Thursday, September 25, 2008

Melamine Poisoning in Children

Melamine resin or melamine formaldehyde (also shortened to melamine) is a hard, plastic made from melamine and formaldehyde by polymerization. This plastic is often used in kitchen utensils and plates, often called melamine wares. It may also used as table lining such as formica. Being fire resistant, it has been made into fibres of fire resistant clothes that firemen use.

Aside from common commercial uses, melamine became a topic of much discussion in early 2007, when veterinary scientists determined it to be the cause of hundreds of pet deaths, because of pet food contamination. Prior to these reports, melamine had been regarded as non-toxic or minimally toxic. However, because of the unexplained presence of melamine in wheat gluten added to mass-produced dog and cat foods, it is the most likely cause. Pet owners report symptoms that are commonly associated with renal failure, which could be explained by the ammonia that may result from the digestion of the melamine.


Time magazine 17 September 2008 mentions “the material — in powdered form — has also come into use by certain unscrupulous food companies as a cheap and abundant filler substance for products ranging from livestock feed to pet food — and now, apparently, to baby formula. In some tests used to determine the nutritional value of a foodstuff, melamine shows up as a protein — so manufacturers can use the compound to make their products appear more nutritious. Melamine is not toxic, but inside the body it can cause kidney stones and renal failure.” The FDA database concurs.

Another Time report 16 September 2008 states that “On September 17, Chinese Health Ministry authorities announced that over 6200 babies had fallen ill, many developing kidney stones, from drinking milk made from toxic powder. At least three have died, and more than 50 remain in serious condition. Officials have said the number of victims could climb, the China Daily reported. Chinese authorities say the milk powder, produced by Chinese dairy giant Sanlu Group, was contaminated with melamine, a chemical used in making plastics. Melamine has been illegally added to food products in China to boost their apparent protein content.” The company started recalling its product on 11 September 2008, a too little, too late to save those who have died and countless others who will suffer kidney problems now or in the future. It was suspected that the company has received complaints about their milk in December 2007.

The World Health Organisation has this to say:



What are the health effects of melamine consumptions in humans?

While there are no direct human studies on the effect of melamine data from animal studies can be used to predict adverse health effects. Melamine alone causes bladder stones in animal tests. When combined with cyanuric acid, which may also be present in melamine powder, melamine can form crystals that can give rise to kidney stones.


These small crystals can also block the small tubes in the kidney potentially stoppingthe production of urine, causing kidney failure and, in some cases, death. Melamine has also been shown to have carcinogenic effects in animals in certain circumstances, but there is insufficient evidence to make a judgment on carcinogenic risk in humans.

What are the symptoms and signs of melamine poisoning?

Irritability, blood in urine, little or no urine, signs of kidney infection, high blood pressure

What is the treatment for kidney stones and kidney failure?

Patients may receive various types of treatment, depending on the severity of the kidney effects. Treatment may include infusion of fluids and urine alkalinisation, correction of electrolyte and acid-base disturbance, haemodialysis or peritoneal dialysis, or surgical removal of kidney stones.


Today I have seen a few children brought in by parents who are afraid their children has melamine poisoning (I practise paediatrics in Malaysia)

My advice is:

(1) There is no need to panic. Most infant formula in Malaysia are sourced from Australia, New Zealand and Europe. Check with the local papers to see if your children have been drinking milk that are on the banned item list.

(2) Eating from melamine plates and bowls do not cause melamine poisoning.

(3) Bring your child to see a doctor only if your child has been drinking milk on these banned list in the last twelve months. It is not necessary for you to bring your child if your child has drunk a glass of the ‘banned’ milk or eaten a White Rabbit candy ten years ago!

(4) Your doctor may suggest a urine test if he or she suspects anything. The urine test is a good screening for injury to the kidneys.


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12 Comments:

Anonymous Alwyn said...

A local expert voice at last! :)

Thanks for this.

8:50 AM  
Anonymous Anonymous said...

I travelled in China from 4 June to 20 July 2008. During this time I consumed milk products (cafe lattes from Starbucks & Kirin Milk Tea, which has just been withdrawn for sale in Australia). Shortly before leaving China for Laos, I suffered severe headaches, lethargy and irritability. On arrival in Laos I went to the Australian Embassy Clinic in Vientiane. My blood pressure was sky-high (120/180). My pulse rate was regular (65 bpm) and my ECG was normal. A blood test was done to test electrolyte levels, which were normal. Since returning to Australia feelings of lethargy have persisted along with bouts of irritablity. If my consumption of milk is typical of a Western traveller in China I would guess that there are many like me who have also been contaminated by melamine and I am concerned that I continue to be affected by this poison. I am seeking medical advice tomorrow and will adivse on the outcomes.

11:22 AM  
Blogger Alex Tang said...

dear Anonymous,

Thank you for sharing. Do let us know the outcome of your visit to your doctor.

7:30 PM  
Anonymous Anonymous said...

Dear Alex,

The outcome of the visit to the doctor was very comforting. I had a battery of blood tests and urine analysis which showed no evidence of impairment of kidney or liver function as a result of ingestion of melamine while travelling in China. Blood pressure has returned to normal (125/70 cf to 180/120 when in Laos). Whether there will be any long-term effects from other ingredients in the the melamine used by criminals to boost apparent protein levels of milk. So all good for the moment and hopefully into the future.

Regards,

Greg

11:42 AM  
Blogger Alex Tang said...

Hi Greg,
I am so glad to know that you have recovered from the unpleasant experience and I pray that there will not be complications from this in the future. Thanks again for sharing. I still am not able to understand how people can do this to baby milk and other products.

11:49 AM  
Blogger chinaRoll said...

Interesting article. I am a foreigner who has been living in southern China for the past three years and I eat local Chinese food everyday. I developed gout while living in China. I am an athletic, active, thin, otherwise healthy, 29 year-old male with no history of the disease. Gout is related to kidney stones and high uric acid. I haven't heard other expats mention this before so I figured I would give my anecdotal experience. I suspect my problem is related to melamine contamination and cyanuric acid. Does anyone know how to test for this in humans?

6:43 AM  
Blogger Alex Tang said...

hi chinaRoll,

Yes, there is an association of gout to kidney stones.

Melamine testing is conducted using rudimentary chromatographic techniques, including analysis via Gas Chromatography, or High Pressure Liquid Chromatography (HPLC). A urine test is a common diagnostic technique.

I do not know where in China can you get such a test. Sorry. Maybe other readers will help?

12:51 PM  
Anonymous LS said...

This is very late, but..
I am 27 and I lived in China for a good year from mid-2006 to summer 2007. A few months after my return I developed gout all of a sudden. I am by no means overweight (on the lower side of normal), female and also don't fall in the age risk group. I don't eat any of the foods commonly cited as high-risk (seafood, organs - legumes VERY rarely) because I don't like them. There is NO family history of gout. And yet I ended up with it for some reason.. I am suspecting by now it has to do with melamine as well.

Long story short, chinaRoll, I really, really sympathize!

10:36 AM  
Blogger chinaRoll said...

LS - very intrigued to hear your account. As Alex comments, there appear to be ways we can be tested to see if our gout is, in fact, melamine related (if not directly caused by melamine crystals). Incidentally, I now live in Hawaii and hope to find one of these tests. I hope the good Doctor's blog here also inspires other China-dwellers with gout to describe their personal experience. If you don't mind me asking LS, do your gout symptoms present in your toe or other joints?

1:49 PM  
Anonymous LS said...

Hi chinaroll, I'd be really interested in the outcome if you can find such a test. I also wonder how long traces can be found in the body. It looks like gout came as suddenly to you as it came to me! For me, it appeared in the toe. It was so abrupt (one morning I woke up and couldn't walk anymore, let alone wear a shoe), I seriously thought I had accidentally broken it until the doctor told me it was gout. Btw, I didn't technically "return" to my home (Europe) after China, I moved on to Singapore which is where I'm now and where I had the first incident of gout a few months after I left China. I have returned a few times for work, but not for a significant amount of time. Did you have a single incident or recurring ones? I had one, but it took months until it was completely gone. *knockonwood*

3:39 PM  
Anonymous Anonymous said...

I found this site very interesting on several levels. As most Americans do, I hear the news but don't listen to it. Until it relates to me. Then the internet searches lead me from one end of the earth to the other looking for information. I truely believe the Lord led me to this site, since I only searched about an hour and a half ago! To get to the point, I don't know why I started searching for melamine poisoning and effects.
So to get on with my story...I am a middle aged white female, midwest United States, relatively health conscience watching weight gain, chloresterol, blood pressure, considered a very average person that has been in excellent health for 11 years since the Lord healed me of cancer 11 years ago. Regular check ups comfirm the healing was real and it is my testamony to the Lord's promises. THEN, something happened, my blood platelets went close to off the chart (+1000) my chloresterol levels went very high although I live on balanced diet. The doctor wanted to start me on drugs to control it. My weight went up, but it could of been due to inactivity because I developed gout in my left ankle and my thumbs!!! Very painful to walk, and giving up my job, and went in for CBC tests, oncology panels, bone biopsy and a dna test. It shows all sorts of imbalances, and the doctors asked me if I was exposed to all sorts of different things, but nothing I know of. I was treated with chemo drug hydroxyurea to reduce the platelets, and some gout medicines, which reduce urea levels, and this has been going on for several months.
Diagnosis: essential thrombocytosis with no cause. It can be controlled, but not cured.
I know this is a long story, but could it be possible that melamine poisoning triggered all this to happen? I know from other reading that melamine can cause stones, and the high platelets are related to injuries. I had no injuries, no surgeries, just terrible pain in my foot and ankle like it was broken. I went to a specialist and he could find nothing wrong, and suggested I keep it bound up and elevated. BUT....about a week ago the Lord did something to remove the pain!!! My foot is good! I have been walking and just about as good as new!!! Now I have to get off the extra weight I am pulling around! I hope this helps someone, I am only now on aspirin and armour thryroid. I made that change last month. Could melamine been used as a filler in generic synthyroid?
So there are some of my random musings! thank you for the space!

4:38 AM  
Blogger Alex Tang said...

Hi Anonymous,

Thank you for your sharing. It is wonderful to know that the Lord healed you of cancer and essential thrombocytosis.

As far as I know, melamine is not used in the manufacture of synthetic thyroxine.

3:42 PM  

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