Interactions between zoonotic pathogens and infectious disease spread: Why understanding mechanisms and modelling...

Interactions among zoonotic pathogens play a critical role in shaping disease transmission, severity, and public health responses. However, the mechanisms and population-level consequences of these interactions remain underexplored in current modelling frameworks. This review aims to synthesize emerging evidence and address key scientific challenges in understanding how pathogen interactions influence transmission dynamics and mathematical modelling, with a focus on zoonotic and other cocirculating pathogens. In this review, we synthesize current evidence on synergistic, antagonistic, and neutral interactions between zoonotic and other cocirculating pathogens. We explore the underlying mechanisms of these interactions, such as transmission enhancement, immune modulation, and resource competition, at both the individual and population levels. We further review mathematical models to illustrate how these interaction features, such as transmission pathways, coinfection histories, cross-immunity, and superspreading potential, could be incorporated into epidemiological frameworks to increase our understanding of the community transmission of infections. Particular attention is given to the challenges of parameter estimation, incomplete surveillance data, and the difficulty of modelling interactions across scales and pathogen types. Understanding and modelling these interactions is essential for predicting outbreak trajectories, designing effective vaccination strategies, and improving early-warning systems. We conclude by calling for enhanced integration of empirical data and mechanistic modelling, especially in the context of emerging zoonoses and postpandemic preparedness. This review provides a structured perspective to support future interdisciplinary efforts aimed at managing cocirculating pathogens and mitigating their public health impact.