Drug Safety Under Scrutiny After 14 Children Die from Toxic Diethylene Glycol Cough Syrup

Recent incidents in India have brought into light the dangers of diethylene glycol (DEG) contamination in pharmaceutical syrups. In Madhya Pradesh’s Chhindwara district, at least 14 children died after consuming a cough syrup containing toxic levels of DEG. This case has renewed global concern about DEG poisoning from medicines and exposed regulatory gaps in drug safety.

What Is Diethylene Glycol (DEG)?

DEG is a colourless, odourless liquid mainly used in industrial products like antifreeze, brake fluids, solvents, and plastics. It is not intended for human consumption due to its toxic nature. DEG can damage vital organs such as the kidneys, liver, and nervous system when ingested.

Toxicity Mechanism of DEG

When consumed, DEG is metabolised into harmful compounds. These cause acute kidney injury and can lead to anuria (cessation of urine production) and death. Early symptoms include vomiting, abdominal pain, and lethargy. Rapid progression to renal failure is common without timely treatment.

Use of Solvents in Pharmaceutical Syrups

Pharmaceutical syrups typically use glycerine or propylene glycol as solvents. These substances safely dissolve active ingredients. However, some manufacturers substitute these with cheaper DEG to reduce costs. Contamination can also occur if industrial-grade glycerine or propylene glycol, which may contain DEG, is used by mistake or negligence.

Historical and Global Incidents of DEG Poisoning

DEG poisoning in medicines is a recurring global issue. Since 2022, the World Health Organization (WHO) has linked over 300 child deaths worldwide to DEG-contaminated cough syrups. Notable incidents include 70 child deaths in The Gambia (2022), 57 in Nigeria (2008-09), and 105 in the United States (1937) due to DEG-tainted medicines.

Regulatory Challenges and Safety Measures

The repeated occurrence of DEG contamination marks regulatory weaknesses in pharmaceutical quality control. Ensuring the use of pharmaceutical-grade solvents and strict monitoring is essential. WHO and national drug authorities advocate for stronger testing protocols and supplier audits to prevent such tragedies.