India is experiencing another disease outbreak besides the COVID-19 pandemic and monkeypox virus. A correspondence published in Lancet Respiratory Medicine on Aug. 17 brought attention to tomato fever as 82 cases have already been reported in the country since May this year.

Tomato fever cases were reported in at least four states: Kerala, Tamil Nadu, Haryana, and Odisha. On Aug. 23, the Union Health Ministry released a set of guidelines on the disease's prevention, testing, and treatment.

What Is Tomato Fever?

The researchers wrote in their paper that tomato fever has a different clinical presentation to hand-and-foot-and-mouth disease (HRMD), which is caused by a group of enteroviruses transmitted through the intestine.

 According to Indian Express, tomato fever or tomato flu is characterized by fever, joint pain, and red or tomato-like rashes commonly seen in children below five years old. Other symptoms may also include diarrhea, dehydration, nausea and vomiting, and fatigue.

Experts initially thought that the new disease outbreak could be an after-effect of the chikungunya and dengue outbreak that is common in Kerala. But researchers believe that it is HFMD that is caused by enteroviruses.

They said that tomato fever could be another variant of the viral HFMD, a common infection that mostly targets children aged 1 to 5 and immunocompromised individuals.

Virology professor Dr. Ekta Gupta from the Institute of Liver and Biliary Sciences noted that, unlike tomato fever, HFMD is not a new infection and is even written in textbooks. But even though it is reported from time to time in the country, they are not very common.

The attention it is getting recently perhaps is because there are more cases this year and because people are more vigilant about viral infections and testing after the world experienced the COVID-19 pandemic.

Surveillance is important to keep an eye out for infectious viruses circulating within the community. Dr. Gupta added that looking for symptoms, like the red rashes in kids, will also help in diagnosing the disease.

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(Photo : Ritesh Shukla/Getty Images)
A woman uses a fan to cool a child suffering from diarrhea at the district hospital on May 21, 2022 in Mirzapur, Uttar Pradesh, India.

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What Virus Causes the Tomato Fever?

Researchers wrote in their paper that tomato fever is very contagious, just like other types of influenza, which is why doctors are calling for more caution. They emphasized the necessity to follow careful isolation procedures among confirmed or suspected cases to prevent further outbreaks of the disease.

 Dr. Jacob John, a prominent virologist in southern India, told Anadolu Agency that HFMD cases are being referred to as tomato fever cases in the country. But he explained that there is no scientific support for this as the flu is only named as such because of the red rashes that resemble a tomato.

He noted that HFMD is caused by two viruses, the Coxsackievirus-A16 and Enterovirus-71. Dr. Asawathyraj, a scientist at the Institute of Advanced Virology, said that Enterovirus-71 causes a disease that is not prevalent now but is known to lead to severe neurologic symptoms, such as fatal encephalitis or brain inflammation.

Health experts said that most HFMD cases in India are reported on the west coast, and although it is not a scary disease, caution should still be implemented.

 RELATED ARTICLE: Tomato Fever Spreading Among Children in India, Raising Concerns of Possible Outbreak Like Monkeypox

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