Stemning Tomato Flu Outbreaks

Nowadays, people are becoming more alert to any new disease that is being reported in the media but the rumours and myths about the disease cause panic to them. In the last few weeks, numerous inquiries were received at the Nepal Drug and Poison Information Centre about a new viral disease, also called Tomato Flu. 

In May 2022, an outbreak of new viral infection was first detected in children in the southern Indian state of Kerala and has spread to other states there, and is feared that it may spread to Nepal as well. All the reported cases so far are among children under nine years of age. The exact causative agent of this infection is still unknown. However, it is better to be aware of the disease and remain vigilant. 

Main symptom

The illness has been named tomato flu as the patients suffering from the flu manifest red and painful blisters that appear throughout and grow gradually to the size of a tomato. However, the tomato has nothing to do with it and has no link with the disease. The name tomato flu comes from the main symptom of this disease, the tomato-shaped blisters are formed on several body parts. The blisters start as red-coloured small blisters, and when they get enlarged become and look tomato-shaped. So, the disease is known as tomato fever or tomato flu.

It is a very contagious disease that spreads through direct contact. Children are particularly vulnerable because it spreads easily through close contact, such as via nappies, touching unclean surfaces, or putting things in their mouths. The symptoms of tomato flu are somehow similar to chikungunya or dengue. The primary symptoms of this infectious disease are the large, red-coloured, and spherical blisters on multiple body parts, rashes, and irritation, dehydration, high-grade fever, body ache, and swollen and painful joints. Other symptoms associated with the disease are nausea and vomiting, patches and discoloration on various body areas, including hands, buttocks, and knees, runny nose and sneezing, frequent coughing, abdominal pain and cramps, and a constant feeling of tiredness and fatigue. 

It has commonly been seen among school-going children due to lack of proper hygiene and often putting hands in their mouths. The virus can remain in a child’s body for many weeks after the infection abates, making them favourable carriers for further spreading. Adults handling children can also transmit the virus without manifesting any signs and symptoms of the disease.

Tomato flu is a self-limiting infectious disease. The signs and symptoms resolve after a few days. The rare disease has recent emergence. So, no specific medications are available for the treatment. For the management of tomato flu, symptomatic and supportive care is the mainstay of therapy. Sometimes antipyretic and pain-relievers are necessary to subside symptoms.

It is advised to educate children about the signs and symptoms and side effects of the illness as it mainly affects children under five years of age. The best way to prevent this disease is to maintain proper hygiene and sanitisation of the surrounding environment and encouraging infected children not to share their toys, clothes, food, or other items with other children.

Some of the preventive measures are to avoid immediate contact with the infected person, not to hug or touch children having fever or rash symptoms, encourage the children about hygiene maintenance, and stop thumb or finger sucking habits. It is advised to encourage the child to use a handkerchief in case of running nose or coughing to avoid the spread of the disease and not to scratch or rub the blister and wash it every time after touching these blisters. Children should be motivated to drink plenty of water, milk, or juice, whatever they prefer. 

A child who develops symptoms of tomato fever, it is recommended to immediately isolate them from other children to contain the disease spread. Isolating children for five-seven days from symptom onset should be practiced to prevent the spread of infection to other children or adults. All utensils, clothes, and other utility items should be separated and sanitised regularly, and use of warm water to clean skin or for bathing the child. Feeding a nutrition-rich, balanced diet and enough rest and sleep help in speedy recovery.

Highly contagious

Tomato flu is a self-limiting infectious disease as the signs and symptoms disappear after a few days. It is a highly contagious infectious disease but is not a lethal and life-threatening condition. The proper preventive measures and symptomatic treatment are the key to its management. Some of the symptoms of tomato flu need immediate medical attention, such as severe diarrhea, vomiting, and dehydration. Those symptoms may have adverse effects on the child’s health and if left untreated may cause death. 

At present, antiviral drugs or vaccines are not available for the treatment or prevention of tomato flu. Continuous surveillance for serious outcomes and sequelae is needed to better understand the need for potential treatments. Lastly, it is important to avoid giving antibiotics for the treatment of tomato flu as it is caused by a virus and may contribute to the development of antibiotic resistance.

(Dr. Lohani is the clinical director at the Nepal Drug and Poison information Centre. lohanis@gmail.com)