WHO warns of more cough syrup deaths, this time in Uzbekistan

A investigation has started into the claims that substandard cough syrup products may be behind the deaths of 18 children in Uzbekistan, once again linked to contamination with diethylene glycol and/or ethylene glycol.

A World Health Organization (WHO) alert has said two products manufactured by India's Marion Biotech - Ambronol syrup and Dok-1 Max syrup – are suspected of being 'substandard', and that the firm had failed to provide guarantees about their safety and quality.

"Laboratory analysis of samples of both products, undertaken by national quality control laboratories of the Ministry of Health of the Republic of Uzbekistan found both products contained unacceptable amounts of diethylene glycol and /or ethylene glycol as contaminants," according to the alert.

It is the third case involving DEG-contaminated cough syrup to emerge in the space of a few months, coming after the WHO linked dozens of deaths among children in Gambia to four cough syrup products made by Maiden Pharmaceuticals, and contaminants were found in eight products sold by PT Alfi in Indonesia .

Noida-based Marion Biotech has denied in a statement to the BBC that ethylene glycol was identified in the Dok-1 Max syrup product, but did not make any comment on the Ambronol allegations.

The company also old the news organisation that 20,000 bottles the Doc-1 Max cough syrup were supplied across Uzbekistan but "fatalities have only been reported in one of the geographical locality of Samarkand".

The WHO said both syrups may have marketing authorizations in other countries in the region and could also have been distributed through informal markets to other countries.

"Manufacturers of liquid dosage forms, especially syrups that contain excipients including propylene glycol, polyethylene glycol, sorbitol, and/or glycerin/glycerol, are urged to test for the presence of contaminants such as ethylene glycol and diethylene glycol before use in medicines," said the UN agency.

Last month, all manufacturing activities at Marion Biotech were suspended following the reports of contamination in the Dok-1 Max syrup.

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