It is worth discussing whether VBNC pathogens maintain their pathogenicity if they are unable to be resuscitated. Although there is no relevant information to confirm that pathogenic bacteria that remain in the VBNC state can cause human disease, it has been reported that some VBNC pathogens retain pathogenic effects. For example, Oliver and Bockian (1995) described mice that were in a lethal state after inoculation with VBNC cells of Vibrio vulnificus. Amel et al. (2008) observed a fluid accumulation in the rabbit ileal loop assay (RICA) in response to VBNC V. cholerae O1. VBNC Legionella pneumophila that retained the capacity to infect the amoeba, which is its natural host (Al-Bana et al., 2014). Furthermore, one study demonstrated that VBNC enteropathogenic E. coli showed pathogenicity due to the continual production of enterotoxin (Pommepuy et al., 1996), and another study showed that uropathogenic E. coli that remained in the VBNC state may be the major causative agent of recurrent urinary tract infections in many individuals (Anderson et al., 2004). However, some VBNC pathogens have been confirmed to be non-pathogenic. Compared with culturable cells, the VBNC cells of L. monocytogenes were avirulent because of a failure to colonize the spleen of mice or adhere to HT-29 cells (Cappelier et al., 2007), VBNC C. jejuni cells were unable to colonize the caecum of newly hatched leghorn chicks (Ziprin et al., 2003) and VBNC Salmonella typhimurium could not infect all mice in the experiment (Habimana et al., 2014). In a word, when VBNC cells are unable to resuscitate in animals, some of them are still pathogenic and others are avirulent. The pathogenicity of VBNC cells in animals may differ due to different strains or the type of animals. To better understand the pathogenicity of VBNC cells, we propose to expand the research to include assessments of the pathogenicity of different VBNC cells and to attempt to distinguish the VBNC cells that can directly lead to disease.