{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T23:52:43Z","timestamp":1784332363729,"version":"3.55.0"},"reference-count":65,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2020,8,11]],"date-time":"2020-08-11T00:00:00Z","timestamp":1597104000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Singapore's Children Society"},{"name":"Saw Swee Hock School of Public Health, National University of Singapore"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"DOI":"10.1371\/journal.pone.0236711","type":"journal-article","created":{"date-parts":[[2020,8,11]],"date-time":"2020-08-11T18:39:35Z","timestamp":1597171175000},"page":"e0236711","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":23,"title":["The epidemiological risk factors of hand, foot, mouth disease among children in Singapore: A retrospective case-control study"],"prefix":"10.1371","volume":"15","author":[{"given":"Jo Ann","family":"Kua","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9788-701X","authenticated-orcid":true,"given":"Junxiong","family":"Pang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2020,8,11]]},"reference":[{"issue":"8","key":"pone.0236711.ref001","article-title":"Distribution of enteroviruses in hospitalized children with hand, foot and mouth disease and relationship between pathogens and nervous system complications","volume":"9","author":"W Xu","year":"2012","journal-title":"Virology Journal"},{"issue":"5","key":"pone.0236711.ref002","doi-asserted-by":"crossref","first-page":"e0127999","DOI":"10.1371\/journal.pone.0127999","article-title":"Seroepidemiology of Coxsackievirus A6, Coxsackievirus A16, and Enterovirus 71 Infections among Children and Adolescents in Singapore, 2008\u20132010","volume":"10","author":"LW Ang","year":"2015","journal-title":"PLoS One"},{"key":"pone.0236711.ref003","doi-asserted-by":"crossref","first-page":"35388","DOI":"10.1038\/srep35388","article-title":"Large outbreak of herpangina in children caused by enterovirus in summer of 2015 in Hangzhou, China","volume":"6","author":"W Li","year":"2016","journal-title":"Sci Rep"},{"issue":"4","key":"pone.0236711.ref004","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1080\/21645515.2016.1236879","article-title":"Epidemiological and etiological characteristics of herpangina and hand foot mouth diseases in Jiangsu, China, 2013\u20132014","volume":"13","author":"X Yao","year":"2017","journal-title":"Hum Vaccin Immunother"},{"issue":"10","key":"pone.0236711.ref005","doi-asserted-by":"crossref","first-page":"1163","DOI":"10.1111\/j.1651-2227.2003.tb02478.x","article-title":"Hand, foot and mouth disease in Singapore: a comparison of fatal and non-fatal cases","volume":"92","year":"2003","journal-title":"Acta Paediatrica"},{"key":"pone.0236711.ref006","first-page":"381","volume-title":"Clinical Characteristics of an Outbreak of Hand, Foot and Mouth Disease in Singapore","author":"VA Shah","year":"2003"},{"issue":"4","key":"pone.0236711.ref007","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1016\/j.pedneo.2013.07.007","article-title":"Epidemiology of enterovirus 71 infections in Taiwan","volume":"55","author":"MY Chia","year":"2014","journal-title":"Pediatr Neonatol"},{"issue":"2","key":"pone.0236711.ref008","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1002\/rmv.1827","article-title":"Comparative epidemiology and virology of fatal and nonfatal cases of hand, foot and mouth disease in mainland China from 2008 to 2014","volume":"25","author":"SL Liu","year":"2015","journal-title":"Rev Med Virol"},{"issue":"4","key":"pone.0236711.ref009","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1007\/s12250-011-3195-8","article-title":"Hand foot and mouth disease due to enterovirus 71 in Malaysia","volume":"26","author":"KB Chua","year":"2011","journal-title":"Virol Sin"},{"key":"pone.0236711.ref010","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1186\/1471-2334-14-341","article-title":"Epidemiological and clinical characteristics of children who died from hand, foot and mouth disease in Vietnam, 2011","volume":"14","author":"NT Nguyen","year":"2014","journal-title":"BMC Infect Dis"},{"issue":"9","key":"pone.0236711.ref011","first-page":"e104","article-title":"Molecular epidemiology of human enterovirus 71 at the origin of an epidemic of fatal hand, foot and mouth disease cases in Cambodia","volume":"5","author":"V Duong","year":"2016","journal-title":"Emerg Microbes Infect"},{"issue":"31","key":"pone.0236711.ref012","first-page":"1","article-title":"<Excretion of enterovirus 71 in persons infected with hand, foot and mouth disease (2013).PDF>","volume":"10","author":"J Li","year":"2013","journal-title":"Virology Journal"},{"key":"pone.0236711.ref013","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1186\/1471-2334-10-178","article-title":"Long persistence of EV71 specific nucleotides in respiratory and feces samples of the patients with Hand-Foot-Mouth Disease after recovery","volume":"10","author":"J Han","year":"2010","journal-title":"BMC Infect Dis"},{"issue":"10","key":"pone.0236711.ref014","first-page":"787","article-title":"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","volume":"51","author":"S Teng","year":"2013","journal-title":"Zhonghua er ke za zhi = Chinese journal of pediatrics"},{"key":"pone.0236711.ref015","volume-title":"Communicable Diseases Surveillance in Singapore 2017","author":"Communicable Diseases Division MOH","year":"2018"},{"issue":"8","key":"pone.0236711.ref016","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1097\/INF.0b013e3182116e95","article-title":"Estimation of the basic reproduction number of enterovirus 71 and coxsackievirus A16 in hand, foot, and mouth disease outbreaks","volume":"30","author":"E Ma","year":"2011","journal-title":"Pediatr Infect Dis J"},{"issue":"5","key":"pone.0236711.ref017","doi-asserted-by":"crossref","first-page":"1028","DOI":"10.1017\/S0950268815002137","article-title":"Basic reproduction number of coxsackievirus type A6 and A16 and enterovirus 71: estimates from outbreaks of hand, foot and mouth disease in Singapore, a tropical city-state","volume":"144","author":"CT Lim","year":"2016","journal-title":"Epidemiol Infect"},{"issue":"10","key":"pone.0236711.ref018","doi-asserted-by":"crossref","first-page":"e285","DOI":"10.1097\/INF.0000000000001242","article-title":"The Epidemiology of Hand, Foot and Mouth Disease in Asia: A Systematic Review and Analysis","volume":"35","author":"WM Koh","year":"2016","journal-title":"Pediatr Infect Dis J"},{"issue":"6","key":"pone.0236711.ref019","first-page":"965","article-title":"An outbreak of hand, foot, and mouth disease in Singapore","volume":"60","author":"K.T. DS Goh","year":"1982","journal-title":"Bull World Health Organ"},{"issue":"1","key":"pone.0236711.ref020","doi-asserted-by":"crossref","first-page":"78","DOI":"10.3201\/eid1301.020112","article-title":"Epidemic hand foot and mouth disease caused by human enterovirus 71, Singapore","volume":"9","author":"K.P. GKT Chan","year":"2003","journal-title":"Emerg Infect Dis"},{"key":"pone.0236711.ref021","first-page":"106","article-title":"Epidemiology and Control of Hand, Foot and Mouth Disease in Singapore, 2001\u20132007","volume":"38","author":"LW Ang","year":"2009","journal-title":"Annals Academy of Medicine"},{"issue":"12","key":"pone.0236711.ref022","doi-asserted-by":"crossref","first-page":"e1076","DOI":"10.1016\/j.ijid.2010.07.006","article-title":"The largest outbreak of hand; foot and mouth disease in Singapore in 2008: the role of enterovirus 71 and coxsackievirus A strains","volume":"14","author":"Y Wu","year":"2010","journal-title":"Int J Infect Dis"},{"issue":"3","key":"pone.0236711.ref023","first-page":"174","article-title":"Outbreak of hand, foot and mouth disease in Singapore","volume":"15","author":"C.H. GCYN Tay","year":"1974","journal-title":"Singapore Med J"},{"issue":"9","key":"pone.0236711.ref024","doi-asserted-by":"crossref","first-page":"995","DOI":"10.3201\/eid0809.010397","article-title":"Seroepidemiology of Human Enterovirus 71, Singapore","volume":"8","author":"EE Ooi","year":"2002","journal-title":"Emerging Infectious Diseases"},{"issue":"2","key":"pone.0236711.ref025","doi-asserted-by":"crossref","first-page":"e56943","DOI":"10.1371\/journal.pone.0056943","article-title":"Spatial-temporal clusters and risk factors of hand, foot, and mouth disease at the district level in Guangdong Province, China","volume":"8","author":"T Deng","year":"2013","journal-title":"PLoS One"},{"issue":"3","key":"pone.0236711.ref026","doi-asserted-by":"crossref","first-page":"e92745","DOI":"10.1371\/journal.pone.0092745","article-title":"Epidemiological analysis, detection, and comparison of space-time patterns of Beijing hand-foot-mouth disease (2008\u20132012)","volume":"9","author":"J Wang","year":"2014","journal-title":"PLoS One"},{"issue":"2","key":"pone.0236711.ref027","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1016\/j.jcv.2010.07.009","article-title":"Epidemiology of hand, foot, and mouth disease and genotype characterization of Enterovirus 71 in Jiangsu, China","volume":"49","author":"LX Mao","year":"2010","journal-title":"J Clin Virol"},{"issue":"5","key":"pone.0236711.ref028","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1007\/s00431-013-1939-1","article-title":"Breastfeeding, previous Epstein-Barr virus infection, Enterovirus 71 infection, and rural residence are associated with the severity of hand, foot, and mouth disease","volume":"172","author":"Y Li","year":"2013","journal-title":"Eur J Pediatr"},{"issue":"6","key":"pone.0236711.ref029","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1542\/peds.109.6.e88","article-title":"Risk Factors of Enterovirus 71 Infection and Associated Hand, Foot, and Mouth Disease\/Herpangina in Children During an Epidemic in Taiwan","volume":"109","author":"LY Chang","year":"2002","journal-title":"PEDIATRICS"},{"issue":"270","key":"pone.0236711.ref030","first-page":"1","article-title":"The changing seroepidemiology of enterovirus 71 infection among children and adolescents in Singapore","volume":"11","author":"LW Ang","year":"2011","journal-title":"BMC Infectious Diseases"},{"issue":"2","key":"pone.0236711.ref031","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1001\/jama.291.2.222","article-title":"Transmission and Clinical Features of Enterovirus 71 Infections in Household Contacts in Taiwan","volume":"291","author":"LY Chang","year":"2004","journal-title":"JAMA"},{"issue":"2","key":"pone.0236711.ref032","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1111\/j.1442-200X.2009.02937.x","article-title":"Risk factors for severe hand foot and mouth disease","volume":"52","author":"Y Suzuki","year":"2010","journal-title":"Pediatr Int"},{"issue":"4","key":"pone.0236711.ref033","doi-asserted-by":"crossref","first-page":"e898","DOI":"10.1542\/peds.2010-1497","article-title":"Risk factors for hand, foot, and mouth disease and herpangina and the preventive effect of hand-washing","volume":"127","author":"F Ruan","year":"2011","journal-title":"Pediatrics"},{"issue":"5","key":"pone.0236711.ref034","doi-asserted-by":"crossref","first-page":"677","DOI":"10.3346\/jkms.2010.25.5.677","article-title":"Transmission of seasonal outbreak of childhood enteroviral aseptic meningitis and hand-foot-mouth disease","volume":"25","author":"SK Park","year":"2010","journal-title":"J Korean Med Sci"},{"issue":"1","key":"pone.0236711.ref035","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.jinf.2018.08.009","article-title":"A hand hygiene intervention to decrease hand, foot and mouth disease and absence due to sickness among kindergarteners in China: A cluster-randomized controlled trial","volume":"78","author":"X Liu","year":"2019","journal-title":"J Infect"},{"issue":"51","key":"pone.0236711.ref036","doi-asserted-by":"crossref","first-page":"e13144","DOI":"10.1097\/MD.0000000000013144","article-title":"Effect of hand washing and personal hygiene on hand food mouth disease: A community intervention study","volume":"97","author":"N Guo","year":"2018","journal-title":"Medicine (Baltimore)"},{"key":"pone.0236711.ref037","first-page":"1","article-title":"Protective effect of exclusive breastfeeding against hand, foot and mouth disease","volume":"14","author":"H Lin","year":"2014","journal-title":"BMC Infectious Diseases"},{"issue":"3","key":"pone.0236711.ref038","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1097\/INF.0000000000001001","article-title":"Prolonged Breastfeeding Is Associated With Lower Risk Of Severe Hand, Foot And Mouth Disease In Chinese Children","volume":"35","author":"Y Li","year":"2016","journal-title":"Pediatr Infect Dis J"},{"issue":"9","key":"pone.0236711.ref039","doi-asserted-by":"crossref","first-page":"2197","DOI":"10.1007\/s10096-012-1555-4","article-title":"Prolonged exclusive breastfeeding, autumn birth and increased gestational age are associated with lower risk of fever in children with hand, foot, and mouth disease","volume":"31","author":"Q Zhu","year":"2012","journal-title":"Eur J Clin Microbiol Infect Dis"},{"issue":"4","key":"pone.0236711.ref040","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1080\/14787210.2019.1585242","article-title":"Hand, foot, and mouth disease associated with coxsackievirus A10: more serious than it seems","volume":"17","author":"L Bian","year":"2019","journal-title":"Expert Rev Anti Infect Ther"},{"key":"pone.0236711.ref041","doi-asserted-by":"crossref","first-page":"e70","DOI":"10.1590\/s1678-9946201860070","article-title":"Hand, foot and mouth disease and herpangina caused by enterovirus A71 infections: a review of enterovirus A71 molecular epidemiology, pathogenesis, and current vaccine development","volume":"60","author":"YK Chang","year":"2018","journal-title":"Rev Inst Med Trop Sao Paulo"},{"key":"pone.0236711.ref042","volume-title":"Weekly Infectious Disease Bulletin","author":"Communicable Diseases Division MOH","year":"2018"},{"issue":"2","key":"pone.0236711.ref043","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1057\/s41271-017-0066-z","article-title":"The impact of hand, foot and mouth disease control policies in Singapore: A qualitative analysis of public perceptions","volume":"38","author":"K Siegel","year":"2017","journal-title":"J Public Health Policy"},{"issue":"5","key":"pone.0236711.ref044","doi-asserted-by":"crossref","first-page":"941","DOI":"10.1542\/peds.2006-0780","article-title":"Maternal antibodies in breast milk protect the child from enterovirus infections","volume":"119","author":"K Sadeharju","year":"2007","journal-title":"Pediatrics"},{"key":"pone.0236711.ref045","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1186\/s12879-015-1195-2","article-title":"Risk factors for severe hand foot mouth disease in Singapore: a case control study","volume":"15","author":"SP Chew","year":"2015","journal-title":"BMC Infect Dis"},{"issue":"1","key":"pone.0236711.ref046","doi-asserted-by":"crossref","first-page":"25","DOI":"10.3109\/14767058.2010.482605","article-title":"Innate immunity in human newborn infants: prematurity means more than immaturity","volume":"24","author":"T Strunk","year":"2011","journal-title":"J Matern Fetal Neonatal Med"},{"issue":"5","key":"pone.0236711.ref047","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1016\/S0022-3476(84)80944-0","article-title":"Epidemiology of neonatal enterovirus infection","volume":"104","author":"JN Jenista","year":"1984","journal-title":"J Pediatr"},{"issue":"2","key":"pone.0236711.ref048","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1093\/ije\/dyp333","article-title":"Predictors of sub-clinical enterovirus infections in infants: a prospective cohort study","volume":"39","author":"E Witso","year":"2010","journal-title":"Int J Epidemiol"},{"issue":"5","key":"pone.0236711.ref049","doi-asserted-by":"crossref","first-page":"322","DOI":"10.2471\/BLT.12.111310","article-title":"Breastfeeding rates in central and western China in 2010: implications for child and population health","volume":"91","author":"S Guo","year":"2013","journal-title":"Bull World Health Organ"},{"key":"pone.0236711.ref050","unstructured":"Chua L, Win AM. Prevalence of Breastfeeding in Singapore (Research & Strategic Planning Division, Health Promotion Board). Statistics Singapore Newsletter 2013."},{"key":"pone.0236711.ref051","volume-title":"Complementary Feeding of Infants and Young Children: Report of a technical consultation","author":"World Health Organization WHO","year":"1995"},{"key":"pone.0236711.ref052","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1038\/sj.ejcn.1601168","article-title":"Systematic review concerning the age of introduction of complementary foods to the healthy full-term infant","volume":"55","author":"JA Lanigan","year":"2001","journal-title":"European Journal of Clinical Nutrition"},{"issue":"2","key":"pone.0236711.ref053","doi-asserted-by":"crossref","first-page":"e13","DOI":"10.1016\/j.ajic.2015.04.202","article-title":"Evaluating the transmission routes of hand, foot, and mouth disease in Guangdong, China","volume":"44","author":"L Sun","year":"2016","journal-title":"Am J Infect Control"},{"issue":"5","key":"pone.0236711.ref054","first-page":"500","article-title":"Inactivation of EV71 by Exposure to Heat and Ultraviolet Light","volume":"31","author":"J Xie","year":"2015","journal-title":"Bing du xue bao = Chinese journal of virology"},{"issue":"6","key":"pone.0236711.ref055","first-page":"1","article-title":"Hand-Washing: The Main Strategy for Avoiding Hand","volume":"13","author":"D Zhang","year":"2016","journal-title":"Foot and Mouth Disease. Int J Environ Res Public Health"},{"issue":"12","key":"pone.0236711.ref056","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1097\/00006454-199912000-00013","article-title":"Comparison of enterovirus 71 and coxsackie-virus A16 clinical illnesses during the Taiwan enterovirus epidemic, 1998","volume":"18","author":"LY Chang","year":"1999","journal-title":"Pediatr Infect Dis J"},{"issue":"9","key":"pone.0236711.ref057","doi-asserted-by":"crossref","first-page":"537","DOI":"10.3949\/ccjm.81a.13132","article-title":"Hand, foot, and mouth disease: identifying and managing an acute viral syndrome","volume":"81","author":"GL Repass","year":"2014","journal-title":"Cleve Clin J Med"},{"issue":"RR-16","key":"pone.0236711.ref058","article-title":"Guideline for Hand Hygiene in Health-Care Settings","volume":"51","author":"Centers for Disease Control and Prevention CDC","year":"2002","journal-title":"Morbidity and Mortality Weekly Report"},{"issue":"4","key":"pone.0236711.ref059","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1016\/j.jhin.2012.12.010","article-title":"Efficacy of alcohols and alcohol-based hand disinfectants against human enterovirus 71","volume":"83","author":"SC Chang","year":"2013","journal-title":"J Hosp Infect"},{"key":"pone.0236711.ref060","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1016\/S0195-6701(98)90077-9","article-title":"The action of three antiseptics\/disinfectants against enveloped and non-enveloped viruses","volume":"38","author":"A Wood","year":"1998","journal-title":"Journal of Hospital Infection"},{"issue":"2","key":"pone.0236711.ref061","first-page":"246","article-title":"Virucidal activity of Virkon S on human enterovirus","volume":"60","author":"YF Chan","year":"2005","journal-title":"Med J Malaysia"},{"issue":"11","key":"pone.0236711.ref062","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1016\/S1473-3099(10)70194-8","article-title":"Virology, epidemiology, pathogenesis, and control of enterovirus 71","volume":"10","author":"T Solomon","year":"2010","journal-title":"The Lancet Infectious Diseases"},{"issue":"9","key":"pone.0236711.ref063","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1016\/j.ajic.2011.01.015","article-title":"Inactivation of human enterovirus 71 and coxsackie virus A16 and hand, foot, and mouth disease","volume":"39","author":"JL Kadurugamuwa","year":"2011","journal-title":"Am J Infect Control"},{"key":"pone.0236711.ref064","volume-title":"Infection Control Guidelines for Schools and Child Care Centres","author":"MOH Ministry of Health","year":"2012","edition":"2"},{"issue":"4","key":"pone.0236711.ref065","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1111\/j.1753-4887.2005.tb00128.x","article-title":"The Validity and Reliability of Maternal Recall of Breastfeeding Practice","volume":"63","author":"R Li","year":"2005","journal-title":"Nutrition Reviews"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0236711","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,8,11]],"date-time":"2020-08-11T18:40:59Z","timestamp":1597171259000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0236711"}},"subtitle":[],"editor":[{"given":"Eric HY","family":"Lau","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2020,8,11]]},"references-count":65,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2020,8,11]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0236711","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,8,11]]}}}