Spectre of toxic cough syrups re-emerges in India

Police in India have reportedly arrested the owner of drugmaker Sresan Pharma in connection with the deaths of at least 19 children in Madhya Pradesh.

The children – all aged under five – died after being dosed with Tamil Nadu-based Sresan's Coldrif Syrup cough medicine containing toxic diethylene glycol (DEG), according to a Reuters report, which suggests that levels of the contaminant were present at nearly 500 times the permissible limit.

Medicinal syrups laced with DEG – a colourless and odourless liquid with a sweet taste – have caused hundreds of fatalities over the decades, usually as a result of acute kidney failure.

DEG and ethylene glycol can be found as contaminants of glycerin, an excipient widely used in oral liquid medicines, and have been associated with a series of fatal incidents involving paediatric medicines over the decades. In some cases, it is suspected that the ingredients have been deliberately added to glycerin to bulk it out and save money.

The presence of DEG in the Coldrif product was confirmed after lab testing last week. For now, it seems that fears that some of the bottles may have been exported to other markets are unfounded, with India's

Sresan's owner, named in the press as S Ranganathan, was taken into custody yesterday and police have opened a manslaughter investigation. The company faces having its operating license revoked pending a decision by the federal authorities. Meanwhile, a doctor suspected of prescribing the tainted product to most of the children is also under scrutiny.

India's Central Drugs Standard Control Organisation (CDSCO) has also warned that two other cough syrups – Respifresh and RELIFE, made by Gujarat state-based Shape Pharma and Rednex Pharmaceuticals – should also not be used as they have also been found to contain DEG.

Other mass poisonings linked to the contaminant occurred in Haiti in 1995-1996 (85 deaths), India in 1998 (33 deaths), Panama in 2006 (97 deaths) and Nigeria in 2008 (84 deaths). Meanwhile, there have been two separate incidents in Bangladesh in 1990-92 and 2009, collectively leading to more than 300 fatalities.