On the left, images of rashes caused by this disease on the feet (CDC) and hands (Grook Da Oger/Wikimedia). On the right, a map of India with the state of Kerala in red.

In recent weeks, the media (see examples 1, two Y 3) have echoed reports of a disease in the state of Keralasouth of the India: tomato fever or tomato flu.


These contents are based on a correspondence published in the scientific journal The Lancet Respiratory Medicinewhere it is reported an outbreak of tomato fever in India. It is a type of scientific publication that does not have the level of evidence of a study or a meta-analysis —much more complete—, although it is used to send communications to the scientific community or discuss a matter of interest.

The authors of this correspondence, in particular, state that more than 82 girls and boys under the age of five have reported this disease between May and July 2022 in hospitals in Kerala, 26 cases in the state of odisha Y health alerts (no recorded cases) in the states of Tamil Nadu and Karnataka. We tell you what is known about this disease.

What is tomato fever and what pathogen causes it

The correspondence from which this information arises indicates that tomato fever or flu is a rare infection caused by a virus endemic to this part of the world that is not considered serious or lethal.


The authors of this article suggest that this disease could be a aftermath of the virus chikungunya or of dengue (two viral infections transmitted by mosquito bites) or a new variant of the hand, foot, and mouth disease virus o (HFMD, acronym in English), a common pathogen that affects children under 5 years of age and adults with weak immune systems that resolves without complications in seven to ten days. In fact, no serious cases or deaths related to this outbreak have been reported.

Sarah Pitt, Professor of Microbiology at the University of Brighton details in The Conversation that these reported infections are most likely to be hand, foot and mouth disease. This information is based on tests carried out on two children from the United Kingdom with symptoms typical of this disease and who had traveled from Kerala. In them was found virus Coxsackie A16that has the ability to cause this disease. A newspaper article published in BMJ also details that this disease is not caused by a pathogen new and that it is a variant of HFMD.

What are the symptoms of tomato fever and why does it receive this name?

The symptoms of this disease are similar to those of other flu processes: fever, tiredness, muscle and joint pain. To this is added some characteristic reddish rashes that can grow up to the size of a tomato, hence its name. These rashes can appear on the palms of the hands, soles of the feet, buttocks, legs, and arms.


Does not exist a specific treatment for this disease nor a vaccine that prevents it, highlight the Centers for Disease Control and Prevention of the United States (CDC, acronym in English). Instead, medications are given to help cope with symptoms, mainly paracetamol for fever and pain. It is recommended to rest, avoid touching the blisters and drink enough water.

Hydration is important because with this disease can generate sores in the mouth that make that swallowing is uncomfortable or painfulso children with this infection may not want to drink the necessary water.

How Tomato Fever Is Transmitted and Who It Affects

Like other common childhood infections, this disease is very contagiousalthough we must remember that it is not serious or lethal, so it is recommended that those who suffer from it remain isolated from schools and health centers during the course of the disease.


The most common routes of transmission are the secretions from the nose and throat (saliva, mucus or phlegm), the liquid from the rashes it generates and the feces of infected people, detailed the CDC. It can also be transmitted by being in contact with contaminated objects and surfaces, such as keys, toys or clothing.

Most people affected by HSMD are children under 10 years of age and adults with weak immune systems. In the Indian outbreak, the cases described are in boys and girls aged five and under.