ISSN: 2456-8090 (online)

DOI: 10.26440/IHRJ/0609.12585

Tomato Flu: A Short Commentary

ARJUN SINGH PHOKELA¹, ANCHAL RAPOTRA¹, ANAMIKA¹, ANAMIKA RAGHWA², SAHIBLEEN KAUR*²

Cite this article as: Phokela AS, Raporta A, Anamika, Raghwa A, Kaur S. Tomato Flu: A Short Commentary. Int Healthc Res J. 2022;6(9):SC1-SC3. https://doi.org/10.26440/IHRJ/0609.12585

Author Affiliations:

1. BDS Final Year Student
2. Intern

Department of Public Health Dentistry, Himachal Dental College, Sundernagar, India.

Contact Corresponding Author at: sahibleenkaursachdeva[at]gmail[dot]com

ABSTRACT

Tomato flu is a contagious disease caused by infection. Its source is said to be a strange virus not known to common knowledge. It is an anonymous virus the symptom of its infection is a blister formed all over the body in the shape of a tomato hence it is called the tomato fever. The blisters appearing all over the body are similar in appearance to a tomato its victim are children below the age of 5 years .The virus effects the hands mouth and feet. It is supposed to be an infection limited to itself and gets to be subsided in 7 to 10 days. The diagnosis are done as per the clinical history and physical check up. Since it is an etiological agent its line of treatment and vaccination are a question mark and needs to be researched upon  at top priority. Covid 19 has imparted a lesson for outbreak alert in propagation and management of such cases during emergency condition by reproposing drugs and vaccines.¹   

INTRODUCTION                   

This disease, “Tomato Flu” is full of infection which has cropped up from an unidentified viral disease.  It was first identified as a viral organism and first detected in India during May 2022 in the state of Kerala. It got its name ‘Tomato Flu owing to its chief symptom of blisters in tomato shape appearing everywhere on the body. It is also called “tomato influenza” and tomato fever because of its resemblance to a tomato. 

It is found in children upto the age of five. Adults are rarely infected due to their strong immunity to the tomato influenza virus. Tomato Flu is considered as an infection  commonly born from a virus whose impact results in results in hand, feet and mouth disease (HFMD). 

HFMD is normally caused by Coxsackie virus. However, the A16 Coxsackie virus causes  only mild illness. A Patient may recover naturally   within  7-10 days even if there is no medical intervention. This virus infects cattle and pigs in cages. Infection is commonly transmitted through the one being in direct contact with saliva, bladder fluid , throat secretion or stool of an infected person or animal. 

New borns whose mothers become a victim  of enteroviral disease at birth may  also become infected. However, most enterovirus infected neonate have mild disease. In additions, further investigations and researches are being pursued to diagnose the exact etiology that causes the infection.² 

CLINICAL FEATURES

Tomato flu is treated as after-effects  of chikungunya or dengue owing  to their  common sign and   symptoms although there is no evidence discovered in their similarity. The common identical symptoms as identified  are³: 

• Large, spherical blisters in reddish tinge appearing on various parts of the body
• High-grade fever
• Dehydration
• Irritation and rash on the outer Skin.
• Unusual change in complexion giving a discoloration as Patches on hands, knees and buttocks.
• Pain in the abdomen
• Lethargic tiredness,
• Fatigue. 

EPIDEMIOLOGY

The disease broke out at the outset in Kollam district of Kerela with eighty two victims being identified in the month of July, 2022. It is speculated that the number of infected cases might increase with time. 

The disease was first detected and identified on 6^th May in a four year old child in Aryankavu village which lies on the borders of Kerela and Tamil Nadu and was the world’s first case. Since, then about 26 cases were identified as positive of hand, foot and mouth diagnosed in Orissa which were also presumed to be tomato flu.⁴                                                

MANAGEMENT OF TOMATO FLU

Tomato flu is a viral fever having its own limits hence it gets over on its normal self in about 7 to 10 days. This infection is diagnosed by its physical appearance in the patients body and the clinical history. The recovery naturally happens due to its self-limitations. 

TREATMENT

The flu is a rare infection that has recently evolved, so there are currently lack of exact or specific drugs available to curb this virus. Since disease-specific treatment is not feasible, owing to the absence of research available, treatment is only prescribed as per the symptoms of other flu using appropriate antipyretics and analgesics. Antibiotics can help only when the blister becomes filled with pus. In this disease, dehydration is observed commonly, so drinking plenty of fluids, such as water, milk etc is recommended. Patients are also advised rest along with precaution of hygiene. The patient should be quarantined for 5-7 days.⁵

OUTBREAK PREPAREDNESS

• When a child develops symptoms of HFMD, guardians and parents should be motivated to seek medical attention at the earliest. One should be alert and aware of any deflection in the patient's normal behaviour. Example include a lack of appetite, persistent nausea and drowsiness.
• Adopting hygiene and regular washing of hands should be emphasized especially after handling diapers and using restroom.
• All surfaces and objects should be thoroughly disinfected with diluted chlorine based bleach.
• A report protocol should be adhered to daily for all levels of healthcare facilities.
• Expansion of Pediatric Intensive Care Unit (ICU) facilities should be top priority with training program for emergency medical personal.
• Provision of a team to provide 24 hour on call service should be imposed in effective areas. Severe cases need to be monitor and assessed.
• Separate examination rooms for fever patients in clinic and paediatric wards be arrange to prevent transmission of other illness to children.
• Medical devices must be sterilized after every use on patients.

PREVENTIVE MEASURES 

The outbreak of a sudden strange infection needs to be handled using preventive measures as its prevention plays a vital role in reducing the effects of the disease and controlling it.

AS observed, tomato flu generally attacks infants and preventive measures may be complicated process for them and thoer parents. Parents in affected areas should be vigilant for the breakout of the disease. Incase of a suspected illnees, the measures appended below may be adopted to prevent tomato flu:¹

• Isolate the infected person to prevent rapid spread of the disease for 5-7 days.
• Owing to its highly contagious nature, the victims should be advised not to scratch the effected surface of the skin or the blisters.
• Avoid contact with the infected patients.
• Children should be advised not to physically touch the rashes or hug infected patients.
• Adopt healthy way of living proper sanitation and clean healthy habits.
• Regular and proper cleanliness and sterilisation of clothes, towel, and materials used by infected persons is advocated
• Dehydration should be avoided
• A balanced diet with ample amount of fluid helps to boost the immunity. 

DRUGS AND VACCINES UNDER TRIAL

Tomato flu is recently identified disease so drug for its unknown virus treatment and vaccines have yet to be developed. The clinical trials are under process. 

STEPS TAKEN BY THE GOVERNMENT

The disease has been identified in the states of Kerela and Tamil Nadu which have already adopted a precautionary alert by keeping surveillance of its borders. The government has advised for screening of such diseases in medical centres and by Anganwadis.  Teams comprising of the Revenue Inspector, Police and Health inspector are deployed  to pursue the victims of fever and rashes. A close watch in the neighbouring areas was also done to avoid the wild spread of the disease.⁸ 

CONCLUSION

Tomato flu cases were discovered during a period of high anxiety in the country due to an outbreak of monkey pox. Despite the fact that it is spreading rapidly, the government's immediate actions toward prevention and treatment have significantly limited the infection's spread. 

REFERENCES

1 Tomato fever symptom, cause, treatment and precautions Demer, Haryana. Online Article. Available from: https://dmerharyana.org/tomato-fever [Last Accessed on 30^th August, 2022]

2. Jeemon J. How Kerala is battling ‘tomato flu’ outbreak Online Article. Available from: https://www.indiatoday.in/india-today-insight/story/how-kerala-is-battling-tomato-flu-outbreak-1949473-2022-05-15. [Last Accessed on 14^th June, 2022].

3 S Panda. What is Tomato Flu that has put health officials of Kerala and neighbouring states on high alert?. (Online Article). Available from: https://www.financialexpress.com/healthcare/news-healthcare/what-is-tomato-flu-that-has-put-health-officials-of-kerala-and-neighbouring-states-on-high-alert/2522478/. [Last Accessed on 14^th June, 2022].

4. Sinclair W, Omar M. Enterovirus. [Updated 2022 Aug 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK562330/

5. Chuang YY, Huang YC. Enteroviral infection in neonates. J Microbiol Immunol Infect. 2019;52(6):851-7. https://doi.org/10.1016/j.jmii.2019.08.018.