Toxic syrups: what is known about a case that has already killed 300 children in 3 countries

About 300 children died in Gambia, Indonesia and Uzbekistan in recent months, presumably due to the intake of various syrups, and now attention is focused on finding the origin of two toxic components found in all medicines.

Director General of the World Health Organization (WHO), Tedros Adhanom Ghebreyesus, Yesterday, he urged the entire world to be extra vigilant and called for increased surveillance of suspicious products that initially contain toxic amounts of diethylene glycol and ethylene glycol.

This is the only common feature between syrups identified as a possible cause of death from kidney failure in children in three countries, and drugs have been investigated in Gambia D uzbekistan from two Indian pharmaceutical companies and engaged in local production in Indonesia.

SINCE WHEN AND WHERE WERE THE CASES DETECTED?

The first deaths were detected in October Gambiawhere at least 70 children have died of abnormal acute renal failure to date. WHO issuing a warning about multiple syrups as suspected causes on the 5th of this month.

Shortly thereafter, on November 2, the organization activated another alert for Indonesia after the death of at least 200 children, most of them under the age of five, from the same condition in the country, where one or two cases of abandoned babies are usually identified. kidney disease per month.

Finally, at least 21 child deaths have been reported, also under the same circumstances, in uzbekistanWith WHO issuing a new warning on 11 January.

In addition, the body UN On Monday, he told EFE that “potential” risks exist in four more countries: the Philippines, East Timor, Senegal and Cambodia, although the presence of contaminated syrups in these places has not yet been confirmed.

WHAT CAUSED THE DEATH?

Although there is no final investigation in any of the countries yet, a warning from WHO to Gambia The focus is on four products from the Indian company Maiden Pharmaeuticals: promethazine oral solution, Coffexmalin and Makoff cough syrups, and Magrip cold syrup.

On December 20, while a committee of the Gambian Parliament said it was “convinced” that Maiden Pharmaceuticals Ltd. was at fault, it indicated that the cause of the children’s deaths was still being investigated by the Ministry of Health.

For their part, the Indonesian authorities suspended licenses for various pharmaceuticals local authorities (including PT Samco Farma, PT Ciubros Pharma, PT Yarindo Farmatama and PT Universal Pharmaceutical Industries) and suppliers (PT Mega Setia Agung Kimia and PT Tirta Buana Kemindo) for their possible connection to the deaths.

In the case of Uzbekistan WHO published a health warning that two other cough syrups, Ambronol and DOK-1 Max, made in India by another company, Marion Biotech, also reportedly contain “unacceptable” amounts of diethylene glycol and ethylene glycol.

WHAT DO THE AUTHORITIES IN INDIA AND INDONESIA SAY?

On December 13, the Comptroller General of Medicines of India, V. G. Somani, reported WHO that samples of drugs that allegedly caused the death of children in Gambia “They weren’t infected.”

For its part, the pharmaceutical company Marion Biotech, implicated in the deaths in Uzbekistan, recently said it was an attempt to “tarnish” its reputation and that of India.

Indian authorities suspended the license in early January Marion Biotech, while Maiden Pharmaceutical supports it but has been ordered to stop production. All of these products were allowed for export only.

AT Indonesiatwenty-five families of affected minors sued the government, which came to suspend the sale of all syrups in the country, and several pharmaceutical and chemical manufacturers.

WHERE DO DIETHYLENE GLYCOL AND ETHYLENE GLYCOL COME FROM AND WHAT IS IT?

According to WHO and Indonesian authorities contaminated syrups They had high levels of diethylene glycol and ethylene glycol, chemicals commonly used as industrial solvents and antifreezes, substances that can be very toxic to the kidneys and liver.

At present, attention is partly focused on whether the pharmaceutical companies behind the said syrups may have sourced their raw materials from the same suppliers, which is one of the most likely explanations, according to expert sources consulted by EFE, who requested anonymity.

WHO The EFE assured that “no direct link has been established between the three incidents at this time, but investigations are ongoing.”

Assistant General Manager WHO for access to medicines, Hanan Balkhi said this week that many of these medicines come through the informal market and there is growing concern within the body as “these are very common medicines” that “more children may be exposed to.”

PREVIOUS CASES

Historically, numerous cases of diethylene glycol contamination of various drugs have been described.

More than 800 people died as a result. Panamamany of them are children, since the mass poisonings that took place between 2004 and the same year due to the distribution of cough syrup became known in 2006, which is today considered the worst case of diethylene glycol poisoning in the world.

In India, which has the third largest pharmaceutical industry in the world, the latest relevant case dates back to January 2020 when eleven children died in the state Jammu and Kashmir when using drugs contaminated with diethylene glycol produced by another pharmaceutical company, Digital Vision Pharma.

EFE