Medium- and Large-sized Mammals on the Plateau: An Evolutionary Crucible for Zoonotic Pathogens — Ecological Drivers, Adaptive Evolution, and One Health Control

Plateau regions have emerged as pivotal epicenters of diverse zoonoses because of their distinctive ecological conditions and rich biodiversity. Against the backdrop of intensifying climate change, escalating interactions between wildlife, livestock, and humans, and expanding human activities, these regions now face formidable challenges. To assess public health threats within plateau ecosystems and establish targeted prevention frameworks, this review systematically synthesizes the prevalence and potential cross-species transmission risks of zoonotic pathogens-spanning parasites, viruses, and bacteria-carried by large- and medium-sized wild mammals across China's four major plateaus (Tibetan Plateau, Yunnan-Guizhou Plateau, Loess Plateau, and Inner Mongolia Plateau). Critical issues, including ecological fragility, complexity of pathogen transmission networks, and delayed responsiveness of control measures, are comprehensively analyzed. Future strategies must embrace the One Health concept to construct a multidimensional, coordinated prevention system. By integrating pathogen surveillance, ecological regulation, and technological innovation, a refined zoonosis control framework anchored in safeguarding plateau biosafety and public health can be systematically advanced.