At least 14 children have died of diphtheria in two Delhi hospitals over the past two weeks, according to The Times of India. Thirteen children died at Maharishi Valmiki Infectious Diseases Hospital and one at Lok Nayak Hospital.

Diphtheria is an infectious disease which primarily infects the throat and upper airways, and produces a toxin affecting other organs, according to the World Health Organization. It is preventable with vaccine. India accounted for 60% of all diphtheria cases globally last year.

At least 141 children between the ages of two and 14 have been admitted to the Maharishi Valmiki Infectious Diseases hospital with diphtheria over the last three weeks. An unidentified official of the hospital said nearly 120 children are from Uttar Pradesh and 10 each from Haryana’s Mewat district, and Delhi.

“Most of the children suffering from diphtheria didn’t receive the preventive vaccination,” the official said. “Also, they were referred to MVID when the symptoms had already turned severe.”

Medical superintendent of the hospital Sunil Gupta said the hospital has all facilities to treat such cases. “The patients admitted at advanced stage could not respond to the treatment and hence could not survive,” he said.

Gupta told The Indian Express that there was a shortage of anti-diphtheria serum. “We don’t have this serum since November last year,” he said. “I have been in touch with the administration of Central Research Institute, Kasauli, which is the only agency that supplies this, but they have closed their lab because some upgradation is going on there. I even went to Kasauli in March, but they said they have stopped the production for now.”

On why the hospital is not procuring the serum from private shops, Gupta said he does not encourage the use of serum sold privately since there can be a severe reaction. “Even private ones do not have this at present and we are trying to get in touch with chemists who can give us the serum in bulk.”

But Ajay Kumar Tahlan, director of the Central Research Institute, refuted Gupta’s claims. Tahlan said 150 vials of the diphtheria antitoxin have been ready for the last 15 days, but no one from the hospital collected them despite intimation, reported The Sunday Express.

“We had been getting requests for ADS [anti-diphtheria serum] from the hospital, so we managed to make 150 vials and informed the hospital administration 15 days ago,” Tahlan said. “I have now got information that someone is coming today [Saturday] to collect it.”

Tahlan said the facility was being renovated over the past year and supply was suspended. Since work is almost finished now, they managed to prepare 150 vials, he said. “We will be offering 1,000 more over the next 15 days.”

Mayor of the north civic body Adesh Gupta, under whose jurisdiction the hospital falls, said an inquiry committee has been constituted under the chairmanship of additional commissioner (health).

An unidentified senior official of the health ministry said all state governments have been asked to stock up on the serum. “The ministry is in touch with this hospital and is rushing the serum as an emergency measure,” the official said. “We have also written to the UP government to take preventive measures since most cases are from western UP.”