Review

Global Patterns of Zoonotic

Disease in Mammals
Barbara A. Han,1,* Andrew M. Kramer,2 and John M. Drake2,3
As the frequency and prevalence of zoonotic diseases increase worldwide,
Trends
investigating how mammal host distributions determine patterns of human
Predicting zoonotic disease events
disease and predicting which regions are at greatest risk for future zoonotic remains a prominent scientific challenge.
disease emergence are two goals which both require better understanding of
In response to increasing frequency of
the current distributions of zoonotic hosts and pathogens. We review here the emerging infectious disease events
existing data about mammalian host species, comparing and contrasting these caused by animal-borne (zoonotic)
patterns against global maps of zoonotic hosts from all 27 orders of terrestrial pathogens, recent advances assess
the biogeographic patterns of human
mammals. We discuss the zoonotic potential of host species from the top six infectious diseases.
most species-rich mammal groups, and review the literature to identify analyti-
A disproportionate representation of
cal and conceptual gaps that must be addressed to improve our ability to
mammal-borne zoonoses among
generate testable predictions about zoonotic diseases originating from wild emerging human disease has sparked
mammals. research emphasis on mammal reser-
voirs because improved understanding
of mammal host distributions may lead
Where Will Future Zoonoses Come From? to improved predictions of future hot-
spots for zoonotic disease emergence.
Current understanding about the global distribution of most infectious diseases is surprisingly
limited. Even for human infectious diseases, the spatial distributions of the vast majority remain In addition to spatial distributions of
little known [1]. However, the frequency with which new infectious diseases are emerging animal hosts and human disease, the
(emerging infectious diseases, IEDs; see Glossary) [2], especially zoonoses, underscores concept of ‘disease risk’ is a topic of
intense analysis, and has been quanti-
the necessity of shifting from a reactionary to a pre-emptive approach to mitigating infectious
fied on the basis of hindsight where
disease. regions undergoing frequent or intense
human disease events are categorized
Assessing future disease risk requires baseline data – information about where infectious as possessing numerous factors that
interact to increase disease risk.
diseases are distributed geographically, taxonomically (with respect to animal reservoirs),
and in relation to human populations. Such information is most abundant for records of human
infectious disease. Whether looking across multiple diseases to glean generalizable epidemio-
logical insight, or at specific diseases to identify important covariates predicting particular human
outbreaks, previous studies have combined detailed data on human infectious disease
events and environmental factors to quantify current and to predict future disease hotspots
(e.g., [2–6]). Such baseline data provide important starting points for making projections of
human disease risk, and can be effectively applied to predict the spread of particular infectious
diseases to new areas that are in close proximity, or are located in environments similar to
historical outbreak locations (e.g., [6,7]). As one example, data describing the ecology of bat 1
Cary Institute of Ecosystem Studies,
reservoirs of Nipah virus can help to make projections about the types of environments expected Box AB Millbrook, NY 12545, USA
to support cases of human disease [5]. Such baseline data can then be applied to identify and 2
Odum School of Ecology, University
manage similar locations where future Nipah outbreaks might be predicted to occur. However, of Georgia, 140 East Green Street,
Athens, GA 30602, USA
data from past outbreaks may offer little towards efforts to predict outbreaks of completely novel 3
Center for the Ecology of Infectious
diseases that punctuate the status quo – for example, the emergence of new zoonotic Diseases, University of Georgia,
pathogens, such as the Middle East respiratory syndrome coronavirus (MERS-CoV) [8], or Athens, GA 30602, USA

outbreaks of known zoonoses in unexpected areas, such as Ebola virus disease in West Africa
[9]. Because of their often surprising departures from previous outbreak patterns, some argue *Correspondence:
that disease events may be inherently unpredictable (e.g., [10]). Predicting outbreaks, caused [email protected] (B.A. Han).

Trends in Parasitology, July 2016, Vol. 32, No. 7 http://dx.doi.org/10.1016/j.pt.2016.04.007 565

© 2016 Elsevier Ltd. All rights reserved.
either by novel pathogens or known pathogens in novel places, remains one of the biggest Glossary
scientific challenges of our time. We agree that this is a difficult problem, but disagree that it is Competence: the degree to which a
impossible. This causes us to ask, what types of data are available that may facilitate more host can successfully transmit a
effective prediction? pathogen to its vector.
Disease event: a general term
referring to a collection of human
Because most human infectious diseases have animal origins [2,3,11,12], and the majority of disease cases, including the
emerging human diseases originate from mammals [13,14], better understanding the global emergence of novel zoonoses or
distributions of mammal zoonotic hosts could provide a first-order prediction of future hotspots resurgence of known zoonoses over
any temporal or spatial extent.
for zoonotic disease emergence. Recognizing that a parasite or pathogen is unlikely to persist in Disease hotspots: regions where
all populations of its definitive host(s), we think of the collective geographic ranges of known host infectious diseases should increase in
species as the maximum potential current geographic range of a zoonosis. Visualizing this incidence or geographic range, or
regions most likely to generate novel
potential range offers a baseline from which we can ask basic comparative questions about
disease events.
realized and unrealized risk of zoonotic diseases, and offers a launch point for building predictive Emerging infectious disease
models of future zoonotic disease events. (EID): any infectious disease that is
increasing in incidence or geographic
range.
We review here what is known about the geographical distribution of zoonoses carried by wild
Host breadth: the range of host
mammals [15]. We describe global biogeographic patterns of zoonotic hosts across all 27 species that a given pathogen is able
orders of terrestrial mammals (as confirmed at the species level by the Global Infectious Disease to successfully infect, also commonly
and Epidemiology Network, GIDEON, database [16]), which provides real-time updates of referred to as the host range of a
pathogen or parasite.
infectious diseases of zoonotic relevance to humans and reports animal hosts to the species
Outbreak: defined by a group of
level. For zoonotic hosts in each of the six most speciose mammal groups, we review the epidemiologically connected disease
geographic ranges recorded by the International Union for the Conservation of Nature (www. cases that exceed historical
iucnredlist.org/technical-documents/spatial-data), and address five outstanding research ques- incidence; generally used in this
article to refer to the emergence of a
tions about mammal-borne zoonoses. zoonotic disease over a relatively
short period of time.
What Causes High Zoonotic Disease Risk? Realized disease risk: the
Human zoonotic disease risk can be defined as a function of several factors, including the component of the overall risk of
zoonotic disease in humans that is
probability of successful transmission of a zoonotic pathogen from an animal host into human apparent from current and ongoing
hosts (transmission of infection) and the probability of an infection transitioning to a state of disease in human populations.
disease in human hosts (transition to disease) [17,18]. These components of disease risk rely on Reporting bias: bias that arises
from infection or disease cases being
several factors that are external to the host–pathogen system. Extrinsic factors, such as
reported more frequently due to
urbanization, agriculture, and socioeconomic standing, control host and human population greater resource allocation; thus
dynamics underlying the frequency of transmissible contacts at the human–wildlife and the reporting bias can be high in rich
wildlife–livestock interfaces [5,17,19–21]. Intrinsic factors (of hosts, pathogens, and vectors) countries.
Richness: the number of unique
combine with extrinsic factors to contribute to disease risk in humans. Intrinsic factors include life
species within a particular geographic
history [22–24], behavior [25,26], competence [27–29], and rapid evolutionary changes in area; richness is a count-based
animal hosts and pathogens [30–32]; transmission modes and host breadth in pathogens metric for quantifying diversity, which
[13,33,34]; and differences in host susceptibility, often conferred by prosperity or poverty in contrasts with other metrics, such as
functional trait diversity (the different
human populations [35], and by pristine or degraded communities in wildlife hosts [36]. Thus,
types of traits represented within a
regions can have high zoonotic risk for multiple reasons – people living in regions with inherently geographic area) or genetic diversity.
high zoonotic potential may be considered at high risk, but so too can those living in regions Spillover: occurs when a pathogen
with low host and pathogen diversity but increasing external pressures (such as warming or or parasite successfully infects a
human host.
urbanization) that may facilitate the transmission of some zoonoses through a cascade of Study bias: bias that can arise when
environmental changes [20,37–39]. particular organisms (e.g., hosts and
pathogens) or geographic areas are
Notwithstanding these complexities, areas that are currently experiencing zoonotic outbreaks better studied than others.
Unrealized disease risk: the
are places where a high zoonotic risk has been realized as observable disease events. component of overall zoonotic
Investigating the features shared in common among regions with high realized disease risk disease risk in humans that is not yet
(in the form of recurring or new observed outbreaks) is a first step to understanding what triggers apparent, and comprises underlying
zoonotic potential (see below);
these events (e.g., [2,4,5,40]). However, comparing regions with high realized disease risk offers
intrinsic features of the host,
limited utility for forecasting unexpected disease events, which requires quantifying unrealized
disease risk. Disruptive extrinsic pressures in regions of high zoonotic potential where host or

566 Trends in Parasitology, July 2016, Vol. 32, No. 7

pathogen richness is already particularly high could trigger spillover to human hosts. Identify- pathogen, and vector; and extrinsic
ing locations with high zoonotic potential but without overt signs of disease emergence could pressures that affect human contact.
Zoonosis or zoonotic disease
signal regions where pathogen transmission is high but transition to disease is low (e.g., Ebola (plural, zoonoses): a disease that is
virus outside Africa [41]) or areas where transition to disease is low because pathogen trans- caused by an infectious pathogen or
mission is currently low but, once transmission occurs, disease will increase as a matter of parasite that originates in (or is
course (e.g., Ebola virus disease within Africa [6]). maintained in the wild by) one or
more non-human hosts, but can be
transmitted to and cause disease in
Where Are Global Hotspots of Zoonotic Mammal Hosts? humans.
In general, we expect more zoonotic host species to occur in regions with high biodiversity [42]. Zoonotic coldspots: areas of
unrealized disease risk where
Indeed, mapping the overlapping geographic ranges of zoonotic mammal hosts (Figure 1)
zoonotic host or pathogen richness is
reveals that regions with the greatest host richness include Central and South America (south- higher than observed human disease.
east of the Andes); Central East Africa; Europe (Eastern Europe, some of Western Europe), and Zoonotic host: any species
mainland Southeast Asia (Figure 1). In general, these regions align with global geographic confirmed to carry one or more
zoonotic diseases either as natural
patterns of mammal biodiversity (Figure S5 in the supplemental information online) [43] with the
reservoirs or as hosts susceptible to
exception of the hotspot in the north temperate zone (Europe), which contains a higher diversity some degree of infection; in this
of mammal hosts than expected from global biodiversity patterns. We postulate that this pattern article, hosts are limited to mammals.
may be driven in part by the high richness of rodents and insectivores found in this region (see Zoonotic potential: the dynamic
potential of a particular location or
Question 3, below). animal clade to contribute zoonotic
infection to human hosts; conferred
To what degree do these zoonotic host hotspots align with global patterns of human zoonotic by a high underlying diversity of
disease? While the diversity of host species corresponds well to global biodiversity patterns, the zoonotic hosts or pathogens from
which infection may spill over to
biogeography of human outbreaks is less straightforwardly explained by biodiversity. For humans.
rodents, Han et al. [22] found a greater diversity of zoonotic hosts and diseases in regions
with low overall mammal biodiversity. They also found that the number of human outbreaks
caused by rodent-borne zoonoses (since 1990) is concentrated in northerly latitudes, especially
Europe [22]. In terms of emergence, the majority of human infectious diseases emerged for the
first time in northerly latitudes, with a hotspot in Europe [2]. Unsurprisingly, zoonoses with wildlife
(as opposed to domesticated species) origins were found to emerge more frequently in humans

400
300
200
100

Hosts Arcc ocean

70
Zoonoses
60 60

Species with zoonoses

50
Atlanc ocean 30
Latude

Pacific ocean 40

0 30
Pacific ocean
20
Indian ocean 30
10

60 0
0 0
40 20 120 60 0 60 120
Longitude

Figure 1. Geographic Ranges of Zoonotic Mammal Hosts. Mammal reservoirs of zoonotic diseases are globally distributed, with noteworthy hotspots in Amazonia
and Eurasia. Overlapping geographic ranges of mammal species recognized to carry one or more zoonotic diseases, with counts of unique host species (gold bars) and
unique zoonotic pathogens (red bars) found within 308 latitudinal and longitudinal bands. This map depicts 5007 total wild mammal species from 27 orders.

Trends in Parasitology, July 2016, Vol. 32, No. 7 567

populations occurring in biodiverse areas (as measured by wildlife species richness, which
includes, but is not restricted to, mammals) [2]. By contrast, the emergence frequency of
zoonoses from non-sylvatic (e.g., domesticated species) origins is best explained by human
population density and by latitude [2], with no identifiable significance of biodiversity. These
patterns provide additional evidence for the general expectation that zoonoses pose greater
risks with increasing human contact with animal sources [17,44,45].

Many of the zoonotic host hotspots in higher latitudes also overlap with centers of high human
population density (e.g., Europe, Southeast Asia; Figure 1), which suggests an important role of
reporting bias or study bias in determining larger biogeographical patterns of zoonotic
disease [46]. Because more resources are dedicated to disease-related research and treatment
in the northern hemisphere [2,33,35,42], the number of hosts and pathogens discovered in
these countries tends to increase (e.g., [47,48]). However, if such biases were the sole factor
driving this pattern, hotspots of similar magnitude would be expected in the USA and Canada
because these countries span similar latitudes, exhibit similar overall species richness [43], and
apportion the greatest expenditures towards biological and health-related research (http://apps.
who.int/nha/database/World_Map/Index/en). An open question is whether human population
density alone is driving these geographic patterns because human populations are spread over
larger areas in North America compared to Europe.

An underexplored possibility is that there are intrinsic differences between species comprising
north temperate communities. These communities display different patterns of functional
diversity compared to those in the tropics, with each temperate species contributing dispro-
portionately to ecosystem processes compared to tropical species [49]. Studies that move
beyond occurrence-based metrics (e.g., richness) to consider the functional trait diversity of host
and pathogen species may reveal another dimension to what is driving geographic patterns of
zoonotic diversity. Whether temperate hosts carry proportionately more zoonoses, or whether
zoonotic pathogens in temperate zones exhibit proportionately greater host breadth compared
to tropical systems, is an open question [50]. Comparing the topologies of host–pathogen
networks in temperate versus tropical regions is one approach to answering this question (e.g.,
[51,52]).

Which Mammal Groups Pose the Greatest Zoonotic Disease Risk?

Across the 27 terrestrial mammal orders, there is wide variation in both the total number
of species and the fraction of species in each order that are zoonotic hosts (Figure 2;
Figures S1–S3). In the most speciose orders (blue boxes, Figure 2), the number of zoonotic
hosts increases with total species richness of the order, a pattern which may be explained in
part by accumulating evidence that parasitism drives host diversification (reviewed in [53]).
Nevertheless, further examination of the variation around this general trend is warranted. For
example, groups with more zoonotic host species than expected for the richness of the clade
(e.g., orders that fall above a regression line through points in Figure 2) may share suites of
similar intrinsic or extrinsic factors enabling more-successful pathogen transmission (e.g.,
[54]), or more frequent human contacts that, over time, facilitate the transition of a novel
infection to a disease state in humans [17,18,55] (e.g., the ungulates, a paraphyletic group
that includes the Artiodactyla and Perissodactyla; ungulates comprise the majority of domes-
ticated mammal species). Conversely, orders with fewer zoonotic hosts than expected for the
richness of the clade (those below a regression line) may reflect species that have been poorly
sampled for zoonoses, or species that carry fewer zoonoses owing to unique combinations of
intrinsic and extrinsic features. For example, the marsupial carnivores (Dasyuromorpha),
much like placental carnivores (Carnivora), have less direct contact with humans compared
to other clades (e.g., rodents, ungulates) [56], which may reduce the risk of zoonotic
transmission to humans. However, many dasyuromorphs have regular contact with

568 Trends in Parasitology, July 2016, Vol. 32, No. 7

 250 Rodena ●
85

Number of zoonoc hosts

200
2000
150 Carnivora
●
● Chiroptera
100 Primates
Number of species

1500 ●
●
50 Arodactyla

● ● Soricomorpha
25
0 ●●●●
●●
●
1000 0 500 1000 1500 2000
Number of species
20
500 21 Diprotodona

Number of zoonoc hosts

61
●
83 15
52
11 Lagomorpha
27 17 1 1 11 1 10 2 ●
0 7 14 0 0 1 1 5 0 0 0 0
10
0 ●
Erinaceomorpha Didelphimorphia
Rodena
Chiroptera
Soricomorpha
Primates
Carnivora
Arodactyla
Diprotodona
Lagomorpha
Didelphimorphia
Dasyuromorphia
Afrosoricida
Erinaceomorpha
Peramelemorphia
Cingulata
Scandena
Macroscelidea
Perissodactyla
Pilosa
Pholidota
Paucituberculata
Monotremata
Hyracoidea
Proboscidea
Notoryctemorphia
Dermoptera
Tubulidentata
Microbiotheria
●● ●
5 ●
Cingulata
●● Afrosoricida
● ●● ● ● Dasyuromorphia
0 ●● ●● ●

0 50 100 150
Order Number of species

Figure 2. The Number of Zoonotic Hosts Increases with Total Species Richness of the Order. Zoonotic diseases are found in the majority of terrestrial
mammal orders (21/27), with the most species-rich orders containing the greatest diversity of zoonoses. This split bar plot shows the total number of host species (black
and grey) and the fraction of species that are confirmed zoonotic hosts for one or more zoonotic diseases (grey). The number above each bar represents a tally of the total
unique zoonoses per order. Mammal orders are arranged in descending order of species richness. The number of zoonotic host species in each order is represented by
scatterplots, with the most-speciose orders being contained in the blue boxes (top right; regression R2 = 0.81) and all other orders in the orange boxes (bottom right;
regression R2 = 0.63).

domesticated species (for example, domesticated dogs, especially when Tasmanian devils
and quolls are attracted to livestock on farms [57]), providing an opportunity for human
exposure through farm animals on human-modified environments [44].

Maps depicting geographic range distributions of zoonotic hosts across the most speciose
orders (Figure 3, Key Figure) show that global hotspots (Figure 1) are driven in part by striking
differences in the distribution of zoonotic hosts from specific clades, as will be explained below.
Maps depicting geographic range distributions of zoonotic hosts from mammal orders
endemic to Australia can be found in Figure S2, and maps for all other orders can be found
in Figure S3.

Rodentia
Among mammals, rodents are the most abundant and most species-rich and include a greater
number of zoonotic hosts than any other order: approximately 10.7% of rodents are hosts
(244/2220 species, updated from proportions reported by [22]), carrying 85 unique zoonotic
diseases. Rodent reservoirs of zoonotic diseases are distinguished by features that support a
fast life history profile, reproducing earlier in life and more frequently compared to other rodent
species [22]. Figure 3 shows that north temperate areas in North America and Europe and the
tropical Atlantic forest region of Brazil contain the most rodent host species. We note that the
larger global zoonotic host hotspot observed in Europe and Russia (Figure 1) may be driven in
part by the diversity of rodent and small-bodied insectivore hosts (Soricomorpha, see below), as
well as their predators (Carnivora, see below) (Figure 3).

Trends in Parasitology, July 2016, Vol. 32, No. 7 569

Key Figure
Global Hotspots of Zoonoses Are Driven by Differences in the Distribution of Zoonotic Hosts from
Specific Clades

25

50

0 20

–50 Carnivora Chiroptera

Species with zoonoses

15
50
Latude

0
10
–50 Primates Rodena

50
5
0

–50 Soricomorpha Ungulates

0
–100 0 100 –100 0 100
Longitude

Figure 3. Mapping overlapping geographic ranges of mammal species recognized to carry one or more zoonotic diseases highlights regions of high and low zoonotic
host diversity arising from particular clades. Mammal zoonotic host richness is depicted by color for carnivores, bats (Chiroptera), primates, rodents, shrews and moles
(Soricomorpha), and the hoofed mammals (ungulates, which combine the orders Perissodactyla and Artiodactyla and exclude domesticated species).

Chiroptera
Because they are also relatively small-bodied, speciose, and associated with numerous EID
events in humans, bats are often compared to rodents with respect to their risk of carrying
zoonotic pathogens [58]. There are about half as many zoonotic bat hosts compared to rodents
(108/1100 bat species are hosts, approximately 9.8%), and they carry about a third of the
number of unique zoonoses (27) compared to rodents.

The mammal host hotspot in the Neotropics is likely to be driven in part by the high diversity of
bat hosts in this region (Figure S5) [43]. Figure 3 shows hotspots of zoonotic bat hosts in Central
and South America (wet regions east of Chile, north of Paraguay and Uruguay), as well as in
Southeast Asia. These patterns are generally consistent with bat biodiversity patterns [43],
except for the following departures: (i) within South America, bat species richness is highest in
the Andean countries and in northern Brazil whereas the hotspot of bat hosts is in southern
Brazil; (ii) Southeast Asia and equatorial Africa display similar patterns of bat species richness,
but Southeast Asia has many more zoonotic host species even though it is a much smaller land

570 Trends in Parasitology, July 2016, Vol. 32, No. 7

mass. If, as ecological theory suggests, we expect the number of hosts to be proportional to
overall species richness [51,59,60], these maps suggest either that Africa is understudied or that
Southeast Asia has more zoonotic hosts than expected for its mammal species richness and for
its area.

Soricomorpha
Among the insectivoran mammals, relatively few shrews and moles are known to be zoonotic
hosts, with only about 4% (19/426 species) carrying 19 unique zoonoses. This small percentage
could be due to this group being understudied compared to other, similarly species rich mammal
groups. A Web of Science search on the Latin binomials of all extant mole and shrew species
returned a total of 4600 citations, which is 1–2 orders of magnitude fewer studies than for other
speciose mammal orders (blue box, Figure 2). Zoonotic hosts in this order are distributed widely
across north temperate latitudes, with the greatest number of host species overlapping across
Europe and across the Atlantic coast of the USA (Figure 3). Given their species richness, wide
geographical distribution, and degree of biological and ecological similarity to rodent and bat
hosts (e.g., small body size, high metabolic rates, and plasticity in reproductive traits), zoonotic
disease ecology in insectivorous mammals stands out as an important area for further research.

Carnivora
While ungulates were previously thought to share the most pathogens with humans [13], we find
that carnivoran hosts nearly tie with the rodents to harbor more unique zoonoses than other
terrestrial mammal clades. Approximately 49% (139/285) of all carnivore species – the highest
proportion of any mammal order – carry one or more of 83 unique zoonotic pathogens.
Carnivoran hosts are among the most widely distributed in terms of spatial extent (Figure 3),
with hotspots of host diversity in Southern and East Africa, Southeast Asia, and the subarctic
region of North America. This contrasts patterns of carnivoran species richness, which is
concentrated in the southern hemisphere (particularly in Africa and Southeast Asia;
Figure S5). Previous studies showed that pathogen richness (zoonotic and non-zoonotic) closely
tracked carnivore species richness [61], and that the range of carnivoran host species infected
by a pathogen depends primarily on host phylogenetic relatedness [62]. In addition, research
exploring the degree to which carnivorans accumulate the infectious agents of their prey (which
can themselves be zoonotic hosts) will contribute to understanding whether the distribution of
carnivoran hosts are tracking the diversity of prey items.

Ungulates
Ungulate reservoirs of zoonotic disease have been of particular interest because of high human
contact rates through hunting, and the degree of contact and relatedness between wild and
domesticated species (livestock) [13,19,39,63]. Recent work also shows that the time since
domestication correlates positively with the number of zoonotic infections shared between
ungulates and humans, and that species with the longest history of domestication not only carry
more zoonotic pathogens but may also transmit infection to a greater diversity of alternative host
species [64]. For wild ungulates (excluding domesticated species), we find that approximately
32% of species were zoonotic hosts (73/247 species), carrying 68 unique zoonoses. Ungulates
cover a greater spatial extent than bats, primates and insectivores, and the majority of host
species overlap in East and Southern Africa (Figure 3).

Primates
The high degree of phylogenetic relatedness between human and non-human primates is
thought to contribute to greater risk of pathogen spillover [65]. For example, species that are
closely related and share habitat show the most similar parasite communities [66], suggesting
that spatial overlap and phylogenetic relatedness are likely to be important for understanding
transmission in humans and in wild host species. Primates are generally found in the global

Trends in Parasitology, July 2016, Vol. 32, No. 7 571

equatorial zone, with greatest species diversity in the rainforests of Africa, the Neotropics, and
Asia [67]. Primate zoonotic host richness is greatest in equatorial Africa (in central Africa in the
Congo Basin, and West Africa), in Southeast Asia, and in the tropical/mixed forest regions of
northern Brazil and the Guyana Shield. Over 20% of primate species are zoonotic hosts (21%;
77/365 species) for at least one of 63 unique zoonoses. Thus, while there are fewer species of
primates overall, a greater proportion of the primates are zoonotic hosts than are either the
rodents or the bats.

Zoonotic Potential of Hosts and Human Disease Risk

Importantly, the hotspots identified here depict regions with the greatest number of overlapping
zoonotic host species, excluding other components of disease risk. In general, increasing
opportunities for human exposure to animal groups with high zoonotic potential will increase
the risk of zoonotic disease in humans. In addition to overall host richness of an area, zoonotic
potential depends on the likelihood that a species is a zoonotic host given the order it belongs to,
and the breadth of zoonoses harbored by host species in a given order [13]. Thus, based on the
results described above, rodents can be considered to have high zoonotic potential because
there are more rodent host species than hosts from any other mammal group. Although there
are fewer carnivoran species in comparison to rodents, they may also be considered to
have high zoonotic potential because a greater fraction of them are zoonotic hosts (i.e., given
an encounter with a carnivore, the likelihood that it is a zoonotic host is higher than for an
equivalent encounter with a rodent for which there are comparatively fewer zoonotic hosts). If the
high degree of parasite sharing suggests that the majority of zoonoses has already been
transmitted from wild reservoirs to humans, the fact that humans already share a large number
of zoonoses with carnivorans may indicate there are few zoonoses left to spill over anew (novel
emergence) but many available to seed re-emergence events. Carnivorans also carry a greater
diversity of zoonotic pathogens than any other mammal group. While zoonotic potential is
considered high for rodents, based purely on numerical frequency, there may be something
intrinsic about carnivores where, despite relatively low direct contact with humans, they are more
permissive to zoonotic infections and may be particularly good at sustaining them even if the risk
of transmissible contacts with humans is lower. Similarly, while there are fewer species of
ungulates compared to rodents, bats, primates, carnivorans, or insectivorans (Figure 2, Artio-
dactyla and Perissodactyla), many more wild ungulates are closely related to domesticated
livestock species with which humans are in regular and increasingly close contact, which could
facilitate successful transmission [13,19,64,68]. Bats are suspected to be particularly permissive
hosts of zoonotic infection [69,70],but, outside the paleotropics where bats are hunted as
bushmeat, direct human contact with bats is likely surpassed by contact with rodents. Thus, for
both bats and carnivorans, it may be more likely that spillover is facilitated by indirect transmis-
sion (e.g., for bats, contact with partially consumed food, including insects, vertebrates, and fruit
[12,71]; for carnivorans, contact with domesticated pets or livestock, and through parasite
shedding in encroaching habitats [72]). These patterns should also be tempered by more explicit
quantification of surveillance bias. For example, the surveillance scrutiny applied to bats for
particular pathogen types (e.g., viruses [73,74]) may skew the number of species found to be
positive for zoonotic viruses. Similar surveillance biases across other clades will impede com-
parisons of relative zoonotic disease risk posed by particular mammal groups or species.

Where Are Global Hotspots of Mammal-Borne Zoonoses?

If we make the simplifying assumption that zoonoses are distributed throughout the geographic
ranges of the mammals carrying them [61], then we can generate some baseline hypotheses
about where zoonotic potential may be greatest by identifying zoonotic pathogen hotspots.
Such hotspots occur where many zoonotic hosts overlap in geographic range, and thus their
zoonotic pathogens also overlap. The histograms in Figure 1 show that the species richness of
zoonotic hosts reflects latitudinal gradients reminiscent of well-known biogeographical patterns

572 Trends in Parasitology, July 2016, Vol. 32, No. 7

in free-living organisms (more host species at lower latitudes) [75]. However, the richness of
zoonotic diseases does not exhibit this pattern: despite wide variation in the global distribution of
land mass and species richness, x2 tests showed that the numbers of unique zoonoses found
across 308 longitudinal bands were not significantly different from each other (x211 ¼ 17:571,
P = 0.09; similar analyses across 308 bands of latitude and longitude showed expected
geographical patterns of higher richness of hosts and zoonoses in the tropics, and in the
longitudinal bands capturing greater land mass, Table S1). Compared to zoonotic mammal
hosts, zoonoses are distributed more evenly worldwide (Figure 4) suggesting that, compared to
wildlife-specific pathogens whose ranges are delimited by ecological interactions regulating their
host and vector populations [40,76–78], the distributions of zoonoses are not as tightly coupled
to the distribution of their host species. Zoonoses are not as broadly distributed as human-
specific diseases [33], but are possibly more labile than wildlife diseases owing to the
mobility and range expansion of human populations [33,40,79] while adhering to biogeographic
grouping patterns reflecting ecological barriers to animal host species establishment and
dispersal [40].

Although major hotspots of mammal hosts occur in the New and Old World tropics (South
America and Eastern Africa, particularly; Figure 1), more zoonoses are concentrated in northern
latitudes, Eastern Africa, and Southeast Asia (Figure 4). This is opposite to the patterns depicted
for zoonotic hosts in the tropics, where host richness is expected to match global patterns of
high species richness that increase the frequency of consumer–resource interactions overall,
including parasitic interactions [80]. In addition to the hotspots of human emerging diseases
observed in the tropics and Europe, Figure 4 draws attention to the global subarctic. While this
region has lower zoonotic host and species diversity compared to other biogeographic regions,
mammals found in the subarctic zone harbor more zoonoses than hosts from other regions. In
general, mammal species are predominantly constrained by their abiotic environments, but
pathogens contend primarily with the biotic environment presented by their hosts (e.g., [81]).
Thus, one possible explanation of this pattern is that, although there are fewer host species in the
global subarctic compared to other regions of the world, the pathogens causing zoonoses in
these species are saturating all available niches, leading to greater evenness (i.e., a larger fraction

Total Zoonoses

Arcc Ocean 90

80

50°N 70
Unique zoonoses

Atlanc 60
ocean
Latude

Pacific
ocean 50

40
0°
Pacific
ocean
30
Indian
ocean 20

10
50°S
0
100°W 0° 100°E
Longitude

Figure 4. Overlapping Geographic Ranges of Zoonotic Diseases Carried by Wild Terrestrial Mammal Host Species from 27 Orders.

Trends in Parasitology, July 2016, Vol. 32, No. 7 573

of species are zoonotic hosts; Figure S3) and higher prevalence (i.e., a larger fraction of the host
population that is infected). These broad and opposing patterns call for future studies to
investigate more directly what is driving geographic patterns of zoonotic host richness versus
richness of zoonotic diseases, an endeavor which subsumes direct confrontation of pervasive
issues of sampling bias (for wildlife species) and reporting bias (for human disease cases)
inherent to data on pathogens and disease. Such studies will also benefit from the large literature
investigating biogeography of parasitic organisms writ large [82].

What Is the Zoonotic Risk Posed by Different Pathogen Types?

There are more zoonoses caused by bacteria than any other pathogen type, followed by viruses,
helminths, protozoa, and fungi (Figures 5 and S4). While zoonotic pathogens are geographically
widespread (Figure 5A), they are unevenly distributed across mammal groups (Figure 5B), with
carnivores carrying the greatest number of viral and bacterial zoonoses, rodents carrying the
most zoonotic helminths, and ungulates carrying more zoonotic protozoa compared to other
mammal groups (Figure 5B). Discerning the human disease risk posed by various pathogen
types will require cross-referencing these broad patterns with zoonotic host patterns (Figure 3).
For example, based purely on frequencies (i.e., excluding factors influencing contact rates with
humans, etc.), the zoonotic virus hotspot in Europe (Figure 5A) could be driven by the high

(A)
Arcc ocean Arcc ocean 32

50 Atlanc Atlanc
28
ocean Pacific ocean Pacific
ocean ocean
24
0 Pacific Pacific
ocean ocean

Unique zoonoses
Indian Indian
ocean ocean
20
Latude

–50 Bacteria Virus

Arcc ocean Arcc ocean 16

50 Atlanc Atlanc
12
ocean Pacific ocean Pacific
ocean ocean
8
0 Pacific Pacific
ocean Indian ocean Indian
ocean ocean
4
–50 Helminth Protozoa
0
–100 0 100 –100 0 100

Longitude
(B)
30
Unique zoonoses 25
Bacteria 20
Virus
Helminth 15
Protozoa 10
5

Carnivora Chiroptera Primates Rodena Soricomorpha Ungulates

Figure 5. Zoonoses Caused by the Four Major Pathogen Types Are Globally Distributed, with Notable Hotspots for Bacteria and Helminths in North
America and Eurasia. (A) Richness patterns are depicted by pathogen type in descending order: bacteria, viruses, helminths, protozoa. (B) A histogram showing the
number of unique zoonoses caused by each pathogen types in the six most species-rich mammal groups: the carnivores, bats (Chiroptera), primates, rodents, shrews
and moles (Soricomorpha), and the hoofed mammals (ungulates, which combine the orders Perissodactyla and Artiodactyla and exclude domesticated species).

574 Trends in Parasitology, July 2016, Vol. 32, No. 7

diversity of rodent hosts (Figure 3D). Mapping zoonoses by pathogen type and mammal clade Outstanding Questions
may better characterize the host and pathogen community contributing to broad patterns. Where will future zoonoses come from?
Human disease risk posed by different pathogen types will also depend on their host breadth. In Assessing this question will require the
generation of baseline hypotheses
response to the emergence of prominent viral zoonoses in humans (e.g., MERS, SARS) and about the distribution of animal reser-
evidence of frequent host switching [83,84], recent studies have aimed to understand the voirs and their pathogens from which
zoonotic potential of viruses, particularly those arising from bats [83,85]. In addition to charac- future diseases will emerge.
terizing the propensity for host-switching among particular host clades and pathogen types,
What is the underlying zoonotic poten-
comparative studies of host competence will inform the relative contributions of host species as tial of regions where unrealized risk of
pathogen sinks or conduits for further transmission. future disease is particularly high?
Analyses to formally quantify the under-
lying zoonotic potential of a region, host
Concluding Remarks and Future Perspectives
group, or pathogen type will be neces-
Tallying and mapping zoonotic mammal hosts is an important step to assessing which sary to compare unrealized disease
mammal groups and pathogen types hold the greatest potential to originate new human risk across the landscape. Quantifying
diseases. Ultimately, there are many factors describing hosts, pathogens, and environments the components of unrealized zoonotic
disease risk will also be crucial for
that combine to determine the risk of zoonotic disease emergence from mammal species.
developing a predictive approach to
Understanding the current geographic and taxonomic distributions of zoonotic mammalian managing human and animal popula-
hosts offers an important baseline of empirical data against which observed patterns of tions to minimize or prevent outbreaks.
human disease can be compared to improve first-order predictions of human disease risk
Are there intrinsic differences in permis-
posed by wild mammals. We have summarized here the global distributions of mammal hosts siveness and transmissibility between
and the zoonoses they carry, and discuss them in context of existing research on human reservoir species or among ecological
zoonoses. These hotspots provide only a partial view of zoonotic disease risk in humans and communities? For example, is a zoo-
highlight many outstanding questions for future research (see Outstanding Questions). nosis more virulent if it arises from a
particular animal group (e.g., bats)? Are
Moving forward, studies comparing hotspots of mammal hosts or particular pathogen types future zoonoses more likely to arise
against the spatial landscape of epidemiological metrics (e.g., prevalence, incidence, fre- from regions that have more zoonoses
quency of disease events in human populations) and extrinsic drivers (e.g., environmental, (northerly latitudes) or more reservoir
species (the tropics)?
sociopolitical, economic) will continue to triangulate those areas where high realized risk of
human disease coincides with high zoonotic potential. Such comparisons may also reveal What is driving the geographic patterns
zoonotic coldspots that offer important points of contrast in identifying sources and triggers of zoonotic host richness versus rich-
of unrealized disease risk. ness of zoonotic diseases?

Where does high zoonotic potential

The diversity of zoonotic pathogens and their wild reservoirs may erroneously be considered align with extrinsic pressures that trig-
synonymous with human disease risk, rather than a measure of underlying zoonotic potential, ger human disease events, and with
which is itself mediated by many additional interactions in ecological communities (e.g., [51,86– intrinsic features among hosts and
pathogens that facilitate pathogen spill-
88]). We argue that human zoonotic disease risk in a geographical region relies on both zoonotic
over to humans?
potential and the factors that drive zoonotic potential to be realized as human infection and
disease. Many case studies now concur that these drivers can be intrinsic to the hosts [22,69] or What is the zoonotic risk posed by
result from changing human ecology [5,46,89]. Future studies that partition and quantify the different pathogen types and transmis-
sion modes?
components of zoonotic transmission and the transition of infection to human disease will offer
much-needed inroads to assessing the most effective approaches to prevent, manage, or Are there comparative patterns of host
intervene in wild animal systems to achieve the broader goal of mitigating zoonotic disease breadth across zoonoses or across
burden worldwide. biogeographic regions?

What are the implications of climate

Acknowledgments
warming for zoonosis patterns in north-
The authors thank P. Feinberg, E. O’Dea, and M. Gillespie for assistance with data cleaning, figure generation, and
erly latitudes?
manuscript review. Research reported here was supported by the National Institute of General Medical Sciences of the
National Institutes of Health (NIH) under Award Number 5F32GM087811 and U01GM110744. J.M.D. acknowledges
funding support from the RAPIDD program of the Science and Technology Directorate, Department of Homeland Security,
and the Fogarty International Center, NIH. This work benefited from participation in meetings of a Research Coordination
Network on Macroecology of Infectious Diseases (NSF DEB 1316223).

Supplemental Information
Supplemental information associated with this article can be found, in the online version, at http://dx.doi.org/10.1016/j.pt.
2016.04.007.

Trends in Parasitology, July 2016, Vol. 32, No. 7 575

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