Bordetella pertussis, an obligate human pathogen and the agent of whooping cough, is a clonal species, despite the dynamic selection pressures imposed by host immunity and vaccine usage. Because the generation of variation is critical for species evolution, we employed a variety of approaches to examine features of B. pertussis genetic variation. We found a high level of conservation of gene content among 137 B. pertussis strains with different geographical, temporal, and epidemiological associations, using comparative genomic hybridization. The limited number of regions of difference were frequently located adjacent to copies of the insertion element IS481, which is present in high numbers in the B. pertussis chromosome. This repeated sequence appears to provide targets for homologous recombination, resulting in deletion of intervening sequences. Using subtractive hybridization, we searched for previously undetected genes in diverse clinical isolates but did not detect any new genes, indicating that gene acquisition is rare in B. pertussis. In contrast, we found evidence of altered gene order in the several strains that were examined and again found an association of IS481 with sites of rearrangement. Finally, we compared whole-genome expression profiles of different strains and found significant changes in transcript abundance, even in the same strain after as few as 12 laboratory passages. This combination of approaches provides a detailed picture of a pathogenic species with little gene loss or gain but with the capacity to generate variation by rearranging its chromosome and altering gene expression. These findings have broad implications for host adaptation by microbial pathogens.Bacterial pathogens face a dynamic array of selective pressures as they establish themselves within hosts, replicate, and are transmitted to new hosts. Upon arrival in a host, microbes may be forced to contend with innate immune defenses, scarcity of metabolic resources, competition from other bacteria for resources and colonization sites, and adaptive immunity, and then they must readapt to the outside environment during transmission to a new host. Individual hosts and pathogens adapt and respond to each other during the course of an infection, while evolving new offensive and defensive strategies on a population-wide basis. Pathogens must employ strategies to prevent their eradication by host immunity, which is constantly changing both within an individual host and within the host population. For an obligate pathogen to persist in a host population, its evolutionary process must be ongoing. This evolution can include gaining new functionality through horizontal transfer of genes, losing "antivirulence" genes, or altering the form or regulation of existing proteins through mutation in coding sequences or changes in promoters or operonic structures.The Bordetella genus of respiratory pathogens provides a rich model with which to explore questions of evolution of pathogenesis and host adaptation. The three species comprising the "c...