The Union ministry of health and family welfare has issued a strong advisory on the use of cough syrups in children following a string of deaths in Madhya Pradesh linked to contaminated syrups.
Nine children in Chhindwara district have reportedly died in just over two weeks, prompting an urgent investigation.
A multi-disciplinary team including experts from the National Centre for Disease Control (NCDC), National Institute of Virology (NIV), ICMR, AIIMS Nagpur, and state health authorities is probing all possible causes.
A joint team from NCDC, NIV, and the Central Drugs Standard Control Organisation (CDSCO) visited the sites and collected samples of various cough syrups.
Tests conducted so far show that none of the samples contained Diethylene Glycol (DEG) or Ethylene Glycol (EG), chemicals known to cause acute kidney failure.
“The Madhya Pradesh State Food and Drug Administration (SFDA) also tested three samples and confirmed the absence of DEG/EG,” the ministry said, reported The Economic Times.
Blood and cerebrospinal fluid (CSF) samples tested by NIV Pune revealed one case positive for Leptospirosis. Water, entomological vectors, and respiratory specimens are still under investigation by NEERI, NIV Pune, and other laboratories.
The ministry also addressed reports of two deaths in Rajasthan allegedly linked to cough syrup contamination. It clarified that the product involved did not contain Propylene Glycol, a potential source of DEG/EG contamination.
“Additionally, the product under reference is a dextromethorphan-based formulation, which is not recommended for paediatric use,” the statement added.
DGHS advisory on cough syrups
The DGHS has warned that most acute cough illnesses in children are self-limiting and often resolve without medication. “Most acute cough illnesses in children are self-limiting and often resolve without pharmacological intervention,” the advisory states.
Cough and cold medications should not be given to children under 2 years and are generally discouraged for those under 5.
For older children, “any use should follow careful clinical evaluation with close supervision, strict adherence to appropriate dosing, the shortest effective duration, and avoiding multiple drug combinations.”
The DGHS also urged the public to strictly follow doctors’ prescriptions.
Non-pharmacological measures, such as adequate hydration, rest, and supportive care, should be the first approach.
All healthcare facilities must procure and dispense products manufactured under Good Manufacturing Practices with pharmaceutical-grade excipients.
The advisory stresses that prescribers and dispensers across public and private sectors must be made aware of these standards.
The DGHS has called on all State and UT Health Departments, District Health Authorities, and clinical establishments to implement and disseminate this advisory across government dispensaries, PHCs, CHCs, district hospitals, and medical institutions immediately.