According to Dr. Kelly Reynolds, associate professor at the University of Arizona College of Public Health in Tucson, “Restrooms tend to get disinfected often." On the other hand, playgrounds, doctor’s waiting rooms and restaurant high chairs “almost never get cleaned."

As recently highlighted by a separate study on how various contact surfaces often pose much higher risk of bacterial contamination than most people believe, partly due to the ever-popular “five-second rule” pertaining to dropped food.

Outdoor play areas a cause for concern

In fact, a study conducted by Microban, makers of antibacterial products and involving the analysis of swabs from high chairs in 30 different restaurants found that on average the number of bacteria on a high chair – including E-coli, Staph aureus and enterococcus faecalis - was 147 per square centimetre, which was higher than that found on the average public toilet seat (eight per square centimetre).

Harmful germs - such as those in the mucus that kids wipe from their noses - can linger for days. In outdoor play areas, for example in sandboxes, animals like squirrels and birds can leave behind faecal matter, potentially causing stomach illnesses and skin infections in young children.

Ball pits - enclosed play areas containing plastic balls - popular at kids' gyms and shopping malls, may be even worse. "Kids with leaky diapers play in them, and the pits rarely get cleaned," says Dr. Reynolds. Young children can also pass germs onto the balls with their hands and feet.

A 2005 Singaporean Ministry of Health (MOH) meningitis and Hand, Foot and Mouth disease (HFMD) as common childhood diseases spread by direct contact, which have no vaccines.

Australian infant caught meningitis from shopping cart

In Australia, a 10-month old infant recently caught meningitis and a salmonella infection from sitting on the shopping trolley. "He ended up catching adenovirus, rotavirus, salmonella poisoning and got meningitis because of the strain on his body," his mother, Vivian Wardrop shared.

Baby Logan was also vomiting and experiencing severe diarrhoea. "[He] ended up with a central line as his veins were collapsing due to severe dehydration."

Luckily, Logan recovered after being warded for ten days, of which eight days were spent in the intensive care unit, and took around two weeks to recover fully.

But meningococcal meningitis can kill a young child or destroy its life in just 24 hours, where 11% to 19 % of survivors develop deafness, permanent brain damage, or loss of a limb. It also has high fatality rates that range from 30% to 80% with an average of 56%.

Although there is no outbreak of meningitis, it is still a cause for concern, especially since nearly four in ten children aged two and below are not getting the full pneumococcal vaccine as of 2015. Pneumococcal disease, the leading infectious cause of death in children worldwide, can lead to meningitis.

Part of the reason is cost, and part of it is a lack of awareness among parents, according to Dr Lim Woan Huah of Kidslink Children's Clinic.

"A lot of people still think it is an optional vaccine," she said. From 2004 to 2013, 16 deaths were associated with pneumococcal disease. Five of the patients were under six years old.

HFMD is still a problem in Singapore

HFMD is a more common problem here in Singapore – according to MOH, there were 1,052 cases reported as of May 2016, which are among the highest figures since October 2013, when 1,247 weekly cases were reported.

According to infectious diseases specialist Leong Hoe Nam of Mount Elizabeth Novena Hospital, these figures imply that we are at the “cusp of an epidemic”. He added that the virulence of the virus is exacerbated by the fact that children at childcare centres or kindergartens are in close proximity to one another and share “everything”.

“The kids who were previously infected have moved on from kindergartens and pre-schools, which means these places are currently filled with kids who are vulnerable to the disease,” said Dr. Leong. Moreover, “Singaporeans have relaxed their infection control,” he adds.

Although a less serious condition than meningitis, serious complications involving the nervous system, lungs and heart can occasionally occur.

While disinfecting facilities commonly used by children can help, it is impossible to make an environment sterile. Hence, a better bet would be to ensure parents train their children not to put their hands in their mouth, and to wash their hands/disinfect themselves after play time. MIMS

Read more:
The 'five-second rule' for food: Myth or fact?
5 common food borne diseases that patients need to look out for
Antibiotics can turn hospital beds into hotbeds for spread of C. difficile infection