Human–animal interfaces and zoonotic disease risks in China: a review of contact behaviors and risk communication

Abstract

Zoonotic diseases continue to present health, social, and economic challenges in China. While the country has demonstrated strong outbreak response capabilities, current efforts remain reactive and top-down. Shifting toward primary prevention at the human–animal–environment interface with enhanced risk communication offers a more sustainable approach to reducing zoonotic disease risks. This review synthesized peer-reviewed and gray literature in English and Chinese to characterize human–animal contact behaviors associated with 93 zoonotic diseases monitored by China’s public health, agricultural, and forestry sectors. It examined contact pathways across key animal groups known to carry zoonotic pathogens, identified human populations at risk, and analyzed the demographic, socio-cultural, and ecological factors shaping these contacts. Focusing on four major human–animal interfaces, the review further identified lessons and best practices for effective risk communications. Findings reveal that human–animal contact in China is diverse and embedded in daily routines, cultural practices, and economic activities, with distinct risk profiles presented across animal groups and socio-ecological settings. Populations such as smallholder farmers, herders, rural residents, market vendors, and workers in informal sectors face higher exposure risk, influenced by socio-economic conditions and ecological changes. Gaps remain in surveillance of informal practices, emerging pathogens, and behavioral data. Evidence from global and local experiences highlights the value of behavior-centered, community-engaged communication grounded in One Health principles, emphasizing participatory design, culturally relevant education, local leadership, and integration with public service systems. Overall, this review provides an integrated understanding of zoonotic disease risks and prevention opportunities from social-behavioral and communication perspectives. It identified priority populations, settings, and best practices for targeted and effective strategies, underscoring the need for coordinated One Health efforts to address complex human–animal–environment interactions and promote proactive zoonotic disease prevention in China and beyond.