First reported in Kerala in May this year, India has registered over 80 cases of Tomato flu or Tomato fever, according to a Lancet study. The viral infection usually targets children aged between one and five years of age. However, it can also infect immunocompromised adults. It is said to be a variant of the hand, foot, and mouth disease (HFMD), a highly contagious infection caused by viruses from the Enterovirus genus.
"The rare viral infection is in an endemic state and is considered non-life-threatening," the Lancet said in its report, adding that a "vigilant management is desirable to prevent further outbreaks."
The healthcare system in India has been burdened with coronavirus pandemic since 2020 and the country is grappling with rising cases of monkeypox infection too.
The report added that tomato flu could be an "after-effect of chikungunya or dengue fever in children rather than a viral infection." However, the report noted, that no specific drug exists to treat it.
The first case was reported from Kollam district. Other areas impacted by the viral infection are Anchal, Aryankavu, and Neduvathur. An alert has been sounded in the neighboring states of Tamil Nadu and Karnataka.
Last week, Karnataka Health Minister K Sudhakar asked the citizens to not panic about tomato flu cases in Kerala. He directed the in the border district to remain vigilant to keep the situation in check.
"Though some symptoms are similar to Covid-19, the tomato flu has nothing to do with Covid-19. These symptoms are usually seen in other types of viral infections also. There is no need to panic as the authorities have been asked to remain alert. Moreover, the tomato flu is endemic to Kerala," he was quoted as saying by PTI.
At the Walayar check-post on Tamil Nadu-Kerala border, people coming from Kerala are being screened. the Coimbatore district administration has beefed up surveillance in the border to prevent the disease from entering the state. The surveillance in Coimbatore district has also been beefed up.
Meanwhile, Twenty-six children aged between one to nine years of age have tested positive for the infection.
Symptoms of tomato flu
The symptoms of tomato flu are somewhat similar to that of chikungunya, such as high-grade fever, rashes, and intense pain in joints. The infection is also marked with the eruption of painful blisters throughout the body. "These blisters resemble those seen with the monkeypox virus in young individuals," the Lancet said.
Other symptoms include fatigue, nausea, vomiting, diarrhoea, fever, dehydration, swelling of joints and body aches--typical to other viral infections and flu.
How is the infection detected?
Children showing such symptoms are first tested for dengue, chikungunya, zika virus, varicella-zoster virus, and herpes. "Once these viral infections are ruled out, contraction of tomato virus is confirmed," the Lancet explained.
The treatment is similar to chikungunya and dengue which includes isolation, rest, plenty of fluids, and hot water sponge for the relief of irritation and rashes. Paracetamol is given for relief from body aches and fever.
Why are children at greater risk?
Viral infections are common in younger children. "Young children are also prone to this infection through use of nappies, touching unclean surfaces, as well as putting things directly into the mouth," Lancet said. It warned that if the spread is not controlled, the disease has the potential to transit to adults causing "serious consequences".
Tomato flu, like other influenzas, is "very contagious", according to the Lancet. "It is mandatory to follow careful isolation of confirmed or suspected cases and other precautionary steps to prevent the outbreak of the tomato flu virus from Kerala to other parts of India," it said.
Lancet said that isolation for the first week after the onset of symptoms should be followed to avoid further spread and that maintenance of proper hygiene and sanitisation is needed to keep the infection at bay.
Why the name 'tomato flu'?
The painful blisters caused in this infection can enlarge to the size of a tomato, hence the name.
However, medical professionals in India have called it a "misleading" colloquial name for HFMD. "Tomato fever is a misleading colloquial name for hand, foot, and mouth disease. This is a mild viral illness commonly affecting young children typically below age 10. It is usually caused by a Coxsackie virus," Dr Rajeev Jayadevan, co-chairman of IMA's National task force on Covid-19 told news agency ANI.