results indicate that the pet foodassociated renal failure outbreaks in 2004 and 2007 share identical clinical, histologic, and toxicologic findings, providing compelling evidence that they share the same causation." (articles referenced included Brown CA et al. Outbreaks of renal failure associated with melamine and cyanuric acid in dogs and cats in 2004 and 2007. J Vet Diagn Invest 19:525531 (2007) -- full article available at<
http://jvdi.org/cgi/reprint/19/5/525>) and a USA Today newswire available at<
http://www.usatoday.com/news/nation/2008-03-10-petfood_N.htm>. In the Brown CA et al study, the authors identified melamine and cyanuric acid presnt in renal tissue from both outbreaks and concluded that "These results indicate that the pet food -- associated renal failure outbreaks in 2004 and 2007 share identical clinical, histologic, and toxicologic findings, providing compelling evidence that they share the same causation."
Hence, there is evidence that the use of melamine to boost the apparent protein content of nutritional products (in these cases pet food) dates back to at least 2004.We await further information -- both in terms of other countries identifying melamine contamination of imported (or domestically produced) milk products, and information on possible affected infants in other countries. - Mod.MPP]:tiphat:
http://tinyurl.com/47f2yk</PRE>