Melamine Contamination of Milk : WHO Perspective on Food Safety Issues

1. 4th Dubai International Food Safety Conference Dubai, February 24-26th, 2009. WHO/OMS Melamine Contamination of Milk : WHO Perspective on Food Safety Issues Peter Karim Ben Embarek Department of Food Safety, Zoonoses and Foodborne Diseases World Health Organization (WHO), Geneva, Switzerland

2. Salted butter garlic puree garlic salt lemon parsley pepper water - Ireland - China, USA, Spain Herb Butter : - China, USA, Spain - USA - France, UK - Indonesia - Ireland Chicken Breast: Chicken Batter: - Belgium, France Flour Water - Ireland - Ireland, UK Bread Crumb: Bread crumb Rape-seed oil - EU, Australia Eastern Europe Globalisation of Trade :“The World on your Plate” - Ireland, Belgium UK, France etc. Chicken Kiev Courtesy A. Reilly, FSAI, Ireland

3. H5N1 Avian Influenza, Human cases, Pandemic Threat

4. Communication/education - For at-risk groups - Interventions available for risk reduction - Translation into national guidance - New languages for wider dissemination

5. Consumer education Simple key messages

6. Looking at the whole chain • An integrated and effective food safety system must prioritize consumer protection. • Prevention efforts have to integrate the full food production chain: from Farm to Fork, • Most food safety systems do not follow these principles. This has led to inconsistency and inefficiency of foodsafety systems.

7. Melamine • A chemical we know from inexpensivedinnerware, tabletop, etc... • Is rich in nitrogen • Nitrogen in food will be registered as protein (Kjeldahl analysis) • Added to food it will therefore disguise a low protein content

8. Chronology of Event December 2007: • One dairy producer (Sanlu) began receiving complains from consumers July 2008: • Sixteen babies in Hebei province were found with kidney stones. They were fed with infant formula made by Sanlu WHO/Sari Setiogi

9. Chronology of Event September 2008: • 11 - WHO was informed by the Chinese authorities • 15 - Sanlu apologizes to the public. 11000 tons of milk powder seized or recalled. • 17 – Contaminated products originating from China found in Singapore. • 18 - Melamine found in fresh milk • 22 - Director of China's General Administration of Quality Supervision, Inspection and Quarantine (AQSIQ) resigned • 23 - China confirmed delay in informing the public • 25 - WHO issued "Melamine and Cyanuric Acid: Toxicity, Preliminary Risk Assessment and Guidance on Levelsin Food"

10. Chronology of Event October 2008 : Extension to the feed industry : • 16 - Japan reported melamine in egg products from China • 20 – 1,500 racoon dogs in China died after eating contaminated feed • 30 - Chinese state media reported melamine in animal feed

11. Role of Media The event was broken by the media, both in China and internationally Media are important sourceof information, e.g. for newcontaminated products "New media" – such asblogs and YouTube, alsoplay role in spreadingthe news

12. Contaminated Infant Formula • Melamine was added in milk collection centres to disguise diluted milk with water • 22 of 79 Chinese powdered infant formula producers affected • Powdered Infant formula products from affected producers exported to 5 countries • Levels detected range from <0.1 – 2600 mg/kg

13. Other products contaminated Other products affected: • milk (powder), yoghurt, biscuits, instant & liquid coffee preparations, candies, frozen desserts, novelty products… • egg powder, fresh eggs, animal feed • Sodium bicarbonate (raising agent) • Protein powders • Exports reported all over the world

15. Levels of Melamine

16. Children affected in China • More than 290 000 children affected • 51 900 hospitalized • 6 deaths reported • 22.4 million children screened

17. Epidemiology Signs/symptoms in cases • Unexplained crying in infants, especially when urinating, possible vomiting • Naked eye visible or microscopic hematuria • Acute obstructive renal failure (oliguria or anuria) • Stones discharged while passing urine • High blood pressure, edema,

18. Measures taken FAO/WHO actions • INFOSAN (International network of food safety authorities) Through INFOSAN Emergency network (151 countries) regular updates of information shared (secure website) • Close collaboration and direct communication with Chinese MOH • Collaboration with affected countries information verification and alerts • Assistance to countries Laboratory information, analytical methods, considerations for setting limits etc. • Public Websites Special websites that are continuously updated have been set up;

19. WHO melamine websites • Secure INFOSAN website for food authorities in Member States • Open website for general public:http://www.who.int/foodsafety/fs_management/infosan_events/en/index.html(Preliminary risk assessment and guidance on levels in food; Analytical methods; Podcast) • Disease Outbreak News:http://www.who.int/csr/don/2008_09_19/en/index.htmlhttp://www.who.int/csr/don/2008_09_22/en/index.html • WHO Regional and Country Offices:http://www.searo.who.int/http://www.wpro.who.int/china/media_centre/press_releases/pr_20080926_04.htm

20. Measures Taken: National Authorities • Traceability of imported and exported products • Test for melamine (and cyanuric acid) • Withdrawal of confirmed and suspected melamine contaminated products • Alert to other countries if products exported • Regulatory actions, e.g. import bans • Preliminary risk assessments and interim limits for melamine in food and feed

21. Limits set by National Authorities *These levels will apply to a combined concentration of melamine and cyanuric acid (a chemical generally found together with melamine).

22. Limits set by National Authorities (2) °This level applies to melamine and melamine-related compounds.

23. Toxicology of melamine • On its own melamine is not extremely toxic (but in high concentrations can cause kidney and bladder affections (calculi) – leading to cancer in animals) • Melamine has a low acute toxicity, with an oral LD50 in the rat of 3161 mg/kg body weight (OECD 1998). • Together with cyanuric acid (break-down product of melamine) it forms kidney stone • Effects presumably more serious in infants (because of dramatic exposure when only fed infant formula with high melamine concentration)

25. For further information : Internet : http://www.who.int/foodsafety E.mail: benembarekp@who.int