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Interpretive Handbook

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Test 8172:
Rubella Antibodies, IgG, Serum

Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Primary postnatal rubella infection (German or 3-day measles) is typically a mild, self-limiting disease characterized by a maculopapular rash, fever, malaise, and lymphadenopathy.

 

Conversely, primary prenatal rubella infections may have devastating results. In utero infections may severely damage the fetus, particularly if the infection occurs during the first 4 months of gestation. Congenitally infected infants may exhibit 1 or more defects including congenital heart disease and mental retardation.

 

Prior to the introduction of the rubella vaccines, approximately 15% of childhood sensorineural deafness and 2% of congenital heart defects were attributed to congenital rubella infection in both the United States (US) and the United Kingdom. During the epidemic of 1962 to 1965, rubella infections during pregnancy were estimated to have caused 30,000 stillbirths and 20,000 malformed infants in the US.

 

The US rubella vaccination program, which calls for vaccination of all children, has significantly reduced the incidence of rubella. A total of 9 cases of rubella were reported to the CDC in 2004, and only 4 cases of congenital rubella syndrome were reported between 2001 and 2004.(3) Due to the success of the national vaccination program, rubella is no longer considered endemic in the US (cdc.gov/rubella).

Useful For Suggests clinical disorders or settings where the test may be helpful

Determination of rubella immune status

Interpretation Provides information to assist in interpretation of the test results

Approximately 80% to 90% of the United States (US) adult population shows serologic evidence of immunity to rubella. The rubella vaccine is recommended for all children, as well as nonimmune adolescents and adults (particularly females) unless it is specifically contraindicated. Due to the national vaccination program, the majority of the US population will be positive for rubella IgG.

 

A positive result indicates either prior exposure to the virus or response to vaccination. The presence of rubella IgG suggests immunity against rubella.

Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

This assay should only be used as a means of determining the immune status of an individual through the detection of antirubella IgG-class antibodies.

 

The presence of antirubella IgG antibodies does not exclude the possibility of a recent or ongoing infection. Testing for IgM-class antibody to rubella should be performed at a state health laboratory or at the CDC if the clinical presentation is suggestive of acute rubella infection.

                                                                                                                                                                           

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

Clinical References Provides recommendations for further in-depth reading of a clinical nature

1. Yelland MJ: Rubella immune status in general practice. Aust Fam Physician 1989;18:1279-1281;1284-1285

2. Recommendation of the Immunization Practices Advisory Committee: Centers for Disease Control Morbidity and Mortality Weekly Report 1981;30:37-47

3. Achievements in Public Health: elimination of rubella and congenital rubella syndrome – United States, 1969-2004: Centers for Disease Control Morbidity and Mortality Weekly Report, March, 2005;54(11):279-282