Some of India’s youngest children are suffering through an outbreak of a little-understood illness dubbed tomato flu or tomato fever due to the painful red blisters produced by what appears to be a viral infection.

The painful blisters are not only red like a tomato, but can actually grow quite large.

The journal Lancet Respiratory Medicine reported that 82 children under age 5 have been infected in Kerala, India, as of July 26 and another 26 were ill from it in Odisha.

The article speculates that tomato flu could be “an after-effect of chikungunya or dengue fever in children, rather than a viral infection.” Alternatively, it could possibly be a new variant of the viral hand, foot and mouth disease that can affect young children or those who are frail or immune-compromised.

No one’s sure.

Dr. Suneela Garg, a senior health official in the Delhi government, was quoted by The Guardian: “I agree that chikungunya and dengue can leave children vulnerable to tomato flu because their immune systems are weaker.”

The outbreak has spread to at least two neighboring states: Tamil Natu and Odisha, The Guardian reports. There, children as old as 9 have been infected, though the virus usually only strikes those younger than 5.

Tomato flu symptoms and treatment

The Lancet report suggests young children are likely at greater risk because they like to put things in their mouths.

According to the Lancet report, “The rare viral infection is in an endemic state and is considered non-life-threatening; however, because of the dreadful experience of the Covid-19 pandemic, vigilant management is desirable to prevent further outbreaks.”

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Symptoms are reportedly similar to those of COVID-19, chikungunya and dengue fever. The latter two are mosquito-borne illnesses common during the rainy season in India. Those symptoms include blisters in the mouth and elsewhere, skin irritation, body aches, high fever, vomiting, intense pain in swollen joints and coughing. The New York Post said that limbs became discolored in a few cases, though that was quite rare.

Treatment is similar to what’s offered for the two mosquito-borne illnesses. While there’s no specific drug that helps counter tomato flu, care includes five to seven days of isolation, rest and cleaning and relieving rash irritation with a hot-water sponge. Good hygiene is needed to keep the affected areas clean and the children suffering through the blisters are warned to avoid touching them.