Tomato flu outbreak

A new virus called the ‘tomato flu’ has been reported in India in the state of Kerala. According to a report published in The Lancet Respiratory Medicine, the first such case was reported on August 6, 2022. There are now over 80 cases in the country, with cases spreading to at least three states in the country.


Diagnosing tomato flu has been difficult. It shares symptoms with COVID-19, chikungunya, and dengue fever. Symptoms include high temperature, intense joint pain and a rashes – which are red and painful blisters that grow to the size of a tomato, hence giving it the name. Other symptoms, similar to most viral infections, include fatigue, nausea, vomiting, diarrhoea, fever, dehydration, swelling of joints, body aches, and common influenza-like symptoms.

Who are affected?

The virus has overwhelmingly affected children below five years, with few other cases noted between the ages of 6-9. According to the Lancet study, cases have been detected in three states of India – Kerala, Tamil Nadu, and Odisha.

The infection is highly contagious and is likely to spread through close contact. Young children are also at risk through use of nappies, touching unclean surfaces, and putting things in mouth. The outbreak needs to be controlled as uncontrolled spread can put adults at risk too. While severe infections are possible (viral meningitis), it is rare. No serious case has been reported from India so far.

Possible treatments

Currently, no specific treatment exists except for managing symptoms via existing medications. Isolation, rest, plenty of fluids, and hot water sponge for the relief of irritation and rashes are some of the ways to manage symptoms of the flu. Repurposing existing drugs is being looked at actively. The disease is self-limiting. Infected children should isolate for 5-7 days from onset of symptom and measures should be taken that the infected child does not share toys, clothes, and food with non-infected children.

Does the tomato flu virus resemble some known virus?

While not confirmed, the virus could be a new variant of the virus that causes hand, foot, and mouth disease, the coxsackie A16. This disease mostly targets children between the ages of 1-5 and immunocompromised adults. In fact, two children traveling from Kerala to the UK were suspected of carrying the disease. Tests eventually revealed that coxsackie A16 was infecting the children, and not tomato flu.

Should we be worried?

While a few cases have been reported in India, the outbreak has been under control. It is also possible that the rashes seen due to the flu might be due to a range of different causes, thus highlighting the need for accurate laboratory testing. More answers should be available soon about the nature of the disease.


  1. Chavda, Vivek P., Kaushika Patel, and Vasso Apostolopoulos. “Tomato Flu Outbreak in India.” The Lancet Respiratory Medicine 0, no. 0 (August 17, 2022).
  2. Dhillon, Amrit. “Tomato Flu Outbreak in India Spreads to Two More States.” The Guardian, August 23, 2022, sec. World news.
  3. Pitt, Sarah. “‘Tomato Flu’ Outbreak in India – Here’s What It Really Is.” The Conversation. Accessed September 6, 2022.
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