Emerging diseases caused by coronaviruses of likely bat origin (e.g., SARS, MERS, SADS, COVID-19) have disrupted global health and economies for two decades. Evidence suggests that some bat SARS-related coronaviruses (SARSr-CoVs) could infect people directly, and that their spillover is more frequent than previously recognized. Each zoonotic spillover of a novel virus represents an opportunity for evolutionary adaptation and further spread; therefore, quantifying the extent of this spillover may help target prevention programs. We derive current range distributions for known bat SARSr-CoV hosts and quantify their overlap with human populations. We then use probabilistic risk assessment and data on human-bat contact, human viral seroprevalence, and antibody duration to estimate that a median of 66,280 people (95% CI: 65,351–67,131) are infected with SARSr-CoVs annually in Southeast Asia. These data on the geography and scale of spillover can be used to target surveillance and prevention programs for potential future bat-CoV emergence.

二十年来，由可能起源于蝙蝠的冠状病毒（例如 SARS、MERS、SADS、COVID-19）引起的新发疾病已经扰乱了全球健康和经济。有证据表明，一些与蝙蝠 SARS 相关的冠状病毒 (SARSr-CoVs) 可以直接感染人类，而且它们的溢出比以前认识到的更频繁。一种新型病毒的每次人畜共患溢出都代表着进化适应和进一步传播的机会；因此，量化这种溢出的程度可能有助于制定预防计划。我们推导出已知蝙蝠 SARSr-CoV 宿主的当前范围分布，并量化它们与人类的重叠。然后，我们使用概率风险评估和关于人与蝙蝠接触、人类病毒血清阳性率和抗体持续时间的数据来估计中位数为 66,280 人（95% CI：65,351–67，131）每年在东南亚感染 SARSr-CoV。这些关于溢出的地理和规模的数据可用于针对未来可能出现的蝙蝠冠状病毒的监测和预防计划。