Abstract: Objective To investigate the disease burden caused by pertussis through different surveillance system in Tianjin and evaluate the harm of pertussis in immunization era. Methods There were two pertussis surveillance systems in Tianjin, one is based on the community and another one is based on sentinel hospital. The investigation was carried out on 21st day after onset pf pertussis. The questionnaire included the basic information, medical information, the direct economic burden and indirect economic loss. Results The median of the direct economic burden caused by pertussis was 3364 yuan RMB. The outpatient cost was 850 yuan RMB, and hospitalization cost was 7282 yuan RMB. Indirect economic loss was 641.29 yuan RMB. Missed work time was 12 days. The median of the direct economic burden was 2800 yuan RMB indicated by community surveillance system, which was significantly lower than that indicated by sentinel hospital surveillance (P=0.035). The average outpatient treatment cost was 1450 yuan RMB, and the average inpatient treatment cost was 7105 yuan RMB. The average hospitalization time was 10.5 days, and average cost was 676.67 yuan RMB. The average costs for infants aged Z=69.48, PConclusion The harm of pertussis has been greatly underestimated in immunization era.. The overall disease burden was heaviest in infants aged < 1 year, but attention should be paid to the increase of incidence of pertussis in adolescents and adults The community based surveillance would facilitate the reduction of the economic burden caused by pertussis