In recent years a great deal of information has been generated on the virulence factors produced by Bordetella pertussis, the regulation of their expression, and their molecular mechanisms of action. There are numerous studies of Bordetella virulence factors and strains of B. pertussis in which the genes for some of these components have been mutated or deleted. In addition, several acellular vaccines composed of these virulence factors have been developed, tested, and licensed for use in the prevention of pertussis. Nevertheless, there exists little information specifically on the pathogenesis of the disease process caused by B. pertussis in humans, and such data are necessary for adequate understanding and treatment of this novel infectious disease.