{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T20:01:14Z","timestamp":1774468874410,"version":"3.50.1"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2016,11,7]],"date-time":"2016-11-07T00:00:00Z","timestamp":1478476800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2016,11,7]],"date-time":"2016-11-07T00:00:00Z","timestamp":1478476800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Hand-foot-and-mouth disease (HFMD) is a common infectious disease, which has led to millions of clinical cases and hundreds of deaths every year in China. This study aimed to exploring the effects on HFMD transmission of children\u2019s caregivers and public area, as well as trying to locate the potential reservoirs of infections in primary cases. Total children\u2019s 257 samples (98 children\u2019s caregivers and 159 environmental samples) were tested for the presence of universal enterovirus, enterovirus 71, coxsackie virus A6 and A16 by real-time fluorescence quantitative polymerase chain reaction (qPCR). 5.84% (15\/257, 95% confidence interval [CI]: 2.98%, 8.70%) of total samples had positive results of enterovirus. The enterovirus positive rates of children\u2019s caregiver samples and environmental samples were respectively 7.14% (7\/98, 95% CI: 2.04%, 12.24%), and 5.03% (8\/159, 95% CI: 1.63%, 8.43%); 7.61% (7\/92, 95% CI: 2.21%, 13.01%) of wiping samples from playgrounds and 1.49% (1\/67, 95% CI: 0, 7.00%) of air samples in indoor market places had positive result of enterovirus. High positive rates of enterovirus in children\u2019s caregivers and from playgrounds indicated that they would be potential reservoirs of HFMD infection, as children might be infected via contacting with asymptomatic-infected individuals or exposure of contaminated surface of public facilities.<\/jats:p>","DOI":"10.1038\/srep36375","type":"journal-article","created":{"date-parts":[[2016,11,7]],"date-time":"2016-11-07T11:20:34Z","timestamp":1478517634000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Children\u2019s Caregivers and Public Playgrounds: Potential Reservoirs of Infection of Hand-foot-and-mouth Disease"],"prefix":"10.1038","volume":"6","author":[{"given":"Pengyuan","family":"Li","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tao","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiuyun","family":"Gu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaomin","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiahui","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiashi","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danwei","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rong","family":"Gao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhenjian","family":"He","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xun","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wangjian","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuantao","family":"Hao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dingmei","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2016,11,7]]},"reference":[{"key":"BFsrep36375_CR1","doi-asserted-by":"publisher","first-page":"308","DOI":"10.1016\/S1473-3099(13)70342-6","volume":"14","author":"W Xing","year":"2014","unstructured":"Xing, W. et al. Hand, foot, and mouth disease in China, 2008\u201312: an epidemiological study. Lancet Infect. Dis. 14, 308\u2013318 (2014).","journal-title":"Lancet Infect. Dis."},{"key":"BFsrep36375_CR2","doi-asserted-by":"publisher","first-page":"O442","DOI":"10.1111\/1469-0691.12468","volume":"20","author":"J Lu","year":"2014","unstructured":"Lu, J. et al. Hand, foot and mouth disease in Guangdong, China, in 2013: new trends in the continuing epidemic. Clin. Microbiol. Infect. 20, O442\u2013O445 (2014).","journal-title":"Clin. Microbiol. Infect."},{"key":"BFsrep36375_CR3","doi-asserted-by":"publisher","first-page":"3560","DOI":"10.1128\/JCM.01231-13","volume":"51","author":"YQ He","year":"2013","unstructured":"He, Y. Q. et al. Emergence, Circulation, and Spatiotemporal Phylogenetic Analysis of Coxsackievirus A6- and Coxsackievirus A10-Associated Hand, Foot, and Mouth Disease Infections from 2008 to 2012 in Shenzhen, China. J. Clin. Microbiol. 51, 3560\u20133566 (2013).","journal-title":"J. Clin. Microbiol."},{"key":"BFsrep36375_CR4","doi-asserted-by":"publisher","first-page":"e52073","DOI":"10.1371\/journal.pone.0052073","volume":"7","author":"QB Lu","year":"2012","unstructured":"Lu, Q. B. et al. Circulation of Coxsackievirus A10 and A6 in Hand-Foot-Mouth Disease in China, 2009\u20132011. PLoS One 7, e52073; 10.1371\/journal.pone.0052073 (2012).","journal-title":"PLoS One"},{"key":"BFsrep36375_CR5","doi-asserted-by":"publisher","first-page":"7732","DOI":"10.1128\/JVI.75.16.7732-7738.2001","volume":"75","author":"P McMinn","year":"2001","unstructured":"McMinn, P. et al. Phylogenetic Analysis of Enterovirus 71 Strains Isolated during Linked Epidemics in Malaysia, Singapore, and Western Australia. J. Virol. 75, 7732\u20137738 (2001).","journal-title":"J. Virol."},{"key":"BFsrep36375_CR6","doi-asserted-by":"publisher","first-page":"678","DOI":"10.1086\/314032","volume":"31","author":"LG Chan","year":"2000","unstructured":"Chan, L. G. et al. Deaths of children during an outbreak of hand, foot, and mouth disease in sarawak, malaysia: clinical and pathological characteristics of the disease. For the Outbreak Study Group. Clin. Infect. Dis. 31, 678\u2013683 (2000).","journal-title":"Clin. Infect. Dis."},{"key":"BFsrep36375_CR7","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1186\/1743-422X-7-94","volume":"7","author":"Y Zhang","year":"2010","unstructured":"Zhang, Y. et al. An emerging recombinant human enterovirus 71 responsible for the 2008 outbreak of Hand Foot and Mouth Disease in Fuyang city of China. Virol. J. 7, 94\u201394 (2010).","journal-title":"Virol. J."},{"key":"BFsrep36375_CR8","doi-asserted-by":"publisher","first-page":"6400","DOI":"10.3390\/v7122947","volume":"7","author":"ZC Zhuang","year":"2015","unstructured":"Zhuang, Z. C. et al. Epidemiological Research on Hand, Foot, and Mouth Disease in Mainland China. Viruses 7, 6400\u20136411 (2015).","journal-title":"Viruses"},{"key":"BFsrep36375_CR9","unstructured":"National epidemic situation of statutory infectious diseases in 2015. National Health and Family Planning Commission of the People\u2019s Republic of China Networkhttp:\/\/www.nhfpc.gov.cn\/jkj\/s3578\/201602\/b9217ba14e17452aad9e45a5bcce6b65.shtml (2016)."},{"key":"BFsrep36375_CR10","unstructured":"Guangdong epidemic situation of statutory infectious diseases in 2015. Health and Family Planning Commission of Guangdong Province, People\u2019s Republic of China Networkhttp:\/\/www.gdwst.gov.cn\/a\/yiqingxx\/2016021514978.html (2016)."},{"key":"BFsrep36375_CR11","doi-asserted-by":"publisher","first-page":"405","DOI":"10.11150\/kansenshogakuzasshi.86.405","volume":"86","author":"T Sugawara","year":"2012","unstructured":"Sugawara, T. et al. The possibility of outbreak control by real-time surveillance with PCR method performed immediately-a case study of hand foot and mouth disease outbreak in a day care facility for children. Kansenshogaku Zasshi 86, 405\u2013410 (2012).","journal-title":"Kansenshogaku Zasshi"},{"key":"BFsrep36375_CR12","doi-asserted-by":"publisher","first-page":"616","DOI":"10.3345\/kjp.2010.53.5.616","volume":"53","author":"KH Kim","year":"2010","unstructured":"Kim, K. H. Enterovirus 71 infection: An experience in Korea, 2009. Korean J. Pediatr. 53, 616\u2013622 (2010).","journal-title":"Korean J. Pediatr."},{"key":"BFsrep36375_CR13","doi-asserted-by":"publisher","first-page":"e88","DOI":"10.1542\/peds.109.6.e88","volume":"109","author":"LY Chang","year":"2002","unstructured":"Chang, L. Y. et al. Risk factors of enterovirus 71 infection and associated hand, foot, and mouth disease\/herpangina in children during an epidemic in Taiwan. Pediatrics 109, e88 (2002).","journal-title":"Pediatrics"},{"key":"BFsrep36375_CR14","first-page":"965","volume":"60","author":"KT Goh","year":"1982","unstructured":"Goh, K. T., Doraisingham, S., Tan, J. L., Lim, G. N. & Chew, S. E. An outbreak of hand, foot, and mouth disease in Singapore. Bull. World Health Organ. 60, 965\u2013969 (1982).","journal-title":"Bull. World Health Organ."},{"key":"BFsrep36375_CR15","doi-asserted-by":"publisher","first-page":"1432","DOI":"10.1017\/S0950268814002301","volume":"143","author":"YH Xie","year":"2015","unstructured":"Xie, Y. H. et al. Important roles of public playgrounds in the transmission of hand, foot, and mouth disease. Epidemiol. Infect. 143, 1432\u20131441(2015).","journal-title":"Epidemiol. Infect."},{"key":"BFsrep36375_CR16","doi-asserted-by":"publisher","first-page":"677","DOI":"10.3346\/jkms.2010.25.5.677","volume":"25","author":"SK Park","year":"2010","unstructured":"Park, S. K. et al. Transmission of Seasonal Outbreak of Childhood Enteroviral Aseptic Meningitis and Hand-foot-mouth Disease. J. Korean Med. Sci. 25, 677\u2013683 (2010).","journal-title":"J. Korean Med. Sci."},{"key":"BFsrep36375_CR17","doi-asserted-by":"publisher","first-page":"178","DOI":"10.1186\/1471-2334-10-178","volume":"10","author":"J Han","year":"2010","unstructured":"Han, J. et al. Long persistence of EV71 specific nucleotides in respiratory and feces samples of the patients with Hand-Foot-Mouth Disease after recovery. BMC Infect. Dis. 10, 178\u2013178 (2010).","journal-title":"BMC Infect. Dis."},{"key":"BFsrep36375_CR18","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1186\/1743-422X-10-31","volume":"10","author":"J Li","year":"2013","unstructured":"Li, J. et al. Excretion of enterovirus 71 in persons infected with hand, foot and mouth disease. Virol. J. 10, 31\u201331 (2013).","journal-title":"Virol. J."},{"key":"BFsrep36375_CR19","first-page":"167","volume":"34","author":"PW Chung","year":"2001","unstructured":"Chung, P. W., Huang, Y. C., Chang, L. Y., Lin, T. Y. & Ning, H. C. Duration of enterovirus shedding in stool. J. Microbiol. Immunol. Infect. 34, 167\u2013170 (2001).","journal-title":"J. Microbiol. Immunol. Infect."},{"key":"BFsrep36375_CR20","unstructured":"Causes & Transmission about HFMD. National Centre for Immunization and Respiratory Diseases (NCIRD), Division of Viral Disease Networkhttp:\/\/www.cdc.gov\/hand-foot-mouth\/about\/transmission.html (2015)."},{"key":"BFsrep36375_CR21","first-page":"189","volume":"33","author":"A Deng","year":"2012","unstructured":"Deng, A. et al. Survey on the recessive infection of pathogen to hand-foot-mouth disease among healthy adults and children in Guangdong province. Chinese J.Epidemiol. 33, 189\u2013191 (2012).","journal-title":"Chinese J.Epidemiol."},{"key":"BFsrep36375_CR22","first-page":"787","volume":"51","author":"S Teng","year":"2013","unstructured":"Teng, S. et al. Observation on virus shedding periods of enterovirus-71 and coxsackievirus A 16 monitored by nucleic acids determination in stool samples of children with hand, foot and mouth disease. Chinese J. Pediatrics 51, 787\u2013792 (2013).","journal-title":"Chinese J. Pediatrics"},{"key":"BFsrep36375_CR23","first-page":"616","volume":"31","author":"X Li","year":"2015","unstructured":"Li, X. et al. Case-control Study on Risk Factors of Infection of HFMD Among Children in Chengdu. J. Prev. Med. Inform. 31, 616\u2013619 (2015).","journal-title":"J. Prev. Med. Inform."},{"key":"BFsrep36375_CR24","doi-asserted-by":"publisher","first-page":"e71444","DOI":"10.1371\/journal.pone.0071444","volume":"8","author":"CA Corzo","year":"2013","unstructured":"Corzo, C. A., Culhane, M., Dee, S., Morrison, R. B. & Torremorell, M. Airborne detection and quantification of swine influenza a virus in air samples collected inside, outside and downwind from swine barns. PloS One 8, e71444; 10.1371\/journal.pone.0071444 (2013).","journal-title":"PloS One"},{"key":"BFsrep36375_CR25","doi-asserted-by":"publisher","first-page":"e0127999","DOI":"10.1371\/journal.pone.0127999","volume":"10","author":"LW Ang","year":"2015","unstructured":"Ang, L. W. et al. Seroepidemiology of coxsackievirus A6, coxsackievirus A16, and Enterovirus 71 infections among children and adolescents in Singapore, 2008\u20132010. PloS One 10, e0127999, 10.1371\/journal.pone.0127999 (2015).","journal-title":"PloS One"},{"key":"BFsrep36375_CR26","first-page":"165","volume":"8","author":"Y Yang","year":"2016","unstructured":"Yang, Y., Sun, W., Li, Z. & Wang, D. Analysis on the gene detection results of hand-foot and mouth disease in the Guangzhou Xingtangarea in 2014. J. Mol. Diagn. Ther. 8, 165\u2013187 (2016).","journal-title":"J. Mol. Diagn. Ther."},{"key":"BFsrep36375_CR27","doi-asserted-by":"publisher","first-page":"e102724","DOI":"10.1371\/journal.pone.0102724","volume":"9","author":"S Zhang","year":"2014","unstructured":"Zhang, S. et al. A One-Step, Triplex, Real-Time RT-PCR Assay for the Simultaneous Detection of Enterovirus 71, Coxsackie A16 and Pan-Enterovirus in a Single Tube. PLoS One 9, e102724; 10.1371\/journal.pone.0102724 (2014).","journal-title":"PLoS One"},{"key":"BFsrep36375_CR28","doi-asserted-by":"publisher","first-page":"656","DOI":"10.2471\/BLT.13.130666","volume":"92","author":"Z Li","year":"2014","unstructured":"Li, Z. et al. Hand, foot and mouth disease in China: evaluating an automated system for the detection of outbreaks. Bull. World Health Organ. 92, 656\u2013663 (2014).","journal-title":"Bull. World Health Organ."},{"key":"BFsrep36375_CR29","unstructured":"Determination of atmospheric articles PM10 and PM2.5 in ambient air by gravimetric method. Ministry of Environmental Protection of the People\u2019s Republic of China Networkhttp:\/\/kjs.mep.gov.cn\/hjbhbz\/bzwb\/dqhjbh\/jcgfffbz\/201109\/t20110914_217272.htm (2011)."},{"key":"BFsrep36375_CR30","unstructured":"HFMD specimen collection and testing technology program. Chinese Centre for Disease Control and Prevention Networkhttp:\/\/www.chinacdc.cn\/jkzt\/crb\/bl\/szkb\/jszl_2275\/200906\/W020130106522855465929.pdf (2009)."},{"key":"BFsrep36375_CR31","doi-asserted-by":"publisher","first-page":"4093","DOI":"10.1128\/JCM.39.11.4093-4096.2001","volume":"39","author":"WA Verstrepen","year":"2001","unstructured":"Verstrepen, W. A., Kuhn, S., Kockx, M. M., Van De Vyvere, M. E. & Mertens, A. H. Rapid detection of enterovirus RNA in cerebrospinal fluid specimens with a novel single-tube real-time reverse transcription-PCR assay. J. Clin. Microbiol. 39, 4093\u20134096 (2001).","journal-title":"J. Clin. Microbiol."},{"key":"BFsrep36375_CR32","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1186\/1743-422X-9-298","volume":"9","author":"L Zhang","year":"2012","unstructured":"Zhang, L. et al. Rapid and sensitive identification of RNA from the emerging pathogen, coxsackievirus A6. Virol. J. 9, 298\u2013298 (2012).","journal-title":"Virol. J."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/srep36375.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/srep36375","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/srep36375.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,5]],"date-time":"2023-01-05T01:57:57Z","timestamp":1672883877000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/srep36375"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,11,7]]},"references-count":32,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2016,12,21]]}},"alternative-id":["BFsrep36375"],"URL":"https:\/\/doi.org\/10.1038\/srep36375","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,11,7]]},"assertion":[{"value":"5 April 2016","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 October 2016","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 November 2016","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing financial interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"36375"}}