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"Tomato Flu" Outbreak In India May Actually Be This Common Childhood Illness

It's looking like hand, foot, and mouth disease is the most likely culprit. But what is this disease?

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Tom Hale

Senior Journalist

clockAug 26 2022, 14:10 UTC
Doctor holds the hand of young child with hand, foot, and mouth disease, the likely suspect behind "tomato flu."
Doctor holds the hand of young child with hand, foot, and mouth disease, the likely suspect behind "tomato flu." Image credit: fotohay/Shutterstock.com

Last week, researchers in India reported that over 100 children younger than five years have fallen sick with “tomato flu” in the states of Kerala and Odisha. While details are still pretty scant, there’s increasing evidence that this mysterious outbreak is caused by the well-known virus responsible for hand, foot, and mouth disease. 

The outbreak in India gets its name "tomato flu" or "tomato fever" because it causes red blisters that can gorge to the size of a small tomato. However, the infection also causes more general flu-like symptoms, including fever and body aches. 

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First reported in the Lancet journal Respiratory Medicine on August 17, the infection was described as “a new virus known as tomato flu”.

However, it may be misleading to define this as a “new virus”. The report later speculates that the strange infection may be caused by the virus that causes hand, foot, and mouth disease due to similarities in the symptoms. 

This prediction appears to be on the money. Following the initial report, a case study was published in The Pediatric Infectious Disease Journal detailing two cases who had just returned to the UK after a month-long family holiday to Kerala. 

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The two kids, who featured the characteristic bumpy lesions, were found to test positive for enterovirus, a genus of viruses that are responsible for a number of diseases. Honing in on these results, genetic testing then revealed that the virus was a Coxsackie A virus, the pathogen that causes hand, foot, and mouth disease.

"Early indications are that tomato flu is actually hand foot and mouth disease (HFMD) caused by Coxsackievirus A16, the virus that is most commonly associated with HFMD. The virus and disease are common worldwide, including Australia, mostly causing illness in children," commented Professor Andreas Suhrbier, a biologist at the QIMR Berghofer Medical Research Institute in Brisbane, Australia. 

What Is Hand, Foot, And Mouth Disease?

You might have heard of foot and mouth disease, the infectious disease that’s been known to spread like wildfire among farm animals. However, hand, foot, and mouth disease is an entirely different disease caused by a totally different virus. 

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Hand, foot, and mouth disease is a common childhood illness, although it can also infect adults. It typically results in a fever, headaches, and nasty red blisters that tend to appear – you guessed it – on hands, feet, and mouths. 

The disease is typically mild and generally clears up in seven to 10 days, although it can cause complications in rare instances, such as paralysis, meningitis, and swelling of the brain.

The current outbreak in India, however, appears to be a little different. In the initial report, researchers suggest that the virus may be a  “new variant of the viral hand, foot, and mouth disease.” 

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It’s not yet clear whether this means the disease is more contagious or more severe, but researchers will no doubt be striving to work this out. 


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