Tomato fever may sound like a situation where you really, really want spaghetti or pizza sauce. But that’s not how a letter recently published in the medical journal The Lancet Respiratory Medicine has described the “tomato fever” outbreak in India. Tomato fever, otherwise known as the “tomato flu,” has left over 100 children in the country with high fevers, joint pain, painful blisters, and rashes. As of July 26, this has included at least 82 children younger than five years of age in the state of Kerala and 26 children nine years and younger in the state of Odisha. The first reported case of the tomato flu occurred in the Kollam district of Kerala on May 6. 2022. Since then, according to the letter, cases have been reported in three states in India: Kerala, Tamilnadu, and Odisha.
Before anyone gets all saucy and claims that the “tomato flu” is another global threat like Covid-19, keep in mind that this is a very different situation. And a letter to a medical journal is not the same as a peer-reviewed study. The bar for publishing such a correspondence is a lot lower, assuming that you aren’t simply saying, “hey. what’s up,” in the letter. Moreover, this letter seems to leave a lot more questions than answers, tossing around a salad of other diseases as possibilities. Plus, let’s keep the term “tomato flu” in quotes, because at this point it’s not necessarily an official medical term and can be a bit misleading as a name. But more on this later.
While the “tomato flu” won’t turn you into a tomato, it apparently can lead to red and painful blisters covering your body that gradually expand to the size of a tomato, which is how the illness got its tomato name, according to the letter. Clearly something tomato-sized on your body should be cause for concern, assuming that hasn’t always been there or isn’t a tomato that fell from your salad. But otherwise this illness doesn’t seem to have anything to do with tomatoes.
The flu part of the name may lead you along the wrong vine as well. It seems to have come from the influenza-like symptoms such as fever, fatigue, nausea, vomiting, diarrhea, body aches, and other fun stuff that have accompanied the blistering. But calling something the “flu” may suggest that an influenza virus is somehow the culprit, which doesn’t seem to be the case here. This seems to be a very different situation from the avian flu and the swine flu, where birds and pigs, respectively, can become infected with and carry particular strains of the influenza virus. This outbreak shouldn’t prompt you to duck and roll in the produce section of the supermarket whenever you see tomatoes as the picture in this tomato-in-cheek tweet may suggest:
There’s no indication that you can catch this illness from simply having a close encounter with a tomato.
Instead, the letter indicated that kids have been passing the whatever-this-is to each other via either close direct contact or contaminated objects and surfaces. As you have probably recognized, young children are not great at not putting things into their mouths or not rubbing them all over their bodies. Often, the question is not whether something has been a little kid’s mouth but when and for how long. That’s why the letter mentioned not only placing those with the “tomato flu” in isolation for at least five to seven days after symptoms first appeared but also thoroughly cleaning anything touched by them.
It’s not completely clear what’s causing these “tomato fever” cases. In the letter, Vivek P. Chavda and Kaushika Patel from LJ University, Ahmedabad in Gujarat, India, and Vasso Apostolopoulos from Victoria University in Melbourne, Australia, wrote that tomato flu could be a either viral infection, such as “a new variant of the viral hand, foot, and mouth disease,” or “an after-effect of chikungunya or dengue fever in children rather than a viral infection.” These statements are a bit broad, sort of like saying that something could be caused by either a new variant of a doughnut or be the after-effect of a bagel. The viruses that cause hand, foot, and mouth disease, chikungunya, and dengue fever are quite distinct from each other and not the same. At this moment, there isn’t a specific “tomato flu” test that you can take. Thus, it seems like you have to rule out other possibilities before arriving at a “tomato flu” diagnosis.
There also isn’t a specific medication to take for the “tomato flu.” There is no specific magical “tomato flu” formula or bottle with a symbol showing a tomato with a line through it that would work against this illness. Instead, according to the letter, treatment consists of supportive therapy such as rest, plenty of fluids, fever-controlling medications, and things to ease the pain and irritation from the rashes.
One thing that clearly makes this “tomato fever” outbreak very different from the early days of Covid-19 is that, so far, the tomato flu doesn’t appear to be at all life-threatening. While the letter mentioned a range of very unpleasant symptoms, it describe “tomato fever” as a “self-limiting illness.” While you may want to encourage kids to not limit themselves, the opposite is true with illnesses. An illness that limits itself to non-life threatening outcomes without serious longer-term effects is much less of a concern than Covid-19, which clearly can cause death or leave you with long Covid. Of course, it’s still to early to know everything there is about this so-called “tomato flu.”
So don’t panic about the “tomato flu,” start sketching out toilet paper-hoarding plans on a whiteboard, yell, “another pandemic, another pandemic,” or eye the tomatoes in your refrigerator very suspiciously. This outbreak seems to be very different from the Covid-19 pandemic, the monkeypox outbreak, or even the re-appearance of polio in New York state, which I covered for Forbes recently. There’s been no indication that this outbreak has spread much further than the states of Kerala, Tamilnadu, and Odisha in India yet, although neighboring states have been on alert, according to the letter. Plus, remember that this was just a letter to a medical journal. Comparing such a letter to a peer-reviewed study would be a bit like comparing a movie trailer seen on YouTube to an actual movie in the cinema.
Nevertheless, it will be important to identify the actual cause of this outbreak and contain it as soon as possible. It would be better to get ahead of this “tomato flu” outbreak rather having to “ketchup,” so to speak.
Life Sciences, Forbes – Healthcare