WHO warns against Indian-made cough remedies as 66 children die in Gambia

By Michael Fitzpatrick - RFI
OCT 6, 2022 LISTEN

The World Health Organization has issued a warning that four cough and cold syrups produced by Maiden Pharmaceuticals in India could be linked to the deaths of 66 children in Gambia. The UN health agency says contaminated medication may have been distributed to other countries.

WHO chief Tedros Adhanom Ghebreyesus told reporters the four cold and cough syrups in question "have been potentially linked with acute kidney injuries and 66 deaths among children".

"The loss of these young lives is beyond heartbreaking for their families."

Tedros said the UN agency was also "conducting further investigation with the company and regulatory authorities in India".

According to the medical product alert issued by WHO Wednesday, the four products are Promethazine Oral Solution, Kofexmalin Baby Cough Syrup, Makoff Baby Cough Syrup and Magrip N Cold Syrup.

The WHO said information received from India's Central Drugs Standard Control Organisation indicated that the manufacturer had supplied the contaminated medication only to The Gambia. 

Tedros, however, has warned that wider distribution could not be ruled out. The WHO chief has called for caution at the global level.

Spate of kidney disease in children

On Thursday, Gambian authorities began collecting paracetamol and promethazine syrup from rural households in the West Coast Region and Upper River Region.

A Gambian health ministry investigation, which began in July and is ongoing, also identified the E. coli bacteria as a possible cause of the spate of cases of acute kidney failure.

"The preliminary results from the ongoing investigation indicate that it is most probably the paracetamol and promethazine syrups that caused the acute kidney injury cases in this outbreak," Abubacarr Jagne, the nephrologist leading the health ministry's investigation, told the French AFP news agency.

Gambian health authorities on 23 September ordered a recall of all medicines containing paracetamol or promethazine syrup.

Gambia floods contaminate water supply

Gambia suffered its severest flooding in years in July, causing sewers and latrines to overflow.

"Since July 2022, there has been an increase in the incidence of severe kidney disease with high fatality among children, mainly following diarrheal diseases," the ministry said in a statement in September.

E. coli bacteria were found in the stools of many children, but many had also taken paracetamol syrup, it said.

"To date, the manufacturer has not provided guarantees to WHO on the safety and quality of these products," the alert said, adding that laboratory analysis of samples of the products "confirms that they contain unacceptable amounts of diethylene glycol and ethylene glycol as contaminants".

Those substances are toxic to humans and can be fatal. The WHO says that the effects "can include abdominal pain, vomiting, diarrhoea, inability to pass urine, headache, altered mental state and acute kidney injury which may lead to death".