In this article, the author talks about a new flu virus namely Tomato flu, that has infiltrated southern India. The clinical manifestations, treatment and preventive measures against tomato flu are also discussed in this article.

In the midst of concerns of a probable fourth wave of the current coronavirus pandemic, a new flu virus has infiltrated southern India. In the wake of the Nipah epidemic, Kerala has reported many instances of Tomato Flu, which is predominantly affecting children under the age of five years old. 

On May 6, 2022, the tomato flu was found for the first time in the Kollam district of Kerala, and as of July 26, 2022, the local government hospitals have recorded the illness in over 82 children less than 5 years. Anchal, Aryankavu, and Neduvathur are the other afflicted regions of Kerala. This prevalent viral infection generated an alarm in Tamil Nadu and Karnataka, its neighbouring states. In addition, the Regional Medical Research Centre in Bhubaneswar has identified 26 children (1–9 years of age) in Odisha as having the condition. Other than Kerala, Tamilnadu, and Odisha, no other Indian areas have been infected by the virus yet.

Tomato Flu: What is it?

The flu makes a child's body break out in rashes and blisters that are usually red. This is why it is called "Tomato Flu" or "Tomato fever." Several health professionals assert that the condition may be a viral fever or a complication of chikungunya or dengue fever.

What are the clinical manifestations?

Unusual influenza strikes youngsters under the age of five. The symptoms include rashes, inflammation of the skin, and dehydration. Multiple accounts indicate that the flu may also induce:

• Fatigue
• Joint pain
• Stomach cramps
• Nausea
• Vomiting
• Diarrhoea
• Coughing
• Sneezing
• Runny nose
• High temperature
• Body aches

It has been noticed that in certain infected patients, the legs and hands may also change colour. The predominant symptoms of tomato flu in children are comparable to those of chikungunya, which include high fever, rashes, and severe joint pain. The tomato flu derives its name from the slow expansion of red, painful blisters across the body until they reach the size of a tomato.

These blisters mimic those observed in young persons infected with the monkeypox virus. In addition to skin rashes, tomato flu also causes skin irritation. As with other viral illnesses, other dengue symptoms include tiredness, nausea, vomiting, diarrhoea, fever, dehydration, joint swelling, and body pains. Symptoms comparable to influenza are also present. In children exhibiting these symptoms, molecular and serological testing is conducted to rule out dengue, chikungunya, zika virus, varicella-zoster virus, and herpes; after these viral diseases are ruled out, the diagnosis of tomato virus infection is established.

The symptoms of tomato flu are similar to those of other viral infections, including a prodrome of fatigue, body discomfort, joint pain, cold, and cough, followed by moderate to high-grade fever and red tomato-shaped rashes across the whole body. Abdominal pains, nausea, vomiting, loose stools, and skin discolouration on the hands, elbows, knees, and buttocks may occur. Dehydration is an alarming indicator of a condition that requires hospitalization.

How can you avoid contracting the infection?

Preventive actions

1. Contact a physician immediately.
2. Do not scratch the blisters.
3. Drink boiling water to stay hydrated.
4. Maintain proper hygiene.
5. Avoid close physical touch with the diseased individual.
6. Bathe in warm water.
7. Get sufficient rest to prevent its lingering effects.

Like other influenza strains, tomato flu is extremely contagious. Therefore, it is essential to carefully isolate confirmed or suspected cases and take additional preventative measures to stop the tomato flu virus from spreading from Kerala to other regions of India. To stop the virus from spreading to other children or adults, isolation should be practised for 5-7 days after the onset of symptoms. The greatest method of prevention is maintaining good hygiene, sanitizing the immediate area, and keeping the infected child from sharing toys, clothes, food, or other objects with other children who are not ill.

How is tomato fever treated?

As with other forms of flu, tomato fever is infectious. If a person is infected with this influenza, they must be isolated since it may spread quickly. It is crucial to discourage kids from rubbing their flu-related blisters. Rest and cleanliness are also recommended. To avoid the transmission of influenza, infected individuals' utensils, clothing, and other belongings must be sanitised.

Due to the similarity between tomato flu and chikungunya, dengue, and hand, foot, and mouth illness, the treatment consists of isolation, relaxation, lots of fluids, and a hot water sponge for the alleviation of irritation and rashes. It is necessary to provide paracetamol and other symptomatic therapies for fever and aches. There are currently no antiviral medications or vaccinations for the treatment or prevention of tomato flu. To better comprehend the need for prospective therapies, more follow-up and monitoring of significant outcomes and sequelae is required.

Disclaimer- The views and opinions expressed in this article are those of the author's and do not necessarily reflect the official policy or position of M3 India.

About the author of this article: Dr Monish Raut is a practising super specialist from New Delhi.