The effects of the current outbreak of the H7N9 avian influenza in China has been as varied as causing the sales of KFC to drop and causing the stock-prices of rubber-glove manufacturers to be on the uptrend..but there’s no mistaking the fact that to date, there has been 9 deaths and 28 confirmed cases (see here).
But a mystery is brewing..the first known human case was in eastern China on Feb. 19, but this was not announced to the public until March 31, some 6 weeks later. This delay in announcement is even being questioned by the heavily censored news media, such as the Communist Youth Daily, the official newspaper of the Communist Youth League.
Was there deliberate concealment by the health authorities? The answer may not be that straightforward. Possible reasons for the delay may include that the new virus strain shows unusual properties and that Chinese laboratories might have been doing tests to detect the previous H5N1 strain instead. To recap, the H5N1 outbreak struck in 2003 where a total of 247 people died. Measures instituted at that time included the controversial administration of several million vaccines to the chicken population at a significant economic cost. This could also be a reason why the news has been suppressed.
Avian influenza (also called avian flu, bird flu) is a flu virus that infects poultry but can be transmitted to man by direct or indirect exposure to infected live or dead poultry or contaminated environments. It is generally classified of low virulence (it does not spread to man easily). There is no evidence that the disease can be spread to people through properly cooked food. You can get more info from the WHO Fact Sheet here.
After the melamine scandal surfaced and reported here in September 2008, the Chinese health authorities have seized tons of contaminated milk from local manufacturers as well as received even more from rejected foreign shipments.
The problem with the Chinese Health Ministry now is how to dispose off the tens of thousands of tons of melamine-stained milk which had been seized so far. Well, some of it was buried and mixed with coal while one trash company in Guangzhou actually dumped it into a river, turning the waters a frothy white!
Nobody’s saying how much exactly has been seized, but to give an idea, last month some 32,000 tons – enough to fill up 23 Olympic swimming pools – were disposed off in the province of Hebei alone, according to local news agencies.
Another ingenious method was to icinerate the contaminated milk powder in 3000 degree heat and convert the residue to cement, a technique which was claimed to be environmentally friendly. In fact, this method is one of two officially approved by Beijing, the other being to dispose them into official land-fills.
So, it looks like the official Chinese government stand is.. burn it or bury it!
If you think that only milk and milk products with only Chinese names are contaminated with melamine, the results released by the Center For Food Safety of Hong Kong as reported by China Daily yesterday raised the possibility that the practice may be more widespread.
Of 65 different brands tested, one contained melamine at a level of 1.4 ppm(parts per million), the safety limit being 6.3 mg per kg body weight per day. While the level detected is below the safety limit, it was enough for the authorities to have it removed from the shelves. However, to allay concerns, this product, named as Nestle Dairy Farm Pure Milk (Catering Use Only), was actually manufactured on the Chinese mainland.
The recent outbreak in mainland China was reported widely in the media the last 2 weeks and to date, 53,000 babies are affected, 13,000 hospitalised and 4 have died , and counting..
Melamine is used in making plastics and is loaded with nitrogen molecules. Because of the high nitrogen content, this makes milk products appear to have a higher protein count as the current methods of measuring protein are based on measuring the nitrogen content alone. Health experts say that ingesting small amounts does no harm, but sustained use especially in babies and children can cause kidney stones and renal failure, as melamine is insoluble in the human body and tends to deposit itself in the kidneys which cannot remove it from the system via the urine.
But why add melamine in the first place? This allows milk to be diluted with water by the unscrupulous and the greedy to give more volume. The ‘protein’ levels are then built up back by adding the protein substitute (melamine).
A burning issue is that, while the NZ government raised this issue as early as March this year, no action was taken by the Chinese government. One of the reasons quoted by some newspapers was that the Chinese government had issued a 21-point plan to all journalists covering the Olympics to avoid taboo subjects, including food safety issues (point 8). A sort of news censorship to put the Beijing Olympics in a spotless stage. I guess I should add the melamine issue as an addition to my series of earlier posts on “Beijing Olympics Face Major Health Issues”…. 😦
Update(26/9/08): From milk to sweets: The popular White Rabbit candy, which is distributed worldwide, was tested positive for melamine in Singapore. The manufacturers Guanshengyuan have now halted export of this sweet.
Update (02/10/2008): The Melamine Milk Mess – Other Foods Have Been Banned,too
Update (08/10/2008): Not enough: Despite assurances of new melamine-free milk from the Chinese authorities and a clamp-down on guilty parties, Thailand’s FDA today still found melamine in newly imported milk. See here.
Update (13/10/2008): China’s watchdog on quality GAQSIQ today reported that no traces of melamine have been detected in the 4th round of tests since the outbreak. Sofar,1209 batches have been tested since Sep 14 and none contained melamine, it added. See here.
Update (16/10/08): Switzerland yesterday withdrew S&P Milk Cookies which were made in Thailand. This would be the first food source outside of China to contain significant melamine content, although it is still unclear if the milk used was originally from China. See here. Another startling revelation today is that Thailand’s FDA has detected high melamine in condensed skimmed milk (Mali Brand) whose manufacturers claim they sourced milk from countries other than China. See here and here.
Update (21/10/08): It looks like melamine has found its way into foods other than milk. A raising agent used in making cookies (called ammonium carbonate) has been found spiked with melamine in Taiwan and Malaysia. Nowadays, ammonium carbonate has been replaced by baking soda in most cookie factories, but some still retain the former due to its inexpensiveness.
Update (24/10/08): Consumer confidence regarding drug & food safety watchdogs appeared further shaken with the news that the European Union has banned a popular recently-introduced slimming pill Acomplia. See my post here.
Update (26/10/08): Singapore today banned some more biscuits and cookies originating from China and Malaysia. Get more details here.
Update (27/10/08): Its now eggs.. China has discovered hen’s eggs to be contaminated with twice the permitted levels of melamine. The implication here is that chicken too may be affected as the suspicion is that melamine has been added to animal feed. See here.
Update (1/11/08): The Chinese state-run media yesterday published a report saying the illegal practice of mixing melamine into animal feed to boost its apparent protein levels was an “open secret” in the food industry. This has spurred a series of law-suits by affected families. See here.
Update (4/11/08): The tainting of milk with melamine has been an open secret in China for many years, except that users were told it was ‘protein powder’ instead. An excellent overview by the Wall Street Journal is found here.
Update (6/11/08): Another brand of cream crackers made in Malaysia has been found to contain more than the acceptable amount of melamine, the Food and Drug Administration (FDA) of Thailand said yesterday.See here.
Update (7/11/08): China hits back… as its health authorities released a list of foreign food products which were imported into China and banned for not meeting its health standards. This includes milk products from Australia! See here.
Update (14/11/08): The United States has prevented the entry of a broad range of foods from China which have been implicated to contain melamine, a move which is unprecedented. Read here.
Update (16/11/08): Find out how China has disposed off the thousands of tons of melamine-tainted milk in my new posting.
Update (25/11/08): Well, what do you know! Traces of melamine were found in infant formula milk in the USA which were not originating from China. Expect to hear more. Meanwhile, see here.
Update (28/11/08): Two brands of milk made in USA have been named by FDA: Mead Johnson’s Infant Formula Powder and Enfamil LIPIL. And calls for a national recall of infant formula milk in the US are now spreading. Read here.
Update (30/11/08): In the face of mounting criticism, the US FDA has revised their guidelines on what constitutes safe levels by declaring melamine levels at below 1 ppm to be safe for infants. See here.
Update (02/12/08): For the first time since the outbreak, China has released the latest figures: a total of 294,000 (!) have been taken ill, 51,900 required hospital treatment and 6 have died. Click here.
Update (03/12/08): Saudi Arabia has now joined the list of affected countries. Read my posting here.
Update (06/12/08): Finally! WHO issued safety limits for melamine levels in food. The so-called Tolerable Daily Intake (TDI) has been fixed at 0.2 mg per kilogramme of body weight. See here.
Update (10/12/08): To date, Australia has withdrawn 11 food products from its shelves. See the list here.
Update (17/12/08): China has listed 17 harmful food additives to be banned. See the main ones here.
Update (29/12/08): 22 dairy producers in China have been asked by the Chinese government to come up with compensation totalling close to US 2 billion. Families who lost babies will get US$30,000 while those who were hospitalised will get US$4,500. Read more.
Update (03/01/09): In a surprising turnaround of events, parents of children affected by the milk scandal were detained by Chinese authorities. Read more.
Update (10/01/09): FDA melanine guideline levels are unsafe, say US consumer group. See here.
Update(14/01/09): The final toll? A total of 296,000 babies fell sick. 52,898 infants needed to be hospitalized with 52,582 of the babies being cured and at least six dying. 6 had already died. See here.
Update(23/01/09): A few days before the Chinese New Year, Chinese courts have sentenced 2 to death and the former head of Sanlu milk company to life. But the affected parents remain unhappy. Read here.
Update(02/02/09): While the former head of Sanlu is appealing her life sentence, New Zealand’s Prime Minister has said that the Chinese milk scandal has damaged NZ’s image.
Update (11/02/09) : Its payback time and China goes on the offensive. See my latest blog article here.
Before undergoing surgery, one important info which must be disclosed to your doctor is whether you are taking herbal supplements. This is often left out by patients when doctors enquire on what medications they are taking, as often many people do not equate medicines with supplements.
Many intensive care physicians including anaesthesiologists will tell you of their experience with patients who take a long time to wake up after surgery; develop fits upon recovery or bleed excessively after surgery; all due to the taking of herbals.
Incidents like the above used to mystify many doctors previously but evidence is now clear that several over-the- counter supplements can interfere with the various actions of medications used during surgery.
Take a look below at some common examples:
|Herbal supplement||Possible complications|
|Aloe vera||May cause increased intestinal muscle movement to digest food (peristalsis), may decrease effectiveness of water pills (diuretics) given after surgery|
|Bromelain||May cause bleeding or interact with antibiotics such as amoxicillin or tetracyclines|
|Danshen||May cause bleeding|
|Dong quai||May cause bleeding|
|Echinacea||May interfere with immune functioning, may alter effectiveness of immunosuppressant drugs given after transplant surgery|
|Ephedra||May cause abnormal heartbeat, may cause extreme high blood pressure and coma if combined with certain antidepressants and anesthesia|
|Feverfew||May cause bleeding|
|Garlic||May cause bleeding, may interfere with normal blood clotting|
|Ginger||May cause bleeding|
|Ginkgo||May cause bleeding|
|Ginseng||May cause bleeding, may cause rapid heartbeat, may cause high blood pressure|
|Goldenseal||May cause or worsen swelling and high blood pressure|
|Kava||May enhance sedative effects of anesthesia|
|Licorice (not including licorice candy)||May increase blood pressure|
|Omega-3 fatty acids||May cause bleeding if taken in doses greater than 3 grams a day|
|Senna||May cause electrolyte imbalance|
|St. John’s wort||May increase or decrease the effects of some drugs used during and after surgery|
|Valerian||May prolong the effects of anesthesia|
- Remember that the list of medications that you need to reveal to your doctor includes all supplements, whether as pills or as a drink.
- Some of these herbals may have to be stopped more than 2 weeks prior to planned surgery.
- In emergency surgery, remember to reveal to your doctor and next-of-kin what you are taking so that some preventive measures may be undertaken beforehand by the doctors.