What is the tomato flu virus?

Earlier this summer, a team of scientists reported a “new virus” in India that affected more than 100 children in three states. In the wake of COVID-19, monkeypox, and the resurgence of polio, the tomato flu outbreak stoked fears of another contagious disease threatening public safety.

A little boy in pajamas has a skin rash due to hand, foot and mouth disease.  The photo is only of his feet.

(fake images)

Nicknamed the “tomato flu” because of the red blisters and rash that develop on the skin, scientists reported a rare new viral infection first detected on May 6 in 82 children in the Indian state of Kerala. Soon after, an additional 26 cases were found in two nearby states of Tamil Nadu and Odisha. They reported their findings in an August 2022 article in The Lancet Respiratory Medicine, but experts believe it did not present enough actionable data.

a new virus

“The first step for all these emerging virus infections is to isolate the virus. And that’s a big part of it,” says Dr. Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine and co-director of the Texas Children’s Hospital Center for Vaccine Development. “The problem is that it’s hard to treat if you don’t know what you’re treating. If you knew what kind of virus it was, then you could move a lot faster.”

UK scientists finally sequenced the genetic material of the virus from two infected children and have since identified the culprit behind the outbreak: coxsackievirus A16, a known enterovirus. Enteroviruses are very common viruses that usually only cause mild symptoms similar to those of the common cold.

Although cases of tomato flu are still under investigation, many health experts believe the mystery behind the virus is solved. Like the myriad of COVID-19 variants and other viral strains that have evolved through mutations, tomato flu is not new. Instead, it was simply a branch of the common A16 coxsackie virus that presented with an atypical symptom: red, blood-filled blisters.

“We’re not 100% sure what the cause of tomato flu is, but it’s most likely a Coxsackie virus,” says Dr. Edward Ryan, director of Global Infectious Diseases at Massachusetts General Hospital in Boston. . “I think that’s a reasonable assumption.”

Coxsackievirus A16, which was first identified in the 1950s in South Africa, is best known for causing hand-foot-and-mouth disease, which circulates mainly among young children. Not to be confused with foot-and-mouth disease, also known as foot-and-mouth disease, which is found in animals, foot-and-mouth disease is highly contagious but not life-threatening.

Hand-foot-and-mouth disease typically affects “little children as young as five who come home from daycare or school or catch it from their cousins,” says Ryan, who also teaches medicine at Harvard Medical School and professor of immunology and infectious diseases at the Harvard TH Chan School of Public Health. “It is a virus that gives children fever and irritability … for about three to five days, and they can become dehydrated because it hurts to swallow (from) the lesions in the mouth. ”

While all signs point to tomato flu being a misnomer, there are still more questions than answers about the disease and why there seem to be more cases and more viruses and variants popping up.

“We’re going to see more and more of these situations,” Hotez says. “As the confluence of urbanization, deforestation and climate change begin to merge, these are the new forces of the 21st century that are driving emerging infections.”

Although no reports of tomato flu have been reported in the United States, health experts are aware of and prepared to treat any case of tomato flu as hand, mouth, and foot disease.

Tomato Flu Symptoms

The hallmark sign of tomato flu is red, tomato-like vesicles (small, fluid-filled blisters) that appear on the skin, which is what gives it its nickname.

“For reasons we don’t understand, in this syndrome, they bleed a little bit from the lesions,” says Ryan. “They turn sort of cherry red and can get bigger, (whereas) normal vesicles are more grayish or yellowish.”

Other symptoms associated with tomato flu are similar to hand-foot-and-mouth disease, including:

Symptoms in children are usually mild. According to the Centers for Disease Control and Prevention, children can return to daycare or school as long as they don’t have a fever, mouth sores, or lethargy. But if parents are still undecided, the CDC recommends talking with their child’s pediatrician to discuss options.


Coxsackievirus A16 is a highly contagious virus that can be transmitted from person to person through bodily secretions such as respiratory droplets, fluid from blisters or scabs, and fecal matter.

The CDC notes that people are most contagious during the first week of their infection when the viral load is at its highest. However, the virus can still spread for days or weeks even after symptoms have resolved or the individual is asymptomatic.

People are more likely to get the virus by:

Coming into contact with respiratory droplets from an infected person. Touching or close contact, such as kissing, hugging, or sharing eating utensils. Handling fecal matter from an infected person. Touching objects and surfaces that an infected person came into contact with, and then touching your eyes, nose, or mouth.

“Usually the things that are most infectious are bodily secretions and things that were touched by bodily secretions,” Ryan explains. “That’s why it’s often spread in the home, especially if you have a young child who is crying, irritable, and maybe having diarrhea.”


Currently, there are no specific medications to treat tomato flu. But because it is a self-limiting disease, which is a disease that resolves on its own without treatment, the infection will clear up in a few days.

In the meantime, supportive care can be provided to treat the symptoms of tomato flu. For example, over-the-counter medications such as acetaminophen (Tylenol) and ibuprofen (Advil) can be used to reduce fever and body aches.

However, the main concern is dehydration. Because painful mouth sores make it difficult for children to swallow, parents and caregivers should encourage them to drink as much as they can to stay hydrated.


Health experts say tomato flu is not a cause for alarm based on current knowledge, but given how common hand-foot-and-mouth disease is, especially during the summer and fall, prevention is better than cure.

There is no vaccine for hand-foot-and-mouth disease, but there are steps to reduce the risk of getting it.

“It really comes down to typical coxsackie (virus) precautions,” says Ryan, including what experts call “contact precautions.”

Wash your hands often with soap and water for at least 20 seconds, especially after handling diapers, using the bathroom, blowing your nose, or coming into contact with an infected person. Use alcohol-based hand sanitizer between hand washes. Clean and disinfect frequently touched surfaces and items. Avoid touching your eyes, nose and mouth. Avoid close contact with an infected person.

Although tomato flu is most likely a new symptom of an old virus, it is not out of the question for a new virus to emerge.
“It’s just part of our reality as a human animal on this planet that emerging pathogens, whatever they are (viruses, bacteria, etc.), are a part of life,” says Ryan.

Source: news.google.com