Tomato Flu: What is it and Who is at Risk?

A new outbreak has officials concerned after it affected at least 100 children in India.
The disease has been dubbed the “tomato flu” by researchers.
No deaths have been reported due to the disease.

Ever since COVID-19 was declared a global pandemic, people have been more concerned than ever about potential disease threats.

The newest of these is called “tomato flu,” and has affected over 100 children in India, according to a recent correspondence in The LancetTrusted Source.

The authors report that tomato flu, likely a viral disease, was first identified in the Kollam district of Kerala, India on May 6, 2022.

According to The Lancet, the disease is considered non-life-threatening and resolves on its own in time.

The symptoms of tomato flu

The Lancet reports that primary symptoms observed in infected children resemble those of chikungunyaTrusted Source, a mosquito-borne illness, and include high fever, rashes, and intense pain in joints.

Similar to many viral infections, other symptoms include, fatigue, nausea, vomiting, diarrhea, fever, dehydration, swelling of joints, body aches, and common flu-like symptoms, which resemble those of dengueTrusted Source – another disease spread by mosquitoes.

“Transmission is likely to be through close contact,” Hannah Newman, MPH, director of infection prevention at Lenox Hill Hospital in New York, told Healthline.

“The virus has been named tomato flu on the basis of the red, painful blisters it causes that can mimic the look and size of a tomato,” Newman explained.

She said while the disease is thought to be non-life threatening, it can cause an uncomfortable rash, fevers, and joint pain.

Cause is still unknown

“We don’t know exactly what’s causing the disease,” admitted Robert Glatter, MD, an ER physician at Lenox Hill Hospital in New York. “But it’s possible that it may be a variant of hand foot and mouth disease, or the after-effect of chikungunya or dengue fever, both mosquito-borne diseases.”

Authors of the Lancet correspondence theorize that this disease might even be a new type of hand, foot, and mouth disease. Hand foot and mouth disease is the result of an enterovirusTrusted Source infection, of which, one of the subtypes includes the coxsackievirus, which also causes a blister-like rash.

Since it’s a contagious virus, there is potential for this disease to spread beyond India, warned Newman.

Similar to what happened with COVID-19 and monkeypox, routine air travel could carry a new pathogen almost anywhere, and it might start affecting older individuals.

“Given the similarities to hand, foot, and mouth disease, if the outbreak of tomato flu in children is not controlled and prevented, transmission might lead to serious consequences by spreading in adults as well,” the correspondence authors wroteTrusted Source.

Transmitted via close contact and surfaces

“It’s also believed to spread by contact with an infected person’s clothing, bedding, towels, sheets, toys, books or other nonporous surfaces, similar to Monkeypox,” said Glatter.

He added that while the tomato flu virus may be a variant or “after-effect” of hand foot and mouth disease, there is no evidence the disease is airborne or even droplet spread based on the Lancet report.

Glatter also believes chikungunya and dengue, both endemic to the region, could place both older adults and young children at risk for the tomato virus.

“Because their immune systems may not be as robust after recovering from these mosquito-borne viruses,” he said.

Glatter confirmed that there is currently no vaccine or antiviral medication available to treat this disease. However, much can be done to relieve someone’s discomfort until the infection resolves.

“Supportive care including acetaminophen for fever and aches, along with hydration will help patients feel better,” advised Glatter. “Warm compresses may help to alleviate some of the discomfort associated with the painful nature of the rash.”

What we know about preventing the disease

Newman said ways to prevent tomato flu include quick isolation of infected patients and proper hand hygiene.

She emphasized performing “environmental disinfection” of surfaces, toys, clothes, and other items used by sick individuals.

“And limiting the sharing of these items between other children and adults,” she added.

According to Glatter, what’s concerning is that we don’t know how older patients and those who are immunocompromised will do if they develop the disease.

“That said, at this time the risk of spread in the population is quite low, and people in the US should not be overly concerned,” he continued.

Glatter cautioned that on a global level, “vigilance is paramount” given what we have just been through with COVID-19, and now monkeypox.

“The priority now is to determine whether the tomato virus is even a virus, not to mention a novel virus,” he said. “Or simply a sequela [consequence] of a recent prior infection with a previously well-known and documented virus.”

The bottom line

A new disease has been identified in children from a southern region of India, it resembles certain types of mosquito-borne diseases like chikungunya.

So far it isn’t life threatening.

Experts say the cause is still unknown, but it might be a new form of enterovirus, like coxsackievirus, which also causes painful blisters.

They also say that the risk of population spread is low and people in the U.S. shouldn’t be overly concerned.