The World Health Organization (WHO) has issued a health advisory cautioning against the use and distribution of three cough syrups linked to multiple child deaths in India over the past month.

The affected products include certain batches of Coldrif, Respifresh TR, and ReLife, manufactured by Sresan Pharmaceutical, Rednex Pharmaceuticals, and Shape Pharma. Testing revealed these syrups contained elevated levels of diethylene glycol (DEG), a toxic chemical that can cause severe injury or death, particularly in children.

This is not the first instance of dangerous contamination in Indian-made cough syrups. In 2023, similar medications exported from India were tied to child deaths in Uzbekistan and The Gambia.

Following the WHO alert, Indian authorities have halted production at the three companies, suspended product approvals, and recalled contaminated batches, which have not been exported. The WHO confirmed there is no evidence of illegal exports but warned regulators to scrutinize unregulated supply chains and other liquid medications produced by these manufacturers since December 2024.

In Madhya Pradesh, at least 19 children died after consuming Coldrif syrup. “They initially had a cough and cold, which progressed to kidney failure leading to death,” said Ajau Pandey, superintendent of Chhindwara district. Investigations found DEG levels above permissible limits in the syrup.

Authorities in Tamil Nadu, where Sresan Pharmaceuticals is based, revoked the company’s license and shut it down. The company’s owner was arrested, and two senior drug inspectors had their licenses revoked for failing to perform mandatory inspections. Legal action is also being taken against a doctor who prescribed the medication.

This advisory follows the WHO identifying clusters of acute illness and child fatalities across India in late September. The Central Drugs Standard Control Organization confirmed DEG presence in at least three syrups consumed by affected children.

India has faced similar incidents in the past. In 2022, production of certain cough syrups by Maiden Pharmaceuticals was suspended after chemicals harmful to the brain, lungs, liver, and kidneys were detected, linked to deaths in The Gambia and Indonesia.