EXPLAINED: What Is Tomato Flu? All About The Outbreak In Kerala

Tomato flu is a rare viral infection that could be a new variant of the viral hand-foot-and-mouth disease, a common infectious disease targeting mostly children aged one to five years.

Tomato flu is associated with symptoms such as high fever, rashes, and intense pain in joints. Since tomato flu virus causes red and painful blisters to erupt throughout the body that gradually enlarge to the size of a tomato, the disease is known as tomato flu. | Representational Image

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Tomato Flu: At a time when the number of coronavirus cases in India is on the rise, suggesting the probable emergence of a fourth wave of Covid-19, a new virus known as tomato flu, or tomato fever, has emerged in the state of Kerala in children younger than five years. Tomato flu was first identified in the Kollam district of Kerala, on May 6, 2022. 

According to a report published in the journal The Lancet Respiratory Medicine, more than 82 cases of tomato flu in children below five years of age have been reported by local government hospitals, as of July 26, 2022. 

The different regions of Kerala where cases of tomato fever have been reported include Kollam, Anchal, Neduvathur, and Aryankavu. Since the disease is now endemic in Kerala, the neighbouring states of Tamil Nadu and Karnataka are also on alert. 

The Regional Medical Research Centre in Bhubaneswar has reported 26 cases of tomato flu in children aged one to nine years in Odisha. 

Kerala, Tamil Nadu, and Odisha are the only states in India to have reported tomato flu cases so far. The Kerala Health Department is taking precautionary measures to monitor the spread of the viral infection and prevent its spread in other parts of India. 

What Is Tomato Flu?

Tomato flu is a rare viral infection that could be a new variant of the viral hand-foot-and-mouth disease, a common infectious disease targeting mostly children aged one to five years and immunocompromised adults. In some case studies, hand-foot-and-mouth disease has been found in immunocompetent adults. Hand-foot-and-mouth disease is a mild, contagious viral infection common in young children, and causes symptoms such as sores in the mouth and rashes on the hands and feet. 

The symptoms of tomato flu are similar to those of Covid-19. Both tomato flu and Covid-19 are associated with symptoms such as fever, fatigue, and body aches. Some patients with Covid-19 report rashes on the skin.

However, the tomato flu virus is not related to SARS-CoV-2. Tomato flu is a self-limiting illness, which means that it tends to go away on its own, without treatment. According to the Lancet report, tomato flu is currently in an endemic state and is considered non-life threatening. However, vigilant management is desirable to prevent further outbreaks because of the unpleasant experience of the Covid-19 pandemic.  There is no specific drug to treat tomato flu.

What Causes Tomato Flu?

Tomato flu is caused by a virus, according to the Lancet report. However, some experts suspect that tomato flu could be an after-effect of chikungunya or dengue fever in children rather than a viral infection. 

What Are The Symptoms Of Tomato Flu?

Tomato flu is associated with symptoms such as high fever, rashes, and intense pain in joints. These symptoms are similar to those observed in people infected with chikungunya. 

Since tomato flu virus causes red and painful blisters to erupt throughout the body that gradually enlarge to the size of a tomato, the disease is known as tomato flu. The blisters resemble the lesions that occur during monkeypox virus infection. 

When a person is infected with tomato flu virus, rashes appear on their skin. This leads to skin irritation. Other symptoms of tomato flu include fatigue, diarrhoea, nausea, fever, vomiting, swelling of joints, common influenza-like symptoms, dehydration, and body aches. The influenza-like symptoms caused by tomato flu virus are similar to those manifested in dengue. 

How Is Tomato Flu Transmitted?

Since viral infections are common in children, they are at increased risk of exposure to tomato flu. The disease is likely to spread through close contact. 

According to the Lancet report, young children are prone to infection with tomato flu virus through the use of nappies, touching unclean surfaces, and putting things directly into the mouth. 

Transmission of tomato flu could lead to serious consequences by spreading in adults, if the outbreak of the disease in children is not controlled and prevented. 

Tomato flu is very contagious, similar to other types of influenza. 

How Is Tomato Flu Diagnosed?

Diagnosis of tomato flu is done using the elimination method. Children who show the symptoms for tomato flu are made to undergo molecular and serological tests for the diagnosis of chikungunya, dengue, varicella-zoster virus, herpes, and zika virus.

If a person tests negative for these viral illnesses, contraction of tomato virus is confirmed. 

How Is Tomato Flu Treated?

Since tomato flu is similar to chikungunya, dengue, and hand-foot-and-mouth disease, treatment is also similar. In order to relieve the patient of irritation and rashes, isolation, rest, hot water sponge, and plenty of fluids are important. 

Supportive therapy of paracetamol for bodyache, fever, and other symptomatic treatments are necessary. 

How Can Tomato Flu Be Prevented?

Since tomato flu is very contagious, it is necessary to follow careful isolation of confirmed or suspected cases. Moreover, other precautionary steps must be taken to prevent the outbreak of the tomato flu virus from Kerala to other parts of India. 

In order to prevent the spread of infection to other children or adults, isolation of confirmed or suspected cases should be followed for five to seven days from symptom onset. 

The maintenance of proper hygiene and sanitisation of the surrounding areas and environment, and preventing the infected child from sharing clothes, toys, food, or other items with other non-infected children is the best solution for prevention. 

How To Ensure Safety Of Public Health From Tomato Flu?

The most effective approaches to ensure the safety of public health from tomato flu are drug repurposing and vaccination. Drug repurposing is the process of identifying new therapeutic uses for existing drugs. 

With these approaches, the safety of children, the elderly, immunocompromised people, and those with underlying health issues can be ensured. 

No antiviral drugs or vaccines have been developed for the treatment or prevention of tomato flu so far. 

The disease outcomes should be carefully monitored to develop effective treatments for tomato flu.