Medical Treatment At A Hospital In Hefei Biology Essay

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The 2008 Sanlu milk scandal was a food safety incident in China involving milk and infant formula tainted with the industrial chemical melamine.

The incident unfolded on 16 July, after sixteen infants in Gansu Province were diagnosed with kidney stones. These infants had been fed on formula milk powder produced by the Sanlu Group over many months. It was later found that the product contained melamine. The dairy products from manufacturer Mengniu and Yili were subsequently found to also contain melamine. It was found that unscrupulous milk supplier added melamine to the raw milkin order to mask the protein levels. Melamine, with multiple nitrogen in the molecule could fool the routine quality and safety check which monitors the protein quality of the diary product by determining the amount of total nitrogen in the product.

The State Council soon announced investigation on the accident throughout the nation. In the meantime, consuming tainted milk powder had sickened many babies. Majority of victims were children under age of three. It was reported that by December 2008, approximately 300,000 were reported ill, with more than 50,000 infant hospitalized and six infants died because of renal failure.

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On January 22, 2009, three of the suspects involved in the scandal were sentenced to death in a Chinese court.

Government Response

http://news.xinhuanet.com/newscenter/2008-09/13/content_9974780.htm

Government Response

The State Council

The State Council ordered an overhaul of the dairy industry and set up a working group to tackle the milk powder incident and immediately initiated national food safety emergency response plan, Grade-I response. The working group consisted of Ministry of Health (MOH), State food and Drug Administration (SFDA), Ministry of Agriculture (MOA), The General Administration of Quality Supervision, Inspection, and Quarantine (AQSIQ), and The State Administration for Industry and Commerce (SAIC) and Hebei Province People's Government. The coordinated team set off to Hebei province for investigation.

State Council made six measures on the incident.

Launch national food safety emergency Grade-I response immediately.

Carry out intensive medical treatment on sick infants and toddlers. The treatment was free of charge and the cost was financially supported by the Government.

Rectify the milk powder market comprehensively. AQSIQ led the inspection and analysis of milk powder at national scale. The substandard milk powder would be enforcing off the shelves.

Identify the cause of milk powder contamination. Local government and relevant departments should organize inspection on milk powder production, dairy farm, raw milk purchasing and dairy product processing.

Bring those who were liable to the incidents to justice.

Instruct local authorities to take lessons from the incidence, and to make effort to improve the food safety supervision system and ensure the safety of food consumptions.

Ministry of Health

Ministry of Health organized rescue and medical treatment work. MOH issued urinary track stones treatment proposal for infants and toddlers consuming contaminated Sanlu infant formula milk powder.

MOH informed all provincial health administrative authorities to set up expert groups on medical treatment of sick infants. The group was responsible for daily reporting of new cases.

Details about medical treatment:

Treatment World Health Organization

http://www.who.int/foodsafety/fs_management/infosan_events/en/index3.html

http://blog.sina.com.cn/s/blog_48e828e90100amni.html

The General Administration of Quality Supervision, Inspection, and Quarantine

After the reveal of incidents, The General Administration of Quality Supervision, Inspection, and Quarantine (AQSIQ) immediately organized special inspections. The inspection was focus on melamine detection in milk powder samples from all domestic dairy enterprises. The inspection revealed that 22 enterprises with 69 batches of milk powder contain melamine, which accounted for 20.18% of the total milk powder production of the manufacturer. The results indicated samples of powdered infant formula contained a wide range of melamine concentration. Among the testing samples, Shijiazhuang Sanlu infant formula milk powder possessed the highest level of melamine, up to 2563mg/kg. Other brands of infant formula milk powder contain melamine 0.09-619mg/kg.

To guarantee the safety and quality of infant milk powder, AQSIQ designated supervisor to monitor and supervise the production and perform analysis on each batch. Any milk powder that failed the test would not be permitted to enter the market.

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AQSIQ announced the cessation of national exemption for all eligible food producing enterprises. Remove "China's famous brand" title from Mengniu, Yili and Guangming.

Learning the lesson from Sanlu incident, AQSIQ announced the revocation of all exemptions from inspection previously granted to dairy producers.

http://news.aweb.com.cn/2009/11/25/117200911251055640.html

http://cn.chinareviewnews.com/doc/1007/4/8/4/100748486.html?coluid=7&kindid=0&docid=100748486

The State Administration for Industry and Commerce

The State Administration for Industry and Commerce (SAIC) made effort to ensure that no contaminated milk powder would re-enter the market. SAIC issued an urgent notice to local industrial and commercial administrations to rectify milk powder market. Contaminated Sanlu milk powder would be banned from sale immediately. SAIC with other relevant Governmental Departments sealed the 2176 tons Sanlu milk powder in storage. Together with the recalled milk powder, they were destroyed.

http://www.hb.xinhuanet.com/zhuanti/2008-09/12/content_14403733.htm

Chinese officials prepare to destroy milk powder that was found tainted with melamine, which can cause kidney stones and kidney failure

http://www.dailymail.co.uk/news/worldnews/article-1103462/Bosses-accused-Chinas-tainted-milk-scandal-6-children-died-300-000-contaminated-trial.html

Ministry of Agriculture

MOA commanded the set-up of special inspection working group at local administrative level tobe in charge of inspecting raw milk quality. The action was to prevent any substandard raw milk from entering the market.

MOA reinforced the management of dairy cow breeding farm and milking collection center to guide farmers on feeding operations; promote standardized large-scale cultivation method; organize education and training on cultivation techniques. (no paragraph)MOA also conduct comprehensive examination on fodder of dairy farms by local livestock husbandry departments.

Ministry of Public Security

Ministry of public security started work on investigation, interrogation and evidence collection.

Tian Wenhua, Wang Yuliang, Hang Zhiqi and Wu Jusheng at the Shijiazhuang Intermediate People's Court in Shijiazhuang

http://www.dailymail.co.uk/news/worldnews/article-1103462/Bosses-accused-Chinas-tainted-milk-scandal-6-children-died-300-000-contaminated-trial.html

What is melamine?

Melamine is an organic chemical in the form of white crystals rich in nitrogen. It is not soluble in water. Melamine is neither a food ingredient nor a food addictive. There is no reason to support the use of melamine in food production

Characteristics of Melamine

Molecular formula

C3H6N6

nomenclature

2,4,6-Triamino-1,3,5-triazine

Structure

Molecular weight

126.121

Percentage Composition

C 28.57%; H 4.79%; N 66.63%

Toxicity

LD50 (rat, orl) 3161 mg/kg

Melting point

Approximately 354°C

analogues

cyanuric acid, ammelide, ammeline

http://www.made-in-china.com/showroom/michlzhao/product-detailfGYxNonCjErm/China-Melamine.html

Melamine Chipboard

http://www.alibaba.com/product/timzhang88-11196426-10809396/Melamine_Chipboard_Particle_Board_.html

What is melamine generally used for?

Melamine can be used for plastics, adhesives, coatings, food packaging materials. Melamine is combined with formaldehyde to synthesis Melamine resin, which is very sturdy thermosetting plastic. This kind of plastic can endure higher temperature than ordinary plastic but melamine resin will decompose under adequate high temperature. Melamine can be made into a foam product, which is a surface cleaning eraser. Melamine resin is used in Formica and fire resistant materials since the polymer will release nitrogen gas during combustion.

Why melamine was added into milk and powdered infant formula

Melamine has high nitrogen content, 66.63% by mass. Previously in China, the raw milk is diluted with water to increase its volume and enterprises collect diluted milk to produce other dairy products. This approach results in a low protein concentration which cannot pass the protein concentration test. Hence, melamine is added intentionally to milk to spike the apparent protein level. Standard tests such as the Kjeldahl and Dumas tests check protein content through measuring total nitrogen content; therefore, melamine-adulterated food has false appearance of higher protein content.

Toxicity

As described in Material Safety Data Sheet melamine is "Harmful if swallowed, inhaled or absorbed through the skin. Chronic exposure may cause cancer or reproductive damage. Eye, skin and respiratory irritant". There are data from animal studies. the damage is associated with high dosage of exposure with LD50 of 3161 microgram per kilogram of bodyweight on rat studied by FDA. No human data could be found so far.

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Melamine has low toxicity. The compound is not metabolized and discharged from human body through urination. Melamine largely affects kidney and gallbladder as it may cause cystitis, bladder stones, bladder inflammation. There is not sufficient evidence to conclude that melamine is carcinogenic in human.

The toxicology research shifts the focus from melamine alone to the interaction of melamine with its analogues, particularly with cyanuric acid, which is hypothesized to cause the chronic toxicity on animals. The study finds that melamine or cyanuric acid when administered separately, even at high doses of 181 mg/kg melamine and 243 mg/kg cyanuric acid, did not have any effect on renal function of cats. When melamine and cyanuric acid are ingested simultaneously, even at low dose, it can lead to deadly results, such as acute renal failure. The similar results were found that combination of melamine and cyanuric acid has been linked to acute renal failure in cats and dogs after the outbreak of melamine-tainted pet food in USA 2007.

Chronic exposure to melamine can lead to bladder or kidney stones and as we have noted, acute kidney failure. Renal damage is largely due to the intratubular precipitation of crystals in the kidney. Melamine and cyanuric acid quickly interact into a lattice structure via hydrogen bonds and the crystals are poorly soluble. The retarded removal of melamine-cyanuric acid stones eventually blocks tubules in the kidneys and contributes to renal failure.

http://people-to-pets.com/blog/melamine-used-in-industrial-production-should-not-be-eaten/

Useful links

Melamine World Health Organization

Assessment of melamine and cyanuric acid toxicity in cats Journal of Veterinary Diagnostic Investigation Vol. 19 Issue 6, 616-624

Copyright © 2007 by the American Association of Veterinary Laboratory Diagnosticians

Interim Safety and Risk Assessment of Melamine and its Analogues in Food for Humans U.S. Food and Drug Administration