The Madhya Pradesh drug controller on Monday found two more cough and cold syrups to be contaminated with diethylene glycol, which can cause acute kidney and liver failure, and labelled them as “not of standard quality”.

This came a day after the state’s drug testing laboratory in Bhopal found 46.28% diethylene glycol in a sample of Coldrif cough syrup, which is allegedly linked to the death of at least 14 children from Chhindwara.

The deaths were recorded in the towns of Parasia and Chaurai in the Chhindwara district, the Chhindwara city, and the town of Betul, Shubham Kumar Yadav, sub district magistrate in Parasia, told Scroll.

“Yesterday we received information of two more deaths, one each from Parasia and Betul,” Yadav added. “We are investigating them.”

The permissible limit of diethylene glycol as an impurity is 0.1%. However, drug officials Scroll spoke to said that the chemical is unsafe even in trace amounts and should ideally be completely absent from an ingestible syrup. Its presence is a serious quality compliance issue, the officials said.

An official in Bhopal confirmed to Scroll that the two other cough syrups found contaminated on Monday are Relife syrup and Respifresh TR. “We so far know that the two syrups have been manufactured in Gujarat,” Tina Yadav, state joint director of drugs control, told Scroll. “We will contact the Gujarat drug controller and inform them.”

Of the 13 samples of the cough syrups collected by the Chhindwara drug inspector, 10 were assessed as being of “standard quality”, while three were found to be “not of standard quality”.

Reports accessed by Scroll show diethylene glycol levels were 0.616% in a sample of Relife syrup that was manufactured by Shape Pharma Private Limited in January 2025 and was set to expire in December 2026.

Shape Pharma is based in the Shekhpar village of Gujarat’s Surendranagar district, and works as a third-party manufacturer of cough syrup and ointments.

Hitesh Jesadiya, a director in the company, told Scroll that the government did not inform it about the report. “Technical investigation will begin if we are notified,” he added.

Jesadiya refused to comment on whether the company conducts verification of suppliers of solvents before purchase.

On various e-pharma portals, the supplier of Relife syrup is listed as Leolife Sciences Private Limited. Scroll has reached out to the company for a response. This article will be updated if the firm responds.

A sample of Respifresh TR syrup was found to have 1.34% diethylene glycol. The batch was manufactured in January 2025 and is slated to expire in December 2026.

Its manufacturer is Rednex Pharmaceuticals Limited, based in Ahmedabad. The company claims to be certified by the World Health Organization as one that follows good manufacturing practices.

Rednex Pharmaceuticals produces oral liquid preparations like gel, cream, ointment and lotion. The pharma company did not respond to multiple calls. Scroll emailed the firm, seeking a response. The story will be updated if the company responds.

Deaths of children

Since August, at least 14 children, aged between one and six years, have died due to kidney failure in a case of suspected poisoning by diethylene glycol-laced cough syrups.

Of those dead, 11 are from the Parasia town in the Chhindwara district. Several children remain in hospital for kidney injuries. Scroll confirmed that at least two children are in critical condition and require ventilator support.

Alarm bells rang in the Chhindwara district health department last month when children from Parasia block were reported dead in various Nagpur hospitals due to kidney failure.

The first cases of illness trickled in during mid-August when children consulted one of two local paediatricians in Parasia for cough and cold, and fell acutely ill after consuming cough syrup prescribed by them.

Most children were rushed to Nagpur, 120 kms away, for paediatric dialysis – a facility absent in Chhindwara despite the district having a government medical college.

On September 2, the first death was reported, followed by three more in the next 10 days.

The Chhindwara district administration suspected diethylene glycol poisoning in mid-September when doctors in Nagpur confirmed toxin mediated kidney damage in a child from Parasia who died. Two cough syrups— Coldrif and Nastro DS — were temporarily banned since the two were most commonly prescribed to the affected children.

The drug inspector collected random samples of cough and cold medication prescribed to all children. While Coldrif was the most common syrup consumed by children, samples of Relife and Respifresh were also collected. “I collected samples that were reportedly used by children,” the drug inspector told Scroll. It is unclear how many children consumed Respifresh TR and Relife syrup.

Adulteration findings

On October 2, Tamil Nadu found the control batch of Coldrif cough syrup “adulterated” with 48.6% of diethylene glycol. Coldrif is manufactured by Sresan Pharmaceuticals, located in Kancheepuram, Tamil Nadu.

Following Tamil Nadu's finding, on October 5, Madhya Pradesh also reported that one sample of Coldrif had 48.6% of diethylene glycol in it. Sresan has been issued a stop production notice and the batch of Coldrif allegedly linked to the deaths has been recalled by the Tamil Nadu drug controller.

On Monday, two more syrups – Relife syrup and Respifresh TR – were found laced with diethylene glycol beyond permissible limits in Bhopal's government testing laboratory. The laboratory, however, cleared samples of Nastro DS.

Shubham Kumar Yadav, the Parasia, sub district magistrate, said that the district authority has begun the process of locating bottles of Coldrif syrup and recalling them. “We just received information of the other two cough syrups,” the official said. “We will start recalling them as well.”

The Himachal Pradesh drug controller has not yet released information about laboratory reports of control batch they collected for testing.

Three officials suspended

On Monday, following intense media scrutiny, Madhya Pradesh Chief Minister Mohan Yadav chaired a meeting and ordered the suspension of three drug officials. The state's Drug Controller, Dinesh Maurya, was transferred, and two drug inspectors, Gaurav Sharma and Sharad Jain, were suspended. Shobhit Costa, a deputy director of drugs, was also suspended.

On October 5, the Chhindwara district administration exhumed the body of a child who died to undertake an autopsy and carry out a correlative inquiry into whether diethylene glycol poisoning led to death.

The Jan Swasthya Abhiyaan, a collective of health organisations in India, on Monday demanded a ban on prescribing cough and cold medication for children aged less than 5 years as per the World Health Organisation’s guidelines. It noted in a letter to Union Health Minister JP Nadda that the Indian Academy of Paediatrics also advises against the routine use of cough syrups in children below 4 years of age.