Recent reports of child death in Madhya Pradesh and Rajasthan have once again made headlines on the safety of cough syrup in India. While early apprehensions, these deaths have not been found in the samples collected so far in the trials conducted by national and state health officials, added to the presence of poisonous contaminants such as Dythylene Glycol (DEG) and Ethylene Glycol (EG).

Nevertheless, intimidation has revived questions about these substances: what are really and as, why they are so dangerous, and how do they end in drugs?

What are the DEG and what?

Diathylene glycol (DEG) and Ethylene Glycol (Easy) are industrial chemicals that are commonly used to make products such as brake fluids, antifier esters, paints, plastic and some household items.

They are cheap and colorless liquid, sometimes used in drugs called a safe substance called propalin glycol (a solvent that helps dissolve drugs in liquid form).

The problem is, while propose glycol is safe in regulated amounts, DEG and Easy are highly toxic for humans. When consumed, even in small amounts, these chemicals can cause severe poisoning.

Why are they dangerous?

Both DEG and Easy can damage the kidney, liver and nervous system. Children are particularly weak because their organs are still developing and their body weight is reduced, meaning that a small dose can also be fatal.

Symptoms of DEG/Easy toxicity usually begin with nausea, vomiting and abdominal pain. This can quickly progress for kidney failure, seizures and even death if treated in time.

Many tragic events around the world including India, Gambia and Indonesia have shown that cough syrup contaminated with DEG or EG can cause mass toxicity in children.

Is DEG and such as ever used in drugs?

DEG and EG do not mean to use in drugs. However, contamination occurs when drug manufacturers either cut the corners to reduce the cost or fail to maintain quality standards.

Common secure component, propose glycol, can sometimes be mixed or replaced with DEG or EG.

In legitimate drug use, propaline glycol is the standard solvent, while DEG and EG have no role in human drugs.

What does the latest probe show?

In Madhya Pradesh, a joint team of experts from the National Center for Disease Control (NCDC), National Institute of Virology (NIV), Central Drugs Standard Control Organization (CDSCO), and state officials collected samples of cough syrup after reporting the child’s deaths.

The test confirmed that there was no DEG or EG in any sample. Additional tests are still running to rule for other reasons.

Even in Rajasthan, health officials clarified that cough associated with the deaths of two children in the syrup was not contaminated in the propal glycol (the component which can sometimes be contaminated with DEG/EG).

Instead, the product was based on dextromethorphon, a cough dominance that is not recommended for children.

During examination, a child was diagnosed with leptospirosis, a malignant bacterial infection spreads through contaminated water or soil by the urine of the animal.

Why do children have advice on cough syrup?

In view of frequent global concerns, the Director General of Health Services (DGHS) under the Union Ministry of Health (DGHS) has issued an advice for all states and center areas, emphasizing the rational use of cough syrup in children.

Doctors warned that many cough syrups are not suitable for young children and can harm more than well. In fact, most of the cases of cough in children, especially under the age of 6, are viral, self-limited, and resolve on their own without any medicine.

In India, many available syrups are “irrational” because they have more than three drug combinations. Globally, most cough syrups are made up of only two rationally selected components.

What needs to be addressed, regulation of cough syrup, better monitoring of cough by parents and carers and a conscious prescription of cough syrup by doctors.