Acute Kidney Injury Among Children Likely Associated with Diethylene Glycol-Contaminated Medications - The Gambia, June-September 2022

Abstract

On July 26, 2022, a pediatric nephrologist alerted The Gambia's Ministry of Health (MoH) to a cluster of cases of acute kidney injury (AKI) among young children at the country's sole teaching hospital, and on August 23, 2022, MoH requested assistance from CDC. CDC epidemiologists arrived in The Gambia, a West African country, on September 16 to assist MoH in characterizing the illness, describing the epidemiology, and identifying potential causal factors and their sources. Investigators reviewed medical records and interviewed caregivers to characterize patients' symptoms and identify exposures. The preliminary investigation suggested that various contaminated syrup-based children's medications contributed to the AKI outbreak. During the investigation, MoH recalled implicated medications from a single international manufacturer. Continued efforts to strengthen pharmaceutical quality control and event-based public health surveillance are needed to help prevent future medication-related outbreaks.

FIGURE

Date of first symptom onset for suspected cases of acute kidney injury of unknown etiology* among children (N = 67),^† critical events in the outbreak investigation, and public health recommendations — The Gambia, June 12–September 29, 2022 Abbreviations: AKI = acute kidney injury; MoH = The Gambia’s Ministry of Health. * Baseline incidence of AKI not available. These data include cases from MoH Epidemiology and Disease Control Unit with reported date of initial symptom onset. ^† Among 78 cases reported to MoH, symptom onset date was available for 67 (86%) patients.