With cases of tomato flu reported from at least four states — Kerala, Tamil Nadu, Haryana, and Odisha — the Union Health Ministry has issued a set of guidelines on prevention, testing, and treatment of the infection.

Researchers believe that it is a different clinical presentation of hand-foot-and mouth disease (HFMD) caused by a group of enteroviruses (viruses transmitted through the intestine).

What is Tomato Flu?

• Tomato flu or tomato fever is characterized by fever, joint pain, and red, tomato-like rashes usually seen in children below the age of five years.
• This is accompanied by other symptoms of viral fevers such as diarrhoea, dehydration, nausea and vomiting, and fatigue.
• This was thought to be an aftereffect of dengue and chikungunya that is commonly seen in Kerala.
• However, researchers now believe that it is HFMD caused by enteroviruses like Coxsackievirus A-6 and A-16.

Is it very uncommon?

• Tomato flu could be an after-effect of chikungunya or dengue fever in children rather than a viral infection.
• It could also be a new variant of the viral hand, foot, and mouth disease, a common infectious disease targeting mostly children aged 1–5 years and immunocompromised adults.
• HFMD is not a new infection, we have read about it in our textbooks. It is reported from time to time across the country, but it is not very common.

Why is the infection spreading now?

• There actually are more cases or because we are more vigilant about viral infections and testing after Covid-19.
• Since the disease is self-limiting, doctors do not usually test for it.
• There are so many viral infections in children, but we cannot — and there is no need to — test for each and every one of it.

Which pathogen is causing it now? And how is the clinical presentation different?

• The current HFMD cases are mainly caused by Coxsackievirus A-6 and A-16.
• Another pathogen — Enterovirus71 — that also causes the disease is not very prevalent now, according to her.
• This is good because the pathogen was known to lead to severe neurologic symptoms, including fatal encephalitis (brain inflammation).
• In almost all cases, say 99.9% cases, the disease is self-limiting.
• But, in a small number of cases it can lead to CNS (central nervous system) complications.

Is there a treatment for the infection?

• There is no specific treatment or vaccine available for the disease.
• Those with the infection are treated symptomatically, such as prescription of paracetamol for fever.

How can the infection be prevented?

• As it happens mainly in children, the Centre’s advisory focuses on preventions in these age groups.
• As per the advisory, anyone suspected to have the infection should remain in isolation for five to seven days after the onset of the symptoms.
• It states that children must be educated about the infection and asked not to hug or touch other children with fever or rashes.
• The children should be encouraged to maintain hygiene, stop thumb or finger sucking, and use a handkerchief for a running nose, the advisory states.

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