'Tomato flu' a new epidemic in India: Virology, epidemiology, and clinical features

New Microbes New Infect. 2022 Dec 13:51:101070. doi: 10.1016/j.nmni.2022.101070. eCollection 2023 Jan.

Abstract

This article aims to highlight the current update on the 'tomato flu' outbreak in India. Recently there was an outbreak of a new illness in some parts of India. The disease was very contagious and it manifested with a rash mainly noticed in children younger than nine years. The rash was very painful and blisters were the size of small tomatoes, hence it was termed 'tomato flu'. A detailed literature review was performed on the virology, replication, epidemiology, and clinical features of this disease. The current outbreak was compared with similar other diseases of the past. The affected children exhibited severe rash in the palms, soles, oral cavity, and other body parts. They developed febrile illness with a sore throat, and myalgia followed by blisters on the tongue, gums, and cheeks. The affected children did not develop any complications leading to death. The therapy involved mainly symptomatic, supportive treatment with isolation and maintaining hygienic practices. The causative agent was identified to be Coxsackievirus A16, an RNA virus belonging to the family, Picornaviridae. We conclude that the recent Indian epidemic of this disease might be due to a new variant of Coxsackievirus A16 actually causing HFMD.

Keywords: Blisters; CA-16, Coxsackievirus A16; CA-16, HFMD; Clinical features; Coxsackievirus A16; HFMD, hand foot and mouth disease; Hand foot and mouth disease; Rash; ‘Tomato flu’.

Publication types

  • Review