Alarm bells are ringing across Madhya Pradesh and Rajasthan as the deaths of 12 children have been linked to the consumption of cough syrups. This tragic situation has prompted the central government to issue an advisory against prescribing cough and cold medications to children under the age of two.
In Madhya Pradesh, nine children have died in the Chhindwara district over the past month, with five others undergoing specialized treatment in Nagpur, Maharashtra. Preliminary investigations suggest a link between these deaths and the consumption of certain cough syrups. At least five of the children who died had taken Coldrif syrup, and one had taken Nextro syrup. In Rajasthan, three deaths have been reported in the past week, with several other children developing complications after taking a cough syrup distributed under the state government's free medicine scheme.
The Union Health Ministry has stated that initial tests of cough syrup samples from Madhya Pradesh did not reveal the presence of diethylene glycol or ethylene glycol, toxins known to cause severe kidney damage. Despite these findings, the cause of kidney failure in the affected children remains a mystery. Samples from Rajasthan are currently undergoing testing, and the manufacturing company of the syrup in question is under scrutiny.
The state health department in Rajasthan has denied any connection between the deaths and the dextromethorphan-based formulation, but has still banned the syrup's distribution and sale pending test results and a formal investigation by a three-member committee. A senior doctor in Rajasthan publicly consumed the syrup to demonstrate its safety, but collapsed a few hours later and was found unconscious in his car.
In response to the deaths, the Directorate General of Health Services has issued an advisory to all states and Union Territories, recommending that cough and cold medications not be prescribed to children under two years of age. They are also generally not advisable for those below five. The Tamil Nadu government has banned the sale of cough syrup 'Coldrif' and ordered its removal from the market following suspicions linking it to the deaths.
The affected cough syrups include Coldrif and Nextro-DS in Madhya Pradesh, and a dextromethorphan-based formulation in Rajasthan. Samples of these syrups have been sent for testing, and their sale and use have been restricted. It has been found that the cough syrup from Rajasthan does not contain Propylene Glycol -- a possible source of DEG/EG contamination.
A total of 10,119 samples of medicines manufactured by Jaipur-based Kaysons Pharma, which supplied the dextromethorphan-based cough syrup that has been blamed for three deaths, have been subjected to quality tests since 2012, and 42 of these were found to be substandard. As a precaution, the state health department has stopped the supply of all 19 types of medicines provided by this company until further orders.
These recent incidents echo previous cases of contaminated cough syrups causing deaths in India and abroad. In 2022, cough syrups made by Indian companies were linked to deaths in the Gambia and Uzbekistan, raising concerns about the quality control and regulatory oversight of pharmaceutical manufacturing in India. While investigations were launched and statements were issued, no one was ultimately punished.
The current situation highlights the urgent need for stricter regulations and quality control measures in the pharmaceutical industry to prevent future tragedies.
