What Does ‘Tomato Flu’ Look Like?

Baby with Hand, Foot, and Mouth Disease - stock photo

Joel Carillet

Key Takeaways

  • A non-life-threatening illness referred to as “tomato flu” has emerged among young children in India.
  • Experts believe tomato flu is not a new virus, but rather a variation of hand, foot, and mouth disease.
  • Distinguishing symptoms include large red blisters, as well as mouth ulcers.
  • Cases resolve on their own within two weeks.

Yet another disease has made its way into health news headlines: tomato flu. According to correspondence published in the journal The Lancet Respiratory Medicine last month, the condition is characterized by red, painful blisters that can become the size of a tomato and as of late July had affected at least 82 children under the age of 5 in India since May.

On the heels of COVID, monkeypox, and polio outbreaks, tomato flu has understandably caused alarm. But experts say The Lancet letter—which is not peer-reviewed—has been blown out of proportion. “Tomato flu” is likely just a version of the common childhood virus called hand, foot, and mouth disease. It does not lead to serious illness. 

“Nobody has brought evidence that there is a new virus or new viral sequencing,” John Mourani, MD, medical director of infectious disease at Pomona Valley Hospital Medical Center, told Verywell. In fact, lab sequencing showed two U.K. children who were thought to have contracted tomato flu after returning from vacation in India were infected with Coxsackie A16—an enterovirus that is one of the causes of hand, foot, and mouth disease.

Still, skin lesions associated with tomato flu can reportedly be larger than the flat red spots indicative of traditional hand, foot, and mouth disease. Here’s what we know about its symptoms.

Hallmark Skin Symptoms

The Lancet authors indicate the red blisters and rash associated with tomato flu can appear similar to monkeypox lesions. But Mourani said people may experience a sore throat, which is not a symptom of monkeypox.

The location of lesions also helps differentiate it from other conditions like monkeypox.

“A special thing with this specific strain of Coxsackie is that it includes lesions on the palms and soles of your feet,” Zachary Hoy, MD, a pediatric infectious disease specialist at Pediatrix, told Verywell. Hoy added the lesions are typically spherical and filled with clear fluid.

Other Tomato Flu Symptoms 

In addition to blisters and rashes, the cases of tomato flu documented in The Lancet involve several symptoms:

  • Fatigue
  • Nausea
  • Vomiting
  • Diarrhea
  • Fever 
  • Dehydration 
  • Joint and muscle pain

Assuming the condition is a type of hand, foot, and mouth disease, Hoy said painful mouth ulcers are also quite common. One of the children in the U.K. developed mouth ulcers two days after the rash.

Is It Treatable? 

Hoy said tomato flu lasts about 10 to 14 days and will resolve on its own. There are no antivirals designed to treat it, so symptom management boils down to tactics like sponge baths and upping fluid intake.

If you notice any abnormal rash on your child’s skin, Hoy recommends taking photos to show a physician and to document how it changes over time. This will help the provider rule out any similar-looking condition and understand how the condition is progressing. 

2 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Chavda VP, Patel K, Apostolopoulos V. Tomato flu outbreak in IndiaLancet Respir Med. Published online August 17, 2022. doi:10.1016/S2213-2600(22)00300-9

  2. Tang JW, Iqbal A, Hamal S, et al. Kerala tomato flu - a manifestation of hand foot and mouth disease. Pediatr Infect Dis J. Published online August 19, 2022. doi:10.1097/INF.0000000000003668

By Jocelyn Solis-Moreira
Jocelyn Solis-Moreira is a journalist specializing in health and science news. She holds a Masters in Psychology concentrating on Behavioral Neuroscience.