Tomato Flu Symptoms, Causes and Treatment

Table of Content

• Risk factors of Tomato Flu

• Causes of Tomato Flu

• Symptoms of Tomato Flu

• Diagnosis of Tomato Flu

• Treatment of Tomato Flu

• Prevention of Tomato Flu

• Take-Home Points

• FAQ on Tomato Flu

Introduction

Tomato fever or tomato flu is a rare but highly contagious disease that typically spreads among young children from ages one to nine. The condition got its name due to the appearance of red, round blisters resembling tomatoes in the infected individual's body. Tomato flu is a self-limiting condition and is not common among adults due to their strong immune systems. However, the disease can be problematic for young children. Most experts consider tomato flu as a variant of Hand, Foot, and Mouth Disease (HFMD), caused by viruses of the Enterovirus family. There have been no fatalities reported to tomato flu so far.

Risk factors of Tomato Flu

Young children between the age of one to nine are at high risk of getting tomato flu as the disease spreads through close contact. The children get infected by touching unclean surfaces, putting things directly into their mouths, and sharing toys, clothes, and food with the infected individuals. If the outbreak of tomato fever is not prevented and controlled, transmission could lead to other serious consequences. 

Tomato flu is frequent in tropical countries like India. Kerala was the first state in India to report a case of tomato flu on May 6, 2022. By July 26, the local government hospitals have reported more than 82 children younger than five years with the infection. Soon the Regional Medical Research Centre in Bhubaneswar reported 26 children (aged 1–9 years)with the disease in Odisha. In addition, Tamil Nadu and Haryana states also confirmed the cases of tomato flu. 

Causes of Tomato Flu

The exact cause of tomato flu is indistinct. Most experts consider tomato flu as a variant of Hand, Foot, and Mouth Disease (HFMD) caused by multiple Enterovirus (EV) like coxsackievirus A16(CVA16),  coxsackievirus A6 (CVA6), and Enterovirus 71 (EV71). In HFMD, one may develop blisters under the feet, palms, and inside mouth. Some others consider tomato flu an after-effect of diseases like dengue fever or chikungunya. Dengue is a viral disease causing rashes, body pain, and fever, while chikungunya is another viral disease causing fever and joint inflammation. 

Moreover, the blisters in tomato flu are often confused with the eruptions in chickenpox. But unlike tomato flu, chickenpox's blisters are not seen under the palm and feet.

Two cases reported in the United Kingdom favor the likeliness of the tomato flu as an atypical representation of HFMD. 

The two siblings, a 13-month-old girl, and a five-year-old boy, presented a vesicular rash without systemic symptoms or fever after returning from a family holiday to Kerala in May 2022. The girl's rash was more florid, and she gave two days after painful oral lesions while his brother was healing. About six days later, the boy's lesion completely healed without scarring, while his sister had to wait 16 days for the same result. The Enterovirus PCR was positive, and the EV typing by sequencing showed Coxsackie A-16 for both children.

Symptoms of Tomato Flu

The symptoms have distinct intensities in different cases. The main symptoms of tomato flu include high fever, severe joint pain with sometimes joint swelling, and rashes localized in the tongue, inside of the cheek, gums, soles, and palm. Sometimes red and painful lesions can be seen on the buttocks.

Other symptoms of tomato flu are similar to many other viral infections like

• Nausea

• Vomiting

• Diarrhea

• Dehydration

• Fatigue

• Body aches

• Influenza-like symptoms

Diagnosis of Tomato Flu

Due to similarities in symptoms, only after the diagnostic tests rule out chikungunya, dengue, Zika virus, herpes, and varicella-zoster virus, the tomato flu is confirmed. 

Treatment of Tomato Flu

Tomato flu is a self-limiting disease. There is no special treatment required for tomato fever. The symptoms usually subside in about ten days. The treatment generally given is supportive. 

• Medicines like paracetamol reduce fever, pain, and general discomfort. 

• Affected individuals must increase their fluid intake so that the body remains hydrated.

• Limiting salty and spicy food helps in preventing mouth soreness.

• Warm saline gargles help with mouth blisters.

• Avoid scratching or rubbing on the blisters and burst them. Instead, allow the blisters to reduce on their own.

• Skin irritation can be relieved by a skin-soothing lotion.

• Bathing in warm water would also relieve skin irritation.

• Proper rest till the symptoms of tomato flu subside, and blisters heal correctly without getting further infected.

• Continuous monitoring is required to understand the evolution of the disease and the need for other healthcare interventions.

Prevention of Tomato Flu

Tomato flu is a highly contagious disease that typically spreads among young children. At present, there are no preventive vaccines available for the tomato flu. Though the symptoms of the tomato flu are self-limiting and the symptoms subside within a week, the chances of infecting other individuals are high during the disease period. Thus a week’s isolation is recommended. The precautions include:

• The essential method to prevent the disease's spread is by creating awareness among the public. Though adults do not always develop tomato fever symptoms, they may act as virus carriers. Thus, primary grade teachers, pediatric doctors, and the local authorities must educate the parents on the different ways of disease transmission and how to prevent them.

• Assure social distancing among the caretakers and the children themselves.

• Though the disease is treatable, caretakers should seek emergency medical attention for their kids if they show any symptoms.

• Maintain thorough cleanliness and hygiene. One must keep the children and their surroundings disinfected and clean, especially during toilet training and after diaper changes.

• Do not let the children share their toys or clothes.

• Always maintain a safe distance from the affected individual and do not have direct contact with the affected individual.

• The affected children must stay home and rest. And only send them to school once the contagious period is over. Touching the fluid from the blisters may spread the disease to the next person.

• Avoid touching the eyes, face, mouth, and nose unnecessarily.

• Children must take a warm shower or bath and drink plenty of warm water.

• The outbreak of tomato fever is frequent in tropical countries. If one travels to a tropical country, one should take all the appropriate vaccines and get the doctor's advice on preventing them from catching the disease. So that in case one develops the symptoms of tomato fever, they would know what to do next.

• In case of a large-scale spread of infection, they are causing a public health emergency. In such cases, it is best to keep the childcare facilities and primary-level schools closed to prevent the spread of infection.

Take-Home Points

• Tomato flu is a rare but highly contagious disease that typically spreads among young children from ages one to nine. The condition got its name due to the red, round blisters resembling tomatoes. 

• The exact cause of tomato flu is indistinct. Most experts consider tomato flu a variant of Hand, Foot, and Mouth Disease (HFMD) caused by multiple Enteroviruses. Some others believe tomato flu is an after-effect of diseases like dengue fever or chikungunya. Moreover, the blisters in tomato flu are often confused with the eruptions in chickenpox. But unlike tomato flu, chickenpox's blisters are not seen under the palm and feet.

• Tomato flu is a self-limiting disease. There is no special treatment required for tomato fever. The symptoms usually subside in about ten days. The treatment generally given is supportive.

• At present, there are no preventive vaccines available for the tomato flu. The essential method to prevent the disease's spread is by creating awareness among the public. Though the symptoms of the tomato flu are self-limiting and the symptoms subside within a week, the chances of infecting other individuals are high during the disease period; thus, a week’s isolation is necessary. 

References

• Tomato flu

• Kerala Tomato Flu – A Manifestation of HFMD

• Tomato flu outbreak in India