The late twentieth century witnessed the emergence of numerous infectious diseases that
are caused by microorganisms that rarely cause disease in normal, healthy
immunocompetent hosts. The emergence of these diseases shows that the existing
concepts of pathogenicity and virulence do not take into account the fact that both the
microorganism and the host contribute to microbial pathogenesis. To address this
impediment to studies of host–microorganism interactions, we propose a new theoretical …

Historical and most currently held views of microbial pathogenesis and virulence are
plagued by confusing and imprecise terminology and definitions that require revision and
exceptions to accommodate new basic science and clinical information about microbes and
infectious diseases. These views are also inherently unable to account for the ability of some
microbes to cause disease in certain, but not other hosts, because they are grounded in
singular, either microbe-or host-centric views. The damage-response framework is an …