Cough syrup deaths: Government rules out toxic contamination in Madhya Pradesh, Rajasthan cases

New Delhi: The Union Health Ministry on Friday ruled out toxic contamination of cough syrups as the reason for deaths of children in Madhya Pradesh and Rajasthan as initially suspected, but maintained that investigations are on to determine the cause behind the tragedy.

Medicine samples collected by the official probe team were tested for common contaminants like diethylene glycol and ethylene glycol (DEG and EG) that are known to cause kidney injuries.

“As per the test results, none of the samples contained DEG or EG. The Madhya Pradesh State Food and Drug Administration also tested three samples and confirmed absence of DEG/EG,” a Union Health Ministry official said.

The Director General of Health Services in Union Ministry of Health and Family Welfare, on Friday issued an advisory to all States and Union Territories on rational use of cough syrups in paediatric population, advising strictly not to use them in children below two years. They are also not generally recommended for kids below five years.

This comes after death of seven children – all under five years of age - in Chhindwara district of Madhya Pradesh and two more in Sikar and Bharatpur district of Rajasthan in September.

Suspecting contamination of two common cough syrups given to the kid, the Chhindwara district administration banned the sale of the medicines across the district and issued an advisory to parents, doctors and medicine shops.

The health ministry sent a joint team consisting of experts from National Centre for Disease Control, Delhi; National Institute of Virology, Pune, Central Drugs Standard Control Organisation, Indian Council of Medical Research and All India Institute of Medical Sciences, Nagpur. Multiple samples were collected in coordination with the state authorities including samples of various cough syrups.

“While toxic contaminants have been ruled out, further tests are being conducted by NIV Pune for common pathogens. One case has been found positive for leptospirosis. Samples of water, entomological vectors, and respiratory specimens are under further investigation by NEERI, NIV and other laboratories,” the official said.

On the two deaths in Rajasthan, suspected to be due to contaminated cough syrup consumption, the ministry clarified that the product in question didn't contain Propylene Glycol, which could have been the potential source of contaminants, DEG/EG.

Additionally, the product under reference is a dextromethorphan-based formulation, which is not recommended for paediatric use. The DGHS in its advisory suggested adequate hydration, rest and supportive measures as the first line of treatment because cough illness in children is self-limiting and gets cured without any medicine.

Meanwhile, health campaigners from Jan Swasthya Abhiyan (People’s Health Movement) have approached the Rajasthan Health Minister gajendra Singh Khimsar to constitute an “independent committee” to undertake an urgent and impartial inquiry to determine the cause of the incident, including lapses in manufacturing, quality testing, or distribution of the cough syrup batch.

"It has taken years of effort to convince communities that medicines provided free of cost in public health facilities are safe and reliable, but such incidents risk nullifying those hard-won gains,” the JSA says in its memorandum to the minister.