What to Know About Tomato Flu Outbreak Among Children in India

A new virus known as tomato flu affecting children younger than five years has emerged in India's state Kerala. Over 80 cases of the disease have been confirmed; however, researchers say the virus could also be a new variant of the viral hand, foot, and mouth disease.

According to the study published in The Lancet Respiratory Medicine, a new virus called tomato flu or tomato fever was first identified in the Kollam district of Kerala, a state in India, on May 6, 2022.

As of July 26, 2022, the local government hospitals reported more than 82 infected children under five years old. The infection, considered non-life threatening, has spread from Kerala to the states of Tamilnadu and Odisha.

However, researchers note that tomato flu could also be a new variant of the viral hand, foot, and mouth disease. This common infectious disease primarily affects children 1–5 years and immunocompromised adults.

What are the symptoms?

Patients with tomato virus develop similar symptoms as those with chikungunya — a viral disease resembling dengue and transmitted by mosquitoes.

According to the study authors, the virus causes "red and painful blisters throughout the body that gradually enlarge to the size of a tomato."

The other symptoms of tomato flu may include:

  • High fever
  • Fatigue
  • Nausea
  • Vomiting
  • Diarrhea
  • Dehydration
  • Swelling of joints
  • Body aches
  • Other common influenza-like symptoms

How does it spread?

Tomato virus likely spreads through close contact; for example, children may catch the infection using nappies, touching unclean surfaces, and putting things into their mouths.

Study authors say the tomato virus is very contagious; therefore, people with suspected or confirmed disease should be isolated for 5–7 days from symptom onset.

How to treat tomato flu?

Tomato flu is confirmed by ruling out the diagnosis of dengue, chikungunya, Zika virus, varicella-zoster virus, and herpes using molecular and serological tests.

Treatment of tomato flu requires isolation, rest, plenty of fluids, and a hot water sponge to relieve irritation and rashes. Paracetamol can be taken to alleviate fever and body ache, and other symptomatic treatments can be applied, the study authors say.

To date, no antiviral drugs or vaccines are available to treat or prevent tomato flu.


1. The Lancet Respiratory Medicine. Tomato flu outbreak in India.

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