Co-circulation and co-infection: parasite interactions across scales

Parasite-parasite interactions occur both within and between hosts, but the two scales are rarely considered together. Consequently, there is a gap in our ability to predict the integrated effects of interactions occurring across scales, disentangle their relative contributions to key ecological outcomes, and accurately identify the drivers of host-parasite evolutionary responses. Here, we extend the standard susceptible-infected framework of theoretical epidemiology to explicitly incorporate parasite-parasite interactions across scales. We identify where - in each step of the transmission process - such interactions may occur, at the within- or between-host levels, providing empirical examples where possible. Thus, we demonstrate how integrating the two scales provides a more complete understanding of the evolutionary ecology of multi-parasite systems and suggest future avenues of investigation.