Tragic Loss: Diethylene Glycol Poisoning in Children from Contaminated Cough Syrups

In recent weeks, India has witnessed a devastating series of child fatalities linked to the consumption of contaminated cough syrups. The primary culprit identified is diethylene glycol (DEG), a toxic industrial chemical that has been illicitly introduced into pharmaceutical products. This blog post delves into the nature of DEG, its toxic effects, and the tragic incidents that have unfolded.

What is Diethylene Glycol (DEG)?

Diethylene glycol is a colorless, odorless, and sweet-tasting chemical primarily used in industrial applications such as antifreeze, solvents, and plasticizers. It is not intended for human consumption. However, due to its sweet taste and low cost, DEG has been illicitly used as a substitute for glycerin in pharmaceutical products, leading to severe poisoning incidents.

Toxicity of DEG

When ingested, DEG is metabolized in the liver to toxic compounds that can cause:

Acute Kidney Injury (AKI): DEG is a potent nephrotoxin, leading to kidney failure.
Neurological Symptoms: Headache, dizziness, and seizures.
Metabolic Acidosis: A condition where the blood becomes too acidic, disrupting normal bodily functions.
Death: In severe cases, especially in children, ingestion can be fatal.

The toxic dose of DEG is estimated to be as low as 1.34 mL/kg body weight, making children particularly vulnerable. (JAMA Network)

Recent Tragedies in India

In a series of heartbreaking events, at least 14 children under the age of five have died in Madhya Pradesh after consuming contaminated cough syrups, notably ‘Coldrif’ and ‘Nextro-DS’. Laboratory tests confirmed the presence of DEG in these syrups. (The Times of India)

The symptoms began with mild cold signs but rapidly progressed to acute kidney failure, with affected children ceasing to urinate. Despite treatment efforts, several children succumbed to the poisoning. (The Sun)

Regulatory Actions and Response

In response to these tragedies, Indian authorities have taken stringent measures:

Banning Contaminated Products: The sale and distribution of ‘Coldrif’ and ‘Nextro-DS’ syrups have been prohibited. (The Times of India)
Investigations Initiated: Authorities are investigating the source of contamination and holding responsible parties accountable. (The Times of India)
Public Awareness Campaigns: Health advisories have been issued to prevent further incidents.

Global Incidents of DEG Poisoning

India is not alone in facing this issue. Similar incidents have occurred worldwide:

The Gambia (2022): Over 70 children died after consuming DEG-contaminated cough syrups. (Wikipedia)
Uzbekistan (2023): At least 20 children died from similar exposures. (Wikipedia)
Haiti (1995-1996): 86 children died due to DEG-contaminated acetaminophen syrup. (CDC)

Conclusion

The recent deaths of children in India serve as a stark reminder of the dangers posed by unregulated pharmaceutical products. It is imperative for regulatory bodies, manufacturers, and healthcare providers to ensure the safety and integrity of medications, especially those intended for vulnerable populations like children.

Call to Action

If you reside in areas affected by these incidents, please:

Check Medication Labels: Ensure that any cough syrups or medications for children are from reputable sources and have not been recalled.
Report Suspected Products: If you possess any of the affected syrups, contact local health authorities immediately.
Stay Informed: Follow updates from health departments and the World Health Organization regarding the safety of pharmaceutical products.