Although freshwater ecosystems are among the most diverse and endangered in the world, little attention has been paid to either the importance of parasitic disease as a threatening process for freshwater organisms, or the co-extinction risk of freshwater parasites. In this review, we use theoretical and empirical studies of host/parasite interactions to examine these issues, particularly with respect to the threat posed by climate change to fish and parasite communities in intermittent rivers. Intermittent rivers are those that cease to flow at any point in time or space, with isolated pools providing ecological refuges for freshwater biota between streamflow events. Intermittent rivers are the dominant river type in arid, semi-arid and Mediterranean regions; areas of the world that have experienced dramatic decreases in streamflow as a result of climate change. Reduced streamflow decreases the number, size and connectivity of refuge pools in intermittent rivers, with important consequences for free-living aquatic organisms, particularly fishes, and their parasitic fauna. As a result of more frequent and sustained periods of no flow, parasite diversity within refuge pools is expected to decrease, with a concomitant increase in the prevalence and intensity of those parasite species which do survive, particularly host generalists. Decreased connectivity between refuge pool communities should increase the spatial modularity of host/parasite interactions, leading to a greater structuring of host and parasite communities along the river. This increases the probability of species loss (for both hosts and their parasites), as local extinctions cannot be reversed by colonisation from other localities
