Baby Dies as New Milk Powder Scare Spreads Across China

Tainted milk formula has killed one baby and caused the development of kidney stones in dozens of others who may have drunk the same product, Chinese authorities concluded on Thursday, in a grim reminder of a milk-powder scandal that killed 13 infants four years ago.

Traces of cyanuramide, which can cause kidney stones, were found in Sanlu-brand milk formula, the Ministry of Health said late on Thursday. The Sanlu Group issued an immediate recall of milk formula made before Aug 6.

Doctors in Gansu Province, in northwestern China, told the Xinhua news agency this week that "fake milk powder" from one brand could have been responsible for kidney stones developing in 14 patients, all infants under 11 months.

Parents of the affected babies, mostly from poor and remote areas, said they had bought the powder much more cheaply than usual, Xinhua said.

Gansu health authorities were aware of the problem as early as July 16, after a local hospital reported seeing 16 babies with kidney stones who had all drunk the same brand of formula, Xinhua said, without explaining the delay in disclosure.

Dozens of other cases of babies developing kidney stones had been reported in Gansu this year, after none was reported in 2006 and 2007. It was unclear whether they had drunk the same brand of milk formula.

Cases of babies developing kidney stones had since emerged in two other hospitals in Gansu and also in Jiangsu, Shandong, Hunan, Anhui, Ningxia and Shaanxi, Xinhua said.

A Sanlu Group spokesman surnamed Cui said the milk powder may have been mislabeled and that "someone" might be counterfeiting their product, Xinhua said.

Sanlu Group, based in Shijiazhuang, Hebei Province, is partly owned by New Zealand dairy export giant Fonterra Co-operative Group Ltd. In a statement carried by the New Zealand Press Association, Fonterra said its Chinese partner was moving to ensure its products were safe.

Sanlu has previously been involved in quality scandals. Authorities in the northern port city of Tianjin seized hundreds of cases of mislabeled Sanlu-brand yoghurt in 2005.

Kidney stones are small, solid masses that form when salts or minerals normally found in urine crystallize inside the kidney.

If they become large enough, they can move out of the kidney, cause infection and lead to permanent kidney damage.

In 2004, at least 13 babies in eastern Anhui province died after drinking fake milk powder that investigators later found had no nutritional value, a scandal that rocked the country and triggered widespread investigations into food and health safety.

China is the world's second-biggest market for baby milk powder.

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Bacterial infections linked to cot deaths

The condition, also known as Sudden Infant Sudden Death Syndrome (SIDS), kills 250 babies in Britain every year but the exact cause is not known.

Parents have been advised not to smoke during or after pregnancy and put babies to sleep on their backs to avoid SIDS, but the precise reasons why this helps are not completely understood.

Now a new study has identified a bacterial infection that appears to contribute to some cot deaths.

The research, published in Archives of Disease in Childhood, found samples from babies who had died for no apparent reason often carried Staphylococcus aureus, a particularly virulent bacteria better known for the MRSA strain in which it becomes resistant to the antibiotic methicillin.

Associate professor Paul Goldwater, from The Women's and Children's Hospital and the University of Adelaide in Australia, analysed the post mortem reports for 130 babies who had died of sudden infant death syndrome (SIDS), 32 who had died suddenly as a result of infection, and 33 who had died of non-infectious cause, such as a road traffic accident.

He then analysed the bacterial isolates from "sterile" sites which are normally free of infections, such as heart blood or spleen in all of the babies.

Unsurprisingly he found infection at a sterile site was rare in those infants who had died of non-infectious causes and common in the babies who had died as a result of infection.

However he also found infection was relatively common in those babies that had died of SIDS.

In many cases, the infection was caused by S. aureus. a particularly virulent bacteria, known to produce potentially lethal toxins.

"The finding of S. aureus in a normally sterile site in a large proportion of cases of SIDS would indicate that a proportion of these babies died of staphylococcal disease," said Dr Goldwater.

S. aureus is common in organisms carried by most healthy adults and scientists said colonisation of infants does not imply lack of hygiene but is bound to happen.

Further research is now needed to find out how to prevent death involving these organisms.

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Painkillers Appear To Lower Prostate Cancer Marker

New research from the US found that men who regularly took common painkillers like aspirin and ibuprofen and other non-steroidal anti-inflammatory drugs (NSAIDs) had lower circulating levels of PSA (prostate-specific antigen), the biomarker that doctors use to assess whether a man is at risk of prostate cancer. However, the researchers were keen to stress that this does not necessarily mean that NSAIDs lower the risk of prostate cancer.

The study was the work of first author Dr Eric A Singer, chief urology resident at the Department of Urology, University of Rochester Medical Center, Rochester, New York, and colleagues, and is published on 8th September in the online issue of Cancer.

Singer and colleagues said men should not start taking NSAIDs on the strength of their findings:

"We showed that men who regularly took certain medications like aspirin and other non-steroidal anti-inflammatory drugs, or NSAIDS, had a lower serum PSA level," said Singer, but he then added that:

"There's not enough data to say that men who took the medications were less likely to get prostate cancer."

He explained that this was a limited study, and they did not find out how many of the men they studied actually went on to get prostate cancer.

For the study, Singer and colleagues looked at data on 1,319 men over 40 who participated in the 2001-2002 National Health and Nutrition Examination Survey (NHANES) conducted by the US Centers for Disease Control and Prevention (CDC).

They looked for links between the men's use of NSAIDs like aspirin and ibuprofen, and another painkiller, acetaminophen (paracetamol) and their PSA levels, and adjusted for the effects of: age, race, educational level, smoking status, body mass index, co-existing inflammations, and heart disease.

They found that regular use of NSAIDs was linked to a 10 per cent lower PSA level compared to non-use. The figures for acetaminophen (paracetamol) were similar but not statistically significant, because of the much smaller proportion of men who took this painkiller compared to the others. Only 1.3 per cent of the men regularly took acetaminophen (paracetamol) compared to 19.8 per cent who regularly took NSAIDs like aspirin and ibuprofen.

Singer and colleagues concluded that their findings:

"Suggest that regular NSAID consumption may reduce serum PSA levels. Whether this is indicative of a protective effect on prostate cancer risk or masks possible prostate injury resulting in reduced detection of prostate cancer is unclear. Given the widespread consumption of NSAIDs and the regular use of PSA for the assessment of prostate cancer risk, the potential implications of the current study's findings may be substantial and warrant further investigation."

While some people might suggest that a lower PSA level directly translates to a lower risk of prostate cancer, Singer and colleagues cautioned against this conclusion. Corresponding co-author, Dr Edwin van Wijngaarden who is assistant professor in the Department of Community and Preventive Medicine at the University of Rochester Medical Center, said:

"While our results are consistent with other research that indicates that certain painkillers may reduce a man's risk of getting prostate cancer, the new findings are preliminary and don't prove a link."

Singer added that PSA can go up for other reasons, not to do with cancer. PSA is also an indicator of inflammation that is often but not always linked to cancer, and reduced PSA could just mean that the inflammation has reduced without affecting cancer risk. It could also be possible that the NSAIDs have lowered the PSA and masked a man's risk of getting prostate cancer, but the real risk is unaltered, said Singer.

"These findings underscore the importance for doctors to know what medications their patients are on," said Singer. He said doctors were aware of medications used to treat an enlarged prostate that can also reduce PSA levels, but they should now also ask patients about their use of NSAIDs.

"The data is very interesting, but it will take more research to determine how to interpret the findings," said Singer, adding that:

In the meantime, this shouldn't change men's behavior or prompt them to take these medications to try to prevent prostate cancer."

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