As India reopened after two dreadful years of COVID-19, the country saw a re-emergence of infectious diseases and a new variant of the hand-foot-and-mouth disease, also known as tomato flu, created quite a scare across many states.

Tomato flu is a rare viral infection that could be a new variant of the viral hand-foot-and-mouth disease, a common infectious disease targeting mostly children aged one to five years.

Initially, Kerala, Tamil Nadu and Odisha reported tomato flu cases. Tomato flu was first identified in the Kollam district of Kerala, on May 6, 2022.

The Kerala Health Department took precautionary measures to monitor the spread of the viral infection and prevent its spread in other parts of India.

In September, Assam reported over 100 cases of tomato flu, sounding an alarm for the state health department. The maximum number of cases were reported from two schools in the Dibrugarh district.

The Uttar Pradesh and Tamil Nadu governments had also issued advisories on tomato flu. Though the tomato flu disease is not seen as life-threatening, healthcare experts warned that any further spread of the disease may hit schools again after the COVID-19 pandemic.

Health officials also said that the chances of adults contracting the disease are feeble. Bhawuk Dhir, a dermatologist at Delhi's Ram Manohar Lohia Hospital, said that this is a clear sign of heading towards an era of viral diseases.

"Clearly, we are heading towards an era of viral diseases with the rampage of COVID-19, Monkeypox and now hand-foot-and-mouth disease -- as was predicted by various researchers in the past," Dhir had told IANS.

"Tomato flu is caused by Coxsackie virus A16 (a non-polio enterovirus), which is highly contagious and spreads through secretions from the nose, throat, fluid from the blisters and faecal-oral route," Dhir added.

In most cases, it is a mild self-limiting viral disease and requires supportive care for recovery. A few may develop complications such as meningitis and disseminated infection.

The Union Health Ministry also issued guidelines on tomato flu, underlining that its treatment is similar to other viral infections like isolation, rest, plenty of fluids and a hot water sponge for relief from irritation and rashes. Supportive therapy of paracetamol for fever and body aches and other symptomatic treatments are required.

"Tomato flu is a self-limiting infectious disease as the signs and symptoms resolve after a few days," the ministry guidelines said. No antiviral drugs or vaccines are available for the treatment or prevention of tomato flu.

"The term tomato fever was used because of the red-coloured blisters which resemble a tomato. A similar outbreak was reported in Kerala in 2007," according to Dhir.

Although not many new cases are being reported now, the best way to prevent this disease is to maintain proper hygiene and sanitisation of the surrounding environment as well as prevent the infected child from sharing toys, clothes, food, or other items with other non-infected children.