The Ministry of Health of Uzbekistan has announced that at least 18 children have died after consuming medicinal syrup from the Indian company Marion Biotech Pvt Ltd, Reuters reports.

The ministry reported that 18 out of 21 children who took Dok-1 Max syrup during an acute respiratory illness died after consuming it. It is marketed on the company’s website as a treatment for cold and flu symptoms.

One batch of the syrup contained ethylene glycol, which the ministry said was a toxic substance. The syrup was imported into Uzbekistan by Quramax Medical LLC, the ministry said in a statement released on Tuesday.

He also reported that syrup is given to children at home without a prescription, either by parents or on the advice of pharmacists, in doses that exceed the standard dose for children.

It was not immediately clear whether all or some of the children consumed the suspect batch, consumed more than the standard dose, or both.

A source in the Indian government said that the Ministry of Health is studying the matter.

India on Tuesday began inspecting drug factories across the country to ensure they meet quality standards.

The incident in Uzbekistan follows a similar one in Gambia, where cough and cold syrups made by New Delhi-based Maiden Pharmaceuticals Ltd were blamed for the deaths of at least 70 children. Both the Indian government and the company denied that the drug was to blame.