Results tagged “China” from Pathophilia

A brand of water-based face paint caused a cluster of skin reactions, including rashes, itchiness, burning, and swelling, in children at an "organized event," reports the FDA. The paint contained "significant microbial contamination" according to the agency, and the US seller, Fun Express, is issuing a voluntary recall.* The product was manufactured by Shanghai Color Art Stationery Company Limited in Shanghai, China.

The date and place of the organized event and the number of children affected were not revealed by the FDA. Also the nature of the paint contamination was not specified in the FDA's online press release. However, the AP reports that the agency found elevated counts of yeast and mold in the paint.

The advertised chemical composition of the paint, according to the product label, consists of water, paraffin wax, petroleum, glycerine, calcium carbonate, stearyl alcohol, sodium benzoate (an antimicrobial preservative), acacia senegal, dextrin, and "perfume for body." The label also states that the "paint is made from FDA approved, high quality ingredients, however, as with most cosmetics, a few people may experience an allergic reaction." Fun Express claims that the face paint was sold to 130 customers, and that 95% of these sales were before January of this year—suggesting that the reported cluster of skin reactions was an isolated event.

In 2007, millions of toys were recalled by Mattel after its Chinese-made products were found to be coated with lead-containing paint. The same year, tens of thousands of Chinese-made crayon and paint sets were recalled by Toys "R" Us because of lead contamination.

In 2006, Chinese-imported glycerine (aka glycerol, aka glycerin) that was contaminated with diethylene glycol caused more than 100 deaths of Panamanians who consumed tainted cough syrup. The historical use of diethylene glycol as a deadly, ersatz glycerin substitute has been heavily covered at this blog. Skin contact with diethylene-glycol-containing resins has been reported to cause allergic reactions. 

* Although there is no recall notice at the company's web site or at the web site of its Omaha-based parent company, Oriental Trading Company. The Fun Express web site currently describes its face-paint products as being out of stock.

05/14/09 update: The Columbus Dispatch reports that 43 children in Delaware County, Ohio, who had their faces painted at a Girl Scouts event on Saturday, February 28, developed facial rashes. The local health district revealed today that the purple and red paints caused the most rashes, which typically appeared where the paint was applied. Rashes returned on some children days later, after being exposed to the sun. Three children received medical care for their rashes. In its investigation, the health district received one report that "the paint seemed old, had separated, and was hard to squeeze out of the tube." In the meantime, the Fun Express web site still provides no indication that the products have been recalled.

Yesterday, Chinese courts handed down sentences in proceedings against 21 defendants who were charged with involvement in the country's recent scandal regarding melamine-tainted milk. Sentences ranged from execution to prison time, with the heaviest penalities for 3 men.

• Zhang Yujun, a Hebei province dairy farmer (described by the court as the single largest source of melamine in the country), received the death penalty for "producing and selling poisonous food" or "endangering public security." Zhang reportedly produced 776 metric tons of melamine, 600 of which were added to milk. The court charged that he made $1.26 million in the process.
• Geng Jinping, a small dairy operator in Zhengding County, Hebei province, received the death penalty for "producing and selling poisonous food" or "endangering public security." The court claimed that Jinping added melamine to raw milk and sold "hundreds of tons" of the product to Sanlu, the Chinese dairy-products company.
• Gao Junje, a small business operator, received the death penalty for "producing and selling poisonous food" or "endangering public security." Junje's death sentence was suspended for 2 years.
• Tian Wenhua, 66, former chairwoman of the now-bankrupt Sanlu, received life in prison for "producing and selling shoddy goods." Wenhua pleaded guilty to the charge and was also fined $4.5 million. Some affected parents are reportedly upset that Wenhua was not sentenced to death for her role in the scandal.
• Three former (unnamed) Sanlu executives received 5-15-year prison terms for "producing and selling shoddy goods."

The group of 22 implicated dairies is also offering 200,000 yuan (~$30,000 USD) to parents of a dead child, 30,000 yuan (~$4400) to children with severe kidney stones, and 2000 yuan (~$290) to less severe cases. Total compensation would run to 1.1 billion yuan (~$160 million). State-run television indicates that 90% of families have taken the time-limited and government-backed financial compensation. However, the Toronto Star reports that hundreds of affected parents have rejected the offers.

Melamine, a fake protein additive, in baby formula caused the deaths of at least 6 Chinese infants and sickened nearly 300,000 last year, according to various news sources. But lawyers for the affected families suggest that as many as 10 children died after consuming melamine-laced milk. The Chinese Health Ministry admits that more than 300 affected infants remain hospitalized.

Sources: Toronto Star; China Daily; AP

Depiction of melamine chemical structure from Wikipedia.

The latest in the investigation of melamine in Chinese milk and milk-containing products is the revelation that Cadbury chocolates may contain the contaminant. According to the AP, the British candy maker is recalling 11 of its products made at a Beijing plant, which were distributed in Taiwan, Hong Kong, and Australia.

The Xinhua News Agency reports that 22 people in Hebei Province—including managers of pastures, breeding farms, and milk-purchasing stations—have been detained under the suspicion of making or selling melamine and putting the contaminant into milk. Police seized nearly 500 pounds of the toxin in connected raids.

Last year, melamine (along with cyanuric acid) caused renal dysfunction or failure in unknown numbers of domestic cats and dogs as a result of pet food made with contaminated Chinese wheat gluten. In the September 1 issue of the Journal of the American Veterinary Medical Association, investigators reported their findings in 70 cats from a single, commercial cattery* that were inadvertently fed tainted pet food.

Forty-three cats developed clinical signs of disease, including lethargy, poor eating, vomiting, polydipsia, and polyuria. More than half of the cats (38 of 68) that were biochemically analyzed developed azotemia, and 1 cat died. Among the 13 cats that were euthanized, kidney specimens revealed crystal-associated tubular necrosis and perivascular inflammation.

Cyanuric acid, which is produced by the hydrolysis of melamine, forms insoluble (or poorly soluble) crystals when combined with melamine. According to the FDA, cyanuric acid may be generated in the production of melamine or by its degradation. 

There are no news reports, as yet, regarding the content of cyanuric acid in the currently tainted Chinese milk products.

* Cats were used to assess the "routine palatability and acceptability" of commercial cat foods.

Photomicrograph of cat renal tubule containing gold-brown circular crystals of melamine and cyanuric acid (arrow); bar = 50 microns. Source: Ciancolo RE et al. J Am Vet Med Assoc. 2008;233:729-737.

Melamine-tainted infant formula is now linked to more than 6240 cases of renal stones as of Wednesday, reports WHO. Melamine has been found in products of at least 22 dairy manufacturers in China, with levels ranging from 0.09 to 2.560 mg/kg.

There is also a concern that melamine may turn up in other dairy products, like ice cream. The possible extent of the contamination has caused a nationwide panic among parents, reports the Chinese news agency Xinhua. Today's report also increases the number of melamine-related deaths to 4.

WHO reports that Sanlu, an original source of the tainted formula, received a complaint of illness as early as March of this year and, according to Forbes, Sanlu was urged in early August by its majority owner, New Zealand's Fonterra Cooperative Group, to initiate a product recall. However, Sanlu (in possible collusion with Chinese government officials) delayed the recall to avoid a PR scandal during the upcoming Olympic Games in Beijing. 

Sanlu claims that one of its raw milk suppliers used melamine to artificially boost the product's protein content, wrote Scientific American on Tuesday.

Depiction of melamine chemical structure from Wikipedia.

9/22/08 update: Melamine-tainted infant formula has now sickened 52,857 Chinese children and resulted in the hospitalization of 12,892, reports the AP. More than 80% of those hospitalized were or are 2 years of age or younger, and 104 were or are in serious condition. The latest news report also confirms 4 related deaths. The uptick in ill children may be due to the review of earlier hospital records, from May through August. In addition, the head of the Chinese agency that monitors food and product safety, who had held the position since 2001, resigned.  

Melamine is back. This time, the suspected renal toxin has been found in Chinese-made infant formula, alerts the FDA. The agency is working to inform Asian and ethnic markets in the United States that illegally imported Chinese formula may be contaminated with the fake protein additive. But the FDA is also reassuring consumers that infant formula approved for sale in the United States, which is not made with Chinese ingredients, is safe.

The Xinhua news agency reports an ongoing police investigation into the contamination of Sanlu brand powdered formula in Shijiazhuang, China, where the product was manufactured. The investigation was prompted by reports of kidney dysfunction in at least 50 Chinese infants who consumed the product. One infant reportedly died as a consequence.

Melamine was found last year in Chinese-imported wheat gluten, which was used to produce domestic pet food. Melamine in the contaminated pet food, along with another contaminant, cyanuric acid, are believed to have led to innumerable cases of renal dysfunction or failure in American pets. The event led to the largest recall of pet food in the United States.

In February, the federal government indicted Sally Qing Miller and her husband Stephen S. Miller, from the Las Vegas-based ChemNutra, for importing 800 metric tons of tainted Chinese wheat gluten into the United States, while conspiring to bypass mandatory Chinese inspections.

Primary news source: USA Today

Depiction of melamine chemical structure from Wikipedia.

Update: In a press release, the FDA reports that the following manufacturers have met the necessary FDA requirements for marketing milk-based infant formulas in the United States—Abbott Nutritionals, Mead Johnson Nutritionals, Nestle USA, PBM Nutritionals, and Solus Products LLC. An English-based manufacturer, SHS/Nutricia, sells an amino-acid-based, nondiary infant formula.

9/15/08 update: The AP reports that 2 brothers, who ran a "milk-collection center" (whatever that is) in Hebei province, were arrested on suspicion of adding melamine to the infant formula. The AP also indicates that Chinese officials were slow to initiate a formula recall, after being alerted to the contamination by Fonterra, a New Zealand dairy farmers' cooperative that owns 43% of Sanlu, the manufacturer of the tainted formula. Complaints were reportedly received by Sanlu as early as March, and company tests of formula revealed the presence of the contaminant in August. The AP story does not reveal how the milk-collection center is connected to Sanlu. The latest casualty numbers: 1253 infants possibly sickened, 340 currently hospitalized (53 in "severe" condition), 2 dead.

9/17/08 update: According to the AP, melamine-tainted baby formula has now sickened 6244 Chinese infants, with 1327 hospitalized and 158 experiencing acute renal failure. Three children are now dead as a result. Four milk suppliers have been arrested in China, and the general manager of Sanlu, the manufacturer of the tainted formula, was detained by Chinese police yesterday, wrote the news service. At the center of the investigation is whether Sanlu or the company's local government stalled a public recall of the tainted formula in August. Other Chinese dairy companies are recalling their possibly tainted products, including 2 Chinese exporters, which have sent formula to parts of Asia and Africa. 

Yesterday the Chinese Center for Disease Control and Prevention and the WHO Representative Office in China released their preliminary report on cases of hand, foot, and mouth disease (HFMD) due to enterovirus 71 (EV71) in the country. From January 1 to May 9 of this year, 61,459 cases and 36 deaths were reported on the mainland; the hardest-hit provinces have been Guangdong (11,374), Anhui* (9235), Zhejiang (6134), Shandong (4566), and Henan (3230). A report Wednesday from the Xinhua News Agency provides a current national HFMD death toll of 43. Also 2 children in Lhasa, Tibet, are believed to have contracted the disease.

The known death toll from China's May 12 earthquake is 51,151, according to Xinhua today; 288,431 are believed to be injured, and 29,328 remain missing.

*Home of Fuyang City.

Image of HFMD rash from the Report of the Hand, Foot, and Mouth Disease Outbreak in Fuyang City, Anhui Province and the Prevention and Control in China.

Hand, foot, and mouth disease due to enterovirus 71

: deaths, 42; cases, 24,934.

Earthquake in Sichuan province: deaths, 14,866; estimated missing or buried, 40,000.

Map image highlighting earthquake epicenter in Sichuan province from Wikipedia.

In eastern China, 39 deaths due to hand, foot, and mouth disease (HFMD) are now reported by the official Xinhua News Agency, according to the AP. However, the disease, caused by enterovirus 71 (EV71), is "under control" in Fuyang City, writes Xinhua. There have been no deaths in the hard-hit metropolis of approximately 9 million people between May 2nd and 10th, and most hospitalized children who were in critical condition have recovered, reports a city official.

However, one of the recently reported HFMD deaths occurred in the eastern part of Anhui province, home of Fuyang City (which is in the northwestern part of the province). Another child died on the southern island province of Hainan, and 3 have died in the southern Guangdon province. The number of HFMD cases has escalated to 24,934 in 6 provinces, including Jilin in the far northeast. The cities of Beijing and Shanghai have also been affected.

A total of 22,240 Chinese infants or children this year have contracted hand, foot, and mouth disease (HFMD) due to enterovirus 71 (EV71), reports the official Xinhua News Agency. The tally, which includes 30 deaths, increased by 2278 cases yesterday. It is unclear if the 24-hour surge is due to new cases during that time period, the prompted reporting of existing cases, or both. WHO reveals that the disease only became notifiable in China on May 2. Therefore, the count of those affected has been expected to increase substantially as a result of changes in the reporting policy.

In the hard-hit Anhui Province, home to Fuyang City, 7283 cases of the contagious illness have been identified, with 22 deaths. A total of 738 infections were reported Tuesday, but no fatalities have occurred during the last week. The news agency writes that 2218 patients remain hospitalized in the province, a small fraction of which are in serious or critical condition.

In Fuyang City alone, there have been 4496 cases since May 5, and 1391 children remain hospitalized there, according to WHO. Xinhua reports that a laboratory was recently established in the city, presumably to facilitate diagnostic testing for EV71, which had been performed previously in Beijing (nearly 500 miles away) or Hefei, the province capital (approximately 100 miles away).

WHO reminds us that HFMD is a common and usually mild childhood disease, caused by coxsackie virus A16 or EV71, although EV71-related HFMD can manifest infrequently as encephalitis or poliomyelitis-like paralysis. Outbreaks of EV71-related HFMD throughout southeast Asia and Australia have been documented since 1997. 

Treatment of HFMD consists of supportive, symptomatic care. There is no available vaccine, and prevention relies on appropriate hygienic measures, particularly handwashing. A nationwide personal-hygiene campaign is reportedly ongoing in China. Xinhua also indicates that traditional Chinese medicine is urged by local health authorities, including "a recipe involving a number of Chinese herbs that must be used continuously for at least 7 days."

Map image highlighting Anhui Province (hot pink) from Wikipedia and reproduced under Creative Commons Attribution 3.0 License.

A Chinese health official* said today that the oversulfated chondroitin sulfate found in batches of Baxter's recalled heparin could not have caused the reported allergic reactions and deaths, because only some of the implicated batches contained the contaminant. In a weird turnaround, Chinese health officials state that they will visit Baxter's plant in New Jersey, presumably for inspection purposes. Baxter has numerous manufacturing facilities worldwide, including one in Cherry Hill, NJ.

Source: Reuters

Update: The Philly Inquirer reports that, in February, the FDA inspected Baxter's 372,000-square-foot facility in Cherry Hill, NJ, and observed no infractions.

*Jin Shaohong, deputy director-general of the China National Institute for the Control of Pharmaceutical and Biological Products.