Introduction
Emerging and re-emerging zoonotic diseases are key contributors to morbidity and mortality in southern China.1,2 This region, considered a ‘hotspot’ for emerging zoonotic diseases, harbours abundant wildlife while also undergoing land use change and natural resource overexploitation leading to intensified human–animal interactions that favour the emergence of zoonotic diseases.3 People living in the rural areas of southern China primarily cultivate rice and fruits, raise swine and poultry in households or on small farms,4 but also traditionally hunt wild animals as an alternative income source.5 The mixed landscape has abundant crops, which attracts wild animals into the communities, and livestock rearing is common.6 This brings humans and animals into close contact in dense populations, creating a wildlife–livestock–human interface for zoonotic disease emergence.7
In recognition of the challenges of emerging infectious diseases after the severe acute respiratory syndrome (SARS) outbreak in 2002 caused by a bat-origin coronavirus, the Chinese government established a national real-time hospital-based infectious disease reporting system.1 Likewise, live poultry market interventions were initiated in response to highly pathogenic avian influenza (HPAI) in southern China in 2001.8 In December 2019 (after the completion of the current study), a novel coronavirus (2019-nCoV) emerged in Wuhan, China and spread rapidly across China and the world.9,10 This virus is a group 2b coronavirus, which includes SARS-CoV and bat SARSr-CoVs, and its closest relative is a virus identified in a Rhinolophus affinis bat from Yunnan.10,11 Environmental samples positive for 2019-nCoV were found in an urban market in Wuhan where some of the earliest known human cases originated.12,13 This likely index site sold predominantly seafood, but is also thought to sell live wildlife at the market, and a temporary ban on the wildlife trade for food has been put in place across China. These efforts in response to SARS, HPAI and 2019-nCoV represent a reaction-driven response to zoonotic disease outbreaks, whereas, apart from the new temporary ban on wildlife trade, only limited preventative measures are currently being enacted in the region to reduce the risk of future zoonotic disease outbreaks.14
However, detailed knowledge of the social and ecological mechanisms of zoonotic disease emergence in the region is limited, and therefore cannot yet inform evidence-based policies and practices for targeted surveillance programmes.15 Using a qualitative approach through ethnographic interviews and field observations, this study aimed to understand interactions among humans, animals and ecosystems, to shed light on the zoonotic risks in these presumed high-risk communities and to develop an evidence base for identifying appropriate strategies for zoonotic risk mitigation.