What is the Tomato Flu

What is the Tomato Flu? (Explained)

by | Updated: Jan 28, 2023

Media outlets are hyping “tomato flu” as a newly emerging virus, but this highly contagious viral infection is probably not new at all. What’s more, it may not even be a type of flu.

In this article, we’ll explore the so-called tomato flu, its symptoms, and how it compares to more serious viral infections.

What is the Tomato Flu?

Tomato flu is a virus that causes a rash with round, red skin lesions that look like tomatoes. This is where it got its name, as media outlets pointed out how the inflamed blisters resemble the appearance of tomatoes.

In fact, these lesions can grow rather large in some cases.

Tomato flu acts as an endemic, which means it affects certain people in a specific region. It’s an illness that mostly affects young children. However, adults with compromised immune systems may also contract tomato flu.

It first appeared in India in May of 2022. Health officials reported the condition in more than 82 children under the age of 5 in Kerala, a state on India’s tropical Malabar Coast. By July 26, officials in the neighboring states of Tamil Nadu and Odisha had confirmed cases of tomato flu in 26 more children, ages 1 to 9 years.

Some health officials are worried that tomato flu may spread to healthy adults. Many are also concerned that it will spread outside of India.

tomato flu rash on hand illustration


Researchers are still working to understand tomato flu and its causes. The evidence so far suggests it is just another type of hand, foot, and mouth disease (HFMD), a common illness that affects mostly children.

Tomato flu may develop after exposure to a virus. More specifically, it is caused by an enterovirus, which is a group of viruses that enter through a person’s mouth and are absorbed into the gut.

Sometimes the viruses can travel to the central nervous system (the brain and spinal cord) or other parts of the body.

Tomato Flu is More Likely in Children

Children are more likely to become infected with enteroviruses because they often put their hands and other objects in their mouths. Infections can also happen through the use of diapers and by touching infected surfaces.

There are many enteroviruses. Researchers suspect the enteroviruses Coxsackie A16 (CA16), Coxsackie A6, EV A71, Coxsackie B, and Echo viruses are the cause of tomato flu.

Signs and Symptoms

The early symptoms of tomato flu are similar to other viral infections. In its early stages, tomato flu causes fever, rashes, and joint pain. Later, the blisters that give “tomato flu” its nickname appear on various parts of the body. These blisters can be quite painful and grow large.

Other symptoms of tomato flu include:

  • Fatigue
  • Nausea
  • Vomiting
  • Diarrhea
  • Swelling of joints
  • Body aches
  • Common flu-like symptoms

Doctors will usually order lab tests for children with these signs and symptoms. These tests help doctors rule out other types of infections, such as dengue, chikungunya, zika virus, varicella-zoster virus, and herpes, which can cause similar signs and symptoms.

Once the doctors rule out other infectious diseases, they may diagnose the child as having tomato flu.

Preventing Tomato Flu

To prevent the spread of tomato flu, isolate the infected person as soon as possible. Keep the child isolated for 5 to 7 days after symptoms first appear to prevent the spread of infection to others.

Proper hand hygiene is essential. The virus can spread when a child touches infected materials and then puts their hands in their mouth. Hand washing removes viruses from the child’s hand.

Sanitize toys, clothes, eating utensils, and all other items that the child comes into contact with and that may be touched by other children. Limit sharing of these items between children.

Treatment of Tomato Flu

Treatment of tomato flu is similar to chikungunya and dengue as well as hand, foot, and mouth disease. Tomato flu treatment focuses on:

  • Isolation
  • Getting plenty of rest
  • Drinking fluids

Applying a warm compress to the blisters, rashes, and irritated skin can help reduce skin discomfort. Acetaminophen can help with body aches.

Home Remedies

After consulting with a doctor, parents can usually treat children with tomato flu with home remedies. Some examples include:

  • Cold compress
  • Oatmeal bath
  • Aloe vera
  • Ginger
  • Honey
  • Garlic
  • Coconut oil
  • Tea tree oil
  • Echinacea
  • Apple cider vinegar
  • Vitamin C
  • Probiotics

Some other helpful remedies for tomato flu to consider that can be done at home include:

Maintain Good Hygiene

Encouraging the child to maintain good hygiene can help prevent the spread. Keeping surfaces clean and washing toys, clothing, and other objects can also help reduce transmission.

Don’t Scratch the Blisters

To reduce the risk of skin infections, parents should discourage their sick child from scratching or picking at rashes and blisters.

Drink Plenty of Fluids

Parents should encourage infected children to drink fluids to reduce dehydration. Sweating from fever, diarrhea, and vomiting can all cause dehydration.

Get Plenty of Sleep

Children infected with tomato flu should rest and get extra sleep. The body’s immune system produces proteins, known as cytokines, during sleep. Cytokines play an important role in fever, wound healing, inflammation, tissue repair, and other functions that support healing from infections.

Frequently Asked Questions About Tomato Flu

Why is the Disease Called the “Tomato Flu?”

People call it “tomato flu” because it causes a rash and round, red skin lesions that look like tomatoes. These lesions can grow rather large.

Why Does the Tomato Flu Mostly Affect Children?

Youngsters are at higher risk for contracting tomato flu or other enteroviruses because they are more likely to put toys, bedding, clothing, and other personal items into their mouths.

This gives enteroviruses easy access to the child’s digestive tract, where it can cause infection.

The virus may also be spread through touch. In other words, the child may touch the contaminated object and then put their fingers in or near their mouth, where the infection gains access to the digestive tract.

Should Parents in the United States Be Worried About the Tomato Flu?

At the time of this writing, all cases of tomato flu originated in India. Two children developed symptoms of tomato flu upon returning to their home in the UK after a month-long holiday in India with their family.

Parents in the United States should not worry about tomato flu at this point unless they travel to India or are in close contact with children who have recently been in that nation.

Final Thoughts

While tomato flu does not currently present the same potential for widespread illness as COVID-19 did, many people are keeping a watchful eye on this non-fatal yet highly contagious illness.

It does, however, causes illness in many children in India. For more information about tomato flu, consult with a pediatrician or general practitioner.

Written by:

John Landry, BS, RRT

John Landry is a registered respiratory therapist from Memphis, TN, and has a bachelor's degree in kinesiology. He enjoys using evidence-based research to help others breathe easier and live a healthier life.


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