{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T16:00:37Z","timestamp":1785427237654,"version":"3.56.0"},"reference-count":34,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T00:00:00Z","timestamp":1779667200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Sinovac Biotech","award":["PRO-EV71-MA4002-TUR"],"award-info":[{"award-number":["PRO-EV71-MA4002-TUR"]}]},{"award":["PRO-EV71-MA4002-TUR"],"award-info":[{"award-number":["PRO-EV71-MA4002-TUR"]}],"id":[{"id":"https:\/\/ror.org\/057f25d66","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Background\/Objectives: Hand, foot and mouth disease (HFMD) has recently emerged as a serious health threat, as certain serotypes can cause severe illness. Serotype distribution vary by region, and seroprevalence studies helps in developing preventive strategies. This study aimed to determine the seroprevalence of enterovirus type 71 (EV-A71), Coxsackievirus A16 (CV-A16), Coxsackievirus A10 (CV-A10), and Coxsackievirus A6 (CV-A6), the main causative agents of HFMD and to investigate risk factors for seropositivity. Methods: This multicenter, cross-sectional study was conducted across five major cities in T\u00fcrkiye. Children (6 months\u201317 years) who presented to outpatient clinics for any reason were included between May 2024 and January 2025. Neutralizing antibodies were measured using a microneutralization assay. Statistical analyses included descriptive methods, appropriate group comparisons (Chi-square\/Fisher\u2019s Exact), and backward logistic regression to identify factors associated with HFMD seropositivity. Results: The study included 998 participants (mean age: 8.6 \u00b1 5.2 years; 51.3% male). CV-A6 antibodies were detected in 68.5%, EV-A71 in 66.5%, CV-A10 in 60.2%, and CV-A16 in 46.0% of samples. No viral antibodies were detected in 5.3% of serum samples (All-Negative group); antibodies against at least one HFMD agent were detected in 94.7% (Any-Positive group). HFMD seropositivity increased significantly with age. Handwashing habits did not differ between the groups. The any-positive group more often had a household member aged 12\u201318 years, a mother with lower education, and higher kindergarten attendance. In logistic regression analysis, age, average monthly household income, and mother\u2019s education level were the factors influencing seropositivity. Conclusions: The seroprevalence of HFMD-causing viruses in T\u00fcrkiye is high from six months of age onward. Beyond promoting personal protective measures, the implementation of a vaccination program should also be considered.<\/jats:p>","DOI":"10.3390\/vaccines14060470","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T11:57:44Z","timestamp":1779710264000},"page":"470","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Seroprevalence of Hand, Foot and Mouth Disease Among Children and Adolescents in T\u00fcrkiye"],"prefix":"10.3390","volume":"14","author":[{"given":"Adem","family":"Karbuz","sequence":"first","affiliation":[{"name":"Pediatric Infectious Diseases Clinic, Prof. Dr. Cemil Ta\u015fc\u0131oglu City Hospital, 34384 Istanbul, T\u00fcrkiye"},{"name":"Department of Pediatric Infectious Diseases, Cerahpa\u015fa Medical Faculty, Istanbul University Cerrahpa\u015fa, 34320 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0716-7607","authenticated-orcid":false,"given":"Tu\u011fce","family":"Tural-Kara","sequence":"additional","affiliation":[{"name":"Department of Pediatric Infectious Diseases, Faculty of Medicine, Akdeniz University, 07070 Antalya, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00dcmit","family":"\u00c7elik","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Diseases Clinic, Adana City Hospital, 01230 Adana, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0839-1301","authenticated-orcid":false,"given":"Belgin","family":"G\u00fclhan","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Diseases Clinic, Ankara Bilkent City Hospital, 06800 Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ay\u015fegul","family":"Elvan-T\u00fcz","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Diseases Clinic, \u0130zmir City Hospital, 35540 Izmir, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasemin","family":"Co\u015fgun","sequence":"additional","affiliation":[{"name":"Virology Reference Laboratories, General Directorate of Public Health, Republic of T\u00fcrkiye Ministry of Health, 06100 Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c7igdem","family":"Kirmaci","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Diseases Clinic, Prof. Dr. Cemil Ta\u015fc\u0131oglu City Hospital, 34384 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ay\u015fe K\u00fcbra","family":"A\u00e7\u0131k","sequence":"additional","affiliation":[{"name":"Department of Pediatric Infectious Diseases, Faculty of Medicine, Akdeniz University, 07070 Antalya, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0924-5739","authenticated-orcid":false,"given":"Merve","family":"K\u0131l\u0131\u00e7-\u00c7il","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Diseases Clinic, Adana City Hospital, 01230 Adana, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2538-2872","authenticated-orcid":false,"given":"Saliha","family":"Kan\u0131k-Y\u00fcksek","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Diseases Clinic, Ankara Bilkent City Hospital, 06800 Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dilek","family":"Y\u0131lmaz-\u00c7iftdo\u011fan","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Diseases Clinic, \u0130zmir City Hospital, 35540 Izmir, T\u00fcrkiye"},{"name":"Department of Child Health and Diseases, Faculty of Medicine, \u0130zmir Katip \u00c7elebi University, 35620 Izmir, T\u00fcrkiye"},{"name":"Pediatric Infectious Diseases Clinic, University of Health Sciences, Izmir Tepecik Training and Research Hospital, 35020 Izmir, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merve","family":"Zerey-Albayrak","sequence":"additional","affiliation":[{"name":"Virology Reference Laboratories, General Directorate of Public Health, Republic of T\u00fcrkiye Ministry of Health, 06100 Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vildan","family":"\u015eahin","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Diseases Clinic, Prof. Dr. Cemil Ta\u015fc\u0131oglu City Hospital, 34384 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tu\u011fba","family":"Erat","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Diseases Clinic, Ankara Bilkent City Hospital, 06800 Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2662-5039","authenticated-orcid":false,"given":"\u015eilem","family":"\u00d6zdem-Alata\u015f","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Diseases Clinic, \u0130zmir City Hospital, 35540 Izmir, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ekrem","family":"Sa\u011fta\u015f","sequence":"additional","affiliation":[{"name":"Virology Reference Laboratories, General Directorate of Public Health, Republic of T\u00fcrkiye Ministry of Health, 06100 Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erdem","family":"\u00d6ks\u00fczo\u011flu","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Diseases Clinic, Prof. Dr. Cemil Ta\u015fc\u0131oglu City Hospital, 34384 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammed Emin","family":"Demirkol","sequence":"additional","affiliation":[{"name":"Directorate of Public Health, Republic of T\u00fcrkiye Ministry of Health, 06100 Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1654-3232","authenticated-orcid":false,"given":"Ate\u015f","family":"Kara","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Pediatric Infectious Diseases, Faculty of Medicine, Hacettepe University, 06100 Ankara, T\u00fcrkiye"},{"name":"T\u00fcrkiye Vaccine Institute, 06270 Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2492","DOI":"10.1001\/jama.2018.17288","article-title":"Hand, foot, and mouth disease","volume":"320","author":"Cox","year":"2018","journal-title":"JAMA"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1186\/s12929-023-00908-4","article-title":"Current status of hand-foot-and-mouth disease","volume":"30","author":"Zhu","year":"2023","journal-title":"J. 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