Rubeola (Measles) Antibodies, IgM, Serum
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Measles (rubeola) virus is a member of the family paramyxoviridae, which also includes mumps, respiratory syncytial virus, and parainfluenza viruses. Clinical infection with measles virus is characterized by a prodromal phase of high fever, cough, coryza, conjunctivitis, malaise, and Koplik's spots on the buccal mucosa. An erythematous rash then develops behind the ears and over the forehead, spreading to the trunk.
Measles virus is highly contagious; pregnant women, immuno-compromised, and nutritionally deficient individuals are at particularly high risk for serious complications of pneumonia and central nervous system involvement.(1-3)
Since intensive immunization began in the United States more than 2 decades ago, the incidence of measles infection has been reduced from approximately 1/2 million cases annually in the 1960s to fewer than 500 cases in recent years. Atypical measles can occur in patients who received killed measles virus vaccine and subsequently have been infected with the wild type strain of the virus.(4) In addition, many individuals remain susceptible to measles virus because of vaccine failure or nonimmunization. Screening for antibody to measles virus will aid in identifying these nonimmune individuals.
Determining acute-phase infection with rubeola (measles) virus
As an aid in identifying nonimmune individuals
Positive IgM results, with or without positive IgG results, indicate a recent infection with measles virus.
Positive IgG results coupled with a negative IgM result indicate previous exposure to measles virus and immunity to this viral infection.
Negative IgG and IgM results indicate the absence of prior exposure to rubeola and nonimmunity.
Equivocal results should be followed up with a new serum specimen within 10 to 14 days.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
Grossly contaminated, hemolyzed, hyperlipemic, or icteric serum may yield unreliable results. Serum specimens must not be heat-inactivated prior to testing.
A serum specimen drawn during the acute phase of infection when only low titers of IgM are present may yield negative results by this procedure.
Rare heterotypic responses with rubella virus and varicella virus have been reported from measles virus.(5)
Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
Negative (reported as positive, negative, or equivocal)
Clinical References Provides recommendations for further in-depth reading of a clinical nature
1. Liebert UG: Measles virus infections of the central nervous system. Intervirology 1997;40:176-184
2. Norrby E, Kristensson K: Measles virus in the brain. Brain Res Bull 1997;44:213-220
3. Sable CA, Hayden FG: Orthomyxoviral and paramyxoviral infections in transplant patients. Infect Dis Clin North Am 1995;9:987-1003
4. Matsuzono Y, Narita M, Satake A, et al: Measles encephalomyelitis in a patient with a history of vaccination. Acta Paediatr Jpn 1995;37:374-376
5. Cremer, NE, Devlin VL, Riggs JL, Hagens SJ: 1984. Anomalous antibody responses in viral infection: specific stimulation or polyclonal activation? J Clin Microbio 1984;20:468-472
6. Gershon AA, Krugman S: Measles virus. In Diagnostic Procedures for Viral, Rickettsial and Chlamydial Infections. 5th edition. Edited by EH Lennette, NJ Schmidt. Washington, DC, American Public Health Association, Inc., 1979, pp 665-693