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Gambia Cough Syrup Case: What are Diethylene and ethylene glycols that likely caused 66 children's deaths?

Laboratory analysis of the controversial cough syrups that allegedly caused the deaths of 66 children in the Gambia have shown the presence of Diethylene and ethylene glycols. What are these chemicals?

Kirti Pandey

Updated Oct 7, 2022, 23:54 IST

Cough syrups Promethazine Oral Solution, Kofexmalin Baby Cough Syrup, Makoff Baby Cough Syrup and Magrip N Cold Syrup exported to the Gambia.

In a shocking and rather unfortunate turn of events, 66 precious young lives in the Gambia were lost in the form of children who had been administered cough syrups as a part of the treatment protocol.

The cough syrups had been manufactured and exported to the African country by Delhi NCR (Haryana, to be specific)-based Maiden Pharmaceuticals. The cough syrups are commercially named Promethazine Oral Solution, Kofexmalin Baby Cough Syrup, Makoff Baby Cough Syrup and Magrip N Cold Syrup.

The World Health Organization (WHO) on Wednesday issued a warning over the said four cough and cold syrups, saying that they could be linked to the deaths of 66 children in The Gambia.

The WHO said that the cough and cold syrups could be the reason for serious (fatal) kidney injuries that the innocent children suffered. “Please do not use them," the WHO said in its advisory.

"Laboratory analysis of samples of each of the four products confirms that they contain unacceptable amounts of diethylene glycol and ethylene glycol as contaminants," the WHO said in a medical product alert. The WHO also warned that while the products had so far been found in The Gambia, they could have been distributed to other countries.

What are Diethylene and ethylene glycols?

As per the WHO, diethylene glycol and ethylene glycol are toxic to humans when consumed and can cause death. Symptoms of the toxic effects that diethylene glycol and ethylene glycol can cause are abdominal pain, vomiting, diarrhoea, inability to pass urine, headache, altered mental state, and acute kidney injury - possible death.

According to a report published in Science Direct under the authorship of Dr Allister Vale, MD and Director of the National Poisons Information Service, Birmingham, UK -- Diethylene and ethylene glycols are both metabolized by alcohol and aldehyde dehydrogenases to produce toxic metabolites. Both glycols produce coma, seizures, metabolic acidosis and renal failure, though by different mechanisms.

The children who were administered these cough syrups likely contaminated with Diethylene and ethylene glycols probably stood no chance as had the doctors realised the cause and wanted to manage the crisis, they would have been required to carry out the administration of ethanol or fomepizole to prevent metabolism of the glycol, correction of acidosis and the use of haemodialysis to remove the glycol and metabolites.

Disclaimer: Tips and suggestions mentioned in the article are for general information purposes only and should not be construed as professional medical advice. Always consult your doctor or a dietician before starting any fitness programme or making any changes to your diet.

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