INDIA: The centre issued an advisory to states on Tuesday regarding hand, foot and mouth disease (HFMD), commonly known as tomato flu.
According to the Ministry of Health and Family Welfare, tomato flu was first identified in Kerala’s Kollam district on May 6, and as of July 26, more than 82 children under the age of 5 have been reported from local government hospitals with the infection. Other affected areas of Kerala are Anchal, Aryankavu and Neduvathur.
This endemic viral disease has raised alarm in the neighbouring states of Tamil Nadu and Karnataka. In addition, 26 children (aged 1-9 years) were reported sick in Odisha by the Regional Medical Research Center in Bhubaneswar. To date, apart from Kerala, Tamil Nadu, Haryana and Odisha, no other regions in India have reported the virus in their state/UT.
Tomato flu is a viral disease. The name “tomato flu” comes from the main symptom of this disease, tomato-shaped blisters on several parts of the body. Blisters start as small, red-coloured blisters that resemble tomatoes as they enlarge.
The primary symptoms seen in children with tomato flu are similar to other viral infections, which include fever, rash, and joint pain. Skin rashes can also lead to skin irritation. As with other viral infections, symptoms also include fatigue, nausea, vomiting, diarrhoea, fever, dehydration, joint swelling, body aches and common flu-like symptoms, the Union health ministry said.
HFMD is characterized by fever, mouth ulcers, and a skin rash. It starts with a mild fever, poor appetite, malaise and often a sore throat. A day or two after the onset of fever, small red spots appear, which turn into blisters and then ulcers. The sores are usually found on the tongue, gums, inner cheeks, palms and soles of the feet.
In children with these symptoms, molecular and serological tests are performed to diagnose dengue, chikungunya, zika virus, varicella-zoster virus, and herpes; once these viral infections are ruled out, a diagnosis of tomato flu is considered.
Tomato flu is a self-limiting infectious disease as the signs and symptoms disappear after a few days. This disease appears to be a clinical variant of the so-called hand-foot-mouth disease, which is common in school children. Infants and young children are also susceptible to this infection by using diapers, touching unclean surfaces, and also putting things directly in their mouths.
HFMD occurs mainly in children under 10 years of age, but it can also occur in adults. There are no disease-specific medications available. Treatment is similar to other viral infections, i.e. isolation, rest, plenty of fluids and a hot water sponge to relieve irritation and rashes. Supportive treatment with paracetamol for fever and body aches and other symptomatic treatment is necessary.
Isolation should take place for 5-7 days after the onset of any symptom to prevent the spread of infection to other children or adults.
The best solution for prevention is to maintain good hygiene and sanitation of the surrounding needs and environment, as well as to prevent the infected child from sharing toys, clothes, food or other objects with other uninfected children.
There are currently no antiviral drugs or vaccines available to treat or prevent tomato flu. Further follow-up and monitoring of serious outcomes and sequelae are needed to better understand the need for potential treatment.
Hand, foot and mouth disease (HFMD) is one of the many infections that lead to mouth ulcers. However, health care providers can usually distinguish between HFMD and other causes of mouth ulcers based on the patient’s age, symptoms reported by the patient or parent, and the appearance of the rash and/or ulcers. The diagnosis is mainly clinical.
Throat or stool samples may be sent to a laboratory for testing to isolate the virus that is causing the disease, which may take 2-4 weeks for laboratory results. Testing should be done to investigate the outbreak so that preventive measures can be initiated.
On sampling, the Ministry of Health said that samples from the throat or nasopharynx can be taken within 48 hours of becoming ill. Stool samples should be collected within 48 hours of illness.
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