Tragic Child Deaths Linked to Toxic Cough Syrups in India: A Crisis Unfolds
In a alarming public health crisis, at least 20 children have died in India over the past month after consuming contaminated cough syrups. The affected children, mostly under the age of five, experienced fatal kidney failure linked to cough syrups tainted with diethylene glycol (DEG), a toxic industrial solvent used in antifreeze and not fit for human consumption. These deaths occurred primarily in Madhya Pradesh and Rajasthan, prompting nationwide outrage and urgent regulatory action.
The Toxic Cough Syrups and Manufacturer Details
Three cough syrup brands—Coldrif (by Sresan Pharmaceuticals), Respifresh (Rednex Pharmaceuticals), and ReLife (Shape Pharma)—were found to contain dangerously high levels of DEG far exceeding permissible safety limits. Coldrif syrup alone contained around 48.6% DEG, which is nearly 500 times the allowable limit of 0.1%. The syrup was manufactured in May 2025 with an expiry date of April 2027.
Sresan Pharmaceuticals, the creator of Coldrif syrup, faced severe scrutiny following investigations that uncovered 364 manufacturing violations in their Tamil Nadu facility. These ranged from poor-quality water, unsanitary storage conditions, inadequate pest control, unqualified staff, to lack of quality assurance protocols. The company’s license is being revoked, and the 73-year-old owner was arrested. Legal actions and investigations remain ongoing.
Regulatory and Government Responses
In response to the tragedy, multiple Indian states have banned the implicated syrups and imposed restrictions on cough syrup use for children under two years. For example, Punjab banned Coldrif syrup completely. The central government also issued advisories against the use of cough and cold medications for children below two years, urging caution in prescribing these medicines for children under five.
The World Health Organization has expressed serious concern over the incident, calling attention to gaps in India's pharmaceutical regulatory framework and warning about the risk of contaminated syrups entering other countries through unregulated channels.
Causes and Consequences of DEG Contamination
Diethylene glycol and ethylene glycol are cheap industrial solvents sometimes fraudulently used as substitutes for safe ingredients in cough syrups. DEG is highly toxic, leading to acute kidney failure, neurological damage, multi-organ failure, and even death, especially in children with lower body mass and limited ability to metabolize toxins. Even survivors of DEG poisoning may face lifelong health complications.
This incident highlights serious systemic issues, including weak regulatory enforcement, fragmented drug markets with many small manufacturers, and inadequate quality checks, allowing such hazardous products to reach consumers.
Advice and Precautions for Parents
Pediatricians advise parents to avoid over-the-counter cough syrups and to consult doctors if a child's cough lasts more than 5-7 days or if symptoms worsen. Not every cough requires medication—it is often caused by viral infections or environmental factors that resolve on their own. Careful adherence to prescriptions, choosing single-ingredient formulations, avoiding expired or suspicious products, and proper medicine storage are critical steps parents should follow.
Wider Impact and Ongoing Challenges
The Coldrif tragedy is not an isolated event; similar incidents of DEG-contaminated syrups have caused child fatalities in India and countries like Uzbekistan and The Gambia over the past decade. Despite past reforms, contaminated syrups periodically resurface, emphasizing the urgent need for stronger regulation, comprehensive drug quality control, and public awareness to prevent future loss of young lives.
This crisis is a heartbreaking reminder of the importance of medicinal safety and robust regulatory frameworks. Indian authorities are clamping down on offenders, while healthcare professionals call for cautious prescription and vigilant monitoring of children's medications.
Parents and caregivers should stay informed, seek professional medical advice, and report any suspicious or adverse medication effects promptly.