The virus got its name from one telltale symptom that isn’t seen with COVID — painful bright red blisters that spread all over the body and can gradually grow to the size of a tomato. While the virus is rare, at least 100 cases have been reported in India since the first case was identified in the state of Kerala on May 6, according to a report in the Lancet Respiratory Medicine on August 17. So far there have been no fatalities attributed to tomato flu, according to the Lancet report. Scientists and public health officials are still investigating the recent spate of cases, including 82 cases reported in children under 5 years old in local hospitals in the state of Kerala, as well as an additional 26 cases in youth 1 to 9 years old in the neighboring state of Tamil Nadu. Scientists are still investigating the cause of this catchily named pediatric illness, which shares characteristics with several more common childhood diseases, per the report. “Tomato flu could be an after-effect of chikungunya or dengue fever in children rather than a viral infection,” wrote Vivek Chavda, of the L.M. College of Pharmacy in Gujarat, India, and colleagues in the Lancet. “The virus could also be a new variant of the viral hand, foot, and mouth disease, a common infectious disease targeting mostly children aged 1 to 5 years and immunocompromised adults.” The cases in India are being identified after eliminating other potential causes of illness. That’s because, as with many other viral infections, including influenza, children infected with tomato fever may experience fatigue, nausea, vomiting, diarrhea, fever, dehydration, swelling of joints, body aches, the Lancet report notes. All these symptoms can be present with dengue, a mosquito-borne illness that is most dangerous to infants and pregnant women. Similarly, many tomato flu symptoms, including high fever, rashes, and intense joint pain, resemble what can happen with chikungunya, another viral infection spread by mosquitoes. Right now, tomato flu cases in India are being identified only after diagnostic tests rule out dengue and chikungunya as well as the Zika virus, varicella zoster virus, and herpes, according to the Lancet report. Treatment is similar to what’s done for young children with chikungunya and dengue — lots of fluids, rest, and hot water sponge baths to relieve irritation from rashes, according to the Lancet. Children may also be given fever-reducing medications such as ibuprofen or acetaminophen. Tomato flu is highly contagious, and a five- to seven-day isolation period is recommended. Other precautions to prevent the spread of the virus include hand-washing and not sharing clothes, food, or toys with infected individuals. The virus may be spread by contact with soiled diapers or unclean surfaces as well, or when children put items exposed to the virus in their mouth, the Lancet notes.
