In early September, officials in Madhya Pradesh’s Parasia noticed something was wrong as several children aged under five started dying from unexplained health complications.For two weeks, the district administration scrambled to understand what was killing their youngest residents. Health officials launched an urgent field investigation, testing the usual suspects: contaminated water sources, disease-carrying rodents, and mosquito populations. Each test came back negative. The health department did not conduct postmortems, citing a lack of parental consent, leaving investigators to pursue the mystery.The first death was reported on September 2 when Shivam (4) died. Vidhi (3) died on September 5, followed by Adnan (5) on September 7, Usaid (4) on September 13, Rishika (5) on September 15, and Shreya (2) on September 16.Then, on September 18, after Hitansha (4) died, a message arrived from the Nagpur district administration: the children were dying of kidney failure. The case broke wide open only after another child, Vikas (5), died the same day.His death became the catalyst that altered the course of the investigation. Despite their previous reluctance, hospital officials decided to conduct a renal biopsy, an examination of kidney tissue that would finally reveal why these children were dying.“We could not conduct postmortem reports since parental consent was not there,” explained Parasia Sub Divisional Magistrate Vikas Kumar Yadav. “Even if they had consented, it would not have given us the actual cause; for that, we needed toxicology reports.”When Vikas died, the team decided to perform biopsies on three children, which found “damage to the nephrons”, the functional units of the kidney responsible for filtering blood and producing urine.Story continues below this ad“We grew suspicious about cough syrup-related contamination,” Yadav said, “like in the case of Gambia.”One-year-old Sandhya died at the beginning of this month, and on Saturday, the tenth patient, Yojita, aged a year and a half, died in Nagpur. “She had a fever on September 8. We referred her to a local clinic. Her condition worsened after her second dose of medication. We later found she had an acute kidney infection. We did not take her to Parasia and went to Nagpur. Then we got a call from the Chhindwara medical officer to admit her to a medical hospital. She was then referred to another hospital, where her condition worsened in the ICU. We could not bear that sight and transferred her to another hospital,” Lekhram Thakre, her grandfather, said.The health department had deputed one doctor and two nurses to monitor the children at a local camp set up in Parasia. However, the monitoring system, which would have helped the authorities get in touch with the families and refer them to appropriate hospitals, also suffered from setbacks.Said a senior health official, “The parents were taking their children to Nagpur, where they died during treatment. They were not brought to the local civil hospital… We have a protocol set up where we test the children at their homes and assess their health condition. If we think their health will deteriorate, then we bring them to the civil hospital, monitor them for six hours and then refer them to the district hospital. Since they were taken to Nagpur and then brought back, they are out of our monitoring system. We could not conduct their post-mortem,” the officer said.Story continues below this adA door-to-door health survey is now underway in the Parasia development block of Chhindwara district.SDM Yadav explained that the Parasia development block has a population of nearly 2,84,000, and there are around 25,000 children aged below 5.“We have conducted a door-to-door survey through ASHA (Accredited Social Health Activist) and ANM (Auxiliary Nurse Midwife), and 4,658 children were found to have symptoms of vomiting, cough and viral fever. After that, we conducted a kidney test, liver test and CBC. We received a report of 4,411 children till this morning, and all are normal. The remaining reports are expected by this evening,” the SDM said.On Saturday, the Madhya Pradesh government ordered the immediate stoppage of sales and distribution of a cough syrup after it was allegedly found to contain a substance linked to child deaths in the state’s Chhindwara district.Story continues below this adThe Office of the Controller, Food and Drugs Administration, Madhya Pradesh, issued an urgent directive on Friday to all drugs inspectors across the state regarding Coldrif Syrup manufactured by Sresan Pharmaceutical. The order followed laboratory tests conducted in Tamil Nadu that allegedly revealed alarming findings about the medication. According to a test report from the Government Analyst at the Drug Testing Laboratory in Chennai, the syrup was declared Not of Standard Quality after analysis found it contained 48.6 per cent by volume of Diethylene Glycol, a toxic industrial chemical. The report stated the sample was “found to be adulterated, since it contains Diethylene Glycol (48.6% w/v) which is (a) poisonous substance which may render the contents injurious to health.”Jabalpur drug inspector Sharad Kumar Jain said that according to their investigation, Kataria Pharmaceuticals had ordered 660 bottles of the syrup from Chennai.“It has come to light during the investigation that a total of 660 bottles were purchased, of which 594 were sold in Chhindwara and 66 were stored, which were recovered during inspection. From these 66 bottles, 16 samples were taken and sent for testing. The remaining 50 bottles were frozen, with instructions issued not to sell them,” Jain said.The deaths in Madhya Pradesh coincide with at least four recent casualties in Rajasthan, where children died allegedly after consuming cough syrup. There, the state has banned the distribution of cough syrups containing Dextromethorphan. It has also banned the distribution of all 19 types of medicines supplied by Kaysons Pharma, the company at the centre of the controversy, until further notice.