• Users Online: 167
  • Print this page
  • Email this page

 Table of Contents  
Year : 2022  |  Volume : 55  |  Issue : 6  |  Page : 244-245

Hand-foot-and-mouth disease, tomato flu, and surgery: A new issue

1 Private Academic Consultant, Pune, Maharashtra, India
2 Department of Community Medicine, Dr. D. Y. Patil University, Pune, Maharashtra, India

Date of Submission28-Aug-2022
Date of Acceptance29-Aug-2022
Date of Web Publication22-Nov-2022

Correspondence Address:
Somsri Wiwanitkit
Private Academic Consultant, Pune, Maharashtra
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/fjs.fjs_191_22

Rights and Permissions

How to cite this article:
Wiwanitkit S, Wiwanitkit V. Hand-foot-and-mouth disease, tomato flu, and surgery: A new issue. Formos J Surg 2022;55:244-5

How to cite this URL:
Wiwanitkit S, Wiwanitkit V. Hand-foot-and-mouth disease, tomato flu, and surgery: A new issue. Formos J Surg [serial online] 2022 [cited 2022 Nov 26];55:244-5. Available from: https://www.e-fjs.org/text.asp?2022/55/6/244/361703

Dear Editor,

An important infectious disease called hand-foot-and-mouth disease (HFMD) may first show symptoms in the mouth. The two viruses that cause the contagious but benign febrile sickness known as HFMD are coxsackievirus A16 and enterovirus (EV) 71. Usually affecting youngsters, it can occasionally cause injury to adults as well. Despite the fact that HFM is usually asymptomatic and can be identified by a vesicular appearance in the mouth and foot, pressure and contact can cause pain. Clinical evaluation is used to make the diagnosis and treat the symptoms.

In several Indian districts, a new medical regimen has already gained popularity. It is projected to spread widely in 2022. The condition is also known as tomato flu. According to Tang et al.,[1] the “Kerala tomato flu” in these young people was brought on by CA16 and CA6.3, 4, two of the most common EV causes of HFMD in India. Tomato flu was theoretically a possibility given to the current global epidemics, but CA6 was initially deemed to be the most likely cause based to the infant's unusual rash.[1]

With regard to HFMD, some severe instances show signs of a surgical condition. The therapy of necrotizing fasciitis worsening HFMD is typically surgical.[2] Acute pancreatitis, for example, may be present in certain patients.[3] Numerous recent papers also indicate that an adult problem is developing.[4],[5] In addition, the disease spectrum is already expanding, and some people only experience unusual clinical issues including thrombocytopenia and joint issues. Therefore, it is essential that the surgeon be aware of and ready for any potential new tomato flu outbreak.

It is important to understand that a variety of illnesses can cause severe febrile illness and a rash. It could be difficult to diagnose. Even though it may just be a recent cause for concern, the tomato flu is already spreading in some regions of India. Although not assured, future progression into a serious viral infection is probable.[6] Because there is a real possibility of big epidemics in the future, it is really alarming. It is currently predicted that the illness would be diagnosed in a molecular laboratory, despite the fact that performing this test in rural, poor areas is frequently difficult. Clinical management and diagnostics are frequently used.

Furthermore, there is a possibility that something could go wrong considering that this sickness includes clinical symptoms of both dengue and chikungunya. A sizable fraction of instances are probably not reported. However, it is conceivable for several illnesses to present themselves at once. Finding the likely coinfection can be difficult. Additional research on the unique condition is advised. Now, it is the time that the practitioner has to prepare and recognize for either typical or atypical form of new disease.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

Tang JW, Iqbal A, Hamal S, Mohamedanif T, Tipping LF, Toovey OTR, et al. Kerala tomato flu-A manifestation of hand foot and mouth disease. Pediatr Infect Dis J 2022. doi: 10.1097/INF.0000000000003668.  Back to cited text no. 1
Smith C, Scott J. Necrotising fasciitis complicating hand, foot and mouth disease. BMJ Case Rep 2019;12:e228581.  Back to cited text no. 2
Zhang YF, Deng HL, Fu J, Zhang Y, Wei JQ. Pancreatitis in hand-foot-and-mouth disease caused by enterovirus 71. World J Gastroenterol 2016;22:2149-52.  Back to cited text no. 3
Cordeiro E Cunha J, Lima Silva A, Maia Nogueira R, Silva Fernandes D, Salazar T, Vilela M, et al. Exuberant hand-foot-mouth disease: An immunocompetent adult with atypical findings. Eur J Case Rep Intern Med 2020;7:001609.  Back to cited text no. 4
Kimmis BD, Downing C, Tyring S. Hand-foot-and-mouth disease caused by coxsackievirus A6 on the rise. Cutis 2018;102:353-6.  Back to cited text no. 5
Chavda VP, Patel K, Apostolopoulos V. Tomato flu outbreak in India. Lancet Respir Med 2022;S2213-9. doi: 10.1016/S2213-2600(22)00300-9.  Back to cited text no. 6


Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
Access Statistics
Email Alert *
Add to My List *
* Registration required (free)

  In this article

 Article Access Statistics
    PDF Downloaded17    
    Comments [Add]    

Recommend this journal