Children are the future of a nation. They must not only receive proper education but also maintain good health in order to achieve various milestones in their lives. However, their health is being threatened by various diseases like monkeypox and COVID-19. And now a new disease known as “Tomato Fever,” which infected children under the age of five in India’s southern state of Kerala, has increased the risks to their health.1
“Tomato Fever” gets its name from the appearance of red and painful blisters all over the body in infected patients that may enlarge to the size of a tomato.2 Though tomato fever has been found to be self-limiting1, the fact that it affects young children has caused a wave of panic in the masses, especially in parents.
In the following blog, we will try to understand this disease, how it spreads and what we can do to protect our children from it.
The first outbreak of tomato fever was reported in the areas of Mudakayam, Varzur, and Kanirapally in the Kottayam and Pathinamtita districts of Kerala, India in 2017, in which around 2,800 people were found to have symptoms of tomato fever.3
In 2022, the first case was again reported in the Kollam district of Kerala on May 6, 2022. Since then, a total of 82 cases have been identified by the local healthcare authorities in Kerala in Kollam, Anchal, Aryankavu, and Neduvathur, along with other sites. In addition, the Regional Medical Research Centre in Bhubaneswar has also confirmed that 26 children in the age group of 1–9 years have also been infected with the same disease.
The Kerala government has already issued an alert to the neighboring states of Tamil Nadu and Karnataka to contain its spread.1 Moreover, the government of Uttar Pradesh has also issued an advisory to parents about how to safeguard their children against hand foot and mouth disease (HFMD) that is also identified as tomato fever due to similarities in their symptoms.4 But what is the origin of this disease?
As of now, scientists are not sure of the origins of this fever. They are trying to find the origins of this virus based on the symptoms of the disease, which are listed in Figure 1. Some scientists believe that this disease is just another variant of hand, foot, and mouth disease in children, which is similarly characterized by the appearance of rashes and fever. Others have suggested that since the symptoms of this disease are similar to other viral infections like chikungunya and dengue, tomato fever might just be an after effect of infection with these same viruses. Researchers claimed that since Kerala has a higher rate of chikungunya and dengue viral infections, this hypothesis could be a possible reason for this new disease outbreak. Some have even linked it with COVID-19 infection, while others feel that the tomato fever blisters resemble those caused by the monkeypox virus. Yet there is no consensus about the cause of this fever.1
Tomato fever, like other viral diseases, is highly contagious. It’s thought to be spread by direct physical contact with an infected patient or his or her belongings. Children are more vulnerable to this disease because they may come into contact with unclean surfaces and used nappies before putting their dirty hands and infected fomites directly into their mouth.1 But how do we know that a person is suffering from tomato fever?
Since the cause of this disease is unknown, a specific test is not yet available to diagnose tomato fever directly. Hence, it can only be diagnosed by exclusion, i.e., by ruling out the presence of other infections like dengue, chikungunya, zika virus, varicella-zoster virus, and herpes through various molecular and serological tests
Moreover, no specific treatment is available for tomato fever. However, based on the similarity of its symptoms to other viral infections, it is recommended that the infected children be treated in isolation to prevent the spread of infection to others.
However, for symptomatic treatment, paracetamol could help reduce fever and body aches in patients. In addition, adequate rest and a lot of fluids can help a patient recover. Furthermore, sponging with hot water can provide some relief from irritation and rashes.1 Although this disease is not known to cause serious physical damage or mortality, but due to our past dreadful experience with viruses, it is still better to take adequate precautions to prevent infection with this disease.
The infected patients should be isolated for a period of 5-7 days.5 Moreover, proper hygiene should be maintained with sanitization of the surrounding environment and other items touched by the patient. In addition, the infected children should not be allowed to share toys, clothes, food, or other items with other non-infected children.1
All forms of physical contact like hugs and handshakes should be prevented between infected and non-infected children. They should be taught to cover their nose when sneezing. Lastly, a nutritious diet can help build the immunity of your child, allowing him to ward off any infection.6 In this way, we can limit the spread of this infection and hope to live a healthier life
The above discussion proves that tomato fever is similar to other viral infections like hand, foot, and mouth disease, chikungunya, and dengue. Though this infection is currently limited to children, the possibility of adults becoming infected cannot be ruled out. Moreover, it is extremely contagious.
Tomato fever not only endangers children but also immunocompromised individuals. Hence, appropriate precautionary measures must be taken to prevent its spread. Research efforts should be intensified to identify the cause of this disease and develop suitable preventive and therapeutic measures to combat it. Drug repurposing could prove to be an effective and cost-effective measure in this regard. Meanwhile, in the absence of any suitable drugs or vaccines, prevention and observation remain the only ways to tackle this disease. Hence, all the disease surveillance and case monitoring should be carried out intensively to understand this disease and prevent its spread. We hope the medical researchers can achieve a breakthrough in their efforts quickly.
Reviewer: priyanka
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