Measles (Rubeola) Virus Antibody, IgM and IgG (Separate Determinations), Serum
NY State Approved Indicates the status of NY State approval and if the test is orderable for NY State clients.
Laboratory diagnosis of measles virus infection
Determination of immune status of individuals to the measles virus
Documentation of previous infection with measles virus in an individual without a previous record of immunization to measles virus
Profile Information A profile is a group of laboratory tests that are ordered and performed together under a single Mayo Test ID. Profile information lists the test performed, inclusive of the test fee, when a profile is ordered and includes reporting names and individual availability.
|Test ID||Reporting Name||Available Separately||Always Performed|
|ROM||Measles (Rubeola) Ab, IgM, S||Yes||Yes|
|ROPG||Measles (Rubeola) Ab, IgG, S||Yes||Yes|
ROM/80979: Immunofluorescence Assay (IFA)
ROPG/34941: Multiplex Flow Immunoassay (MFI)
Reporting Name A shorter/abbreviated version of the Published Name for a test; an abbreviated test name
Measles (Rubeola) Ab, IgM and IgG,S
Rubeola (Measles) Ab, IgG, IgM, S
Rubeola Antibodies, IgG and IgM (Separate Determinations), Serum
Rubeola (Measles) Ab, IgG, IgM, S
Rubeola Antibodies, IgG and IgM (Separate Determinations), Serum
Specimen Type Describes the specimen type needed for testing
Specimen Required Defines the optimal specimen. This field describes the type of specimen required to perform the test and the preferred volume to complete testing. The volume allows automated processing, fastest throughput and, when indicated, repeat or reflex testing.
Preferred: Red top
Acceptable: Serum gel
Specimen Volume: 1 mL
Specimen Minimum Volume Defines the amount of specimen required to perform an assay once, including instrument and container dead space. Submitting the minimum specimen volume makes it impossible to repeat the test or perform confirmatory or perform reflex testing. In some situations, a minimum specimen volume may result in a QNS (quantity not sufficient) result, requiring a second specimen to be collected.
Mild OK; Gross reject
Mild OK; Gross reject
Specimen Stability Information Provides a description of the temperatures required to transport a specimen to the laboratory. Alternate acceptable temperature(s) are also included.
|Serum||Refrigerated (preferred)||14 days|
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
The measles virus is a member of the Paramyxoviridae family of viruses, which include parainfluenza virus serotypes 1-4, mumps, respiratory syncytial virus (RSV), and metapneumovirus. The measles virus is among the most highly contagious infectious diseases among unvaccinated individuals and is transmitted through direct contact with aerosolized droplets or other respiratory secretions from infected individuals. Measles has an incubation period of approximately 8 to 12 days, which is followed by a prodromal phase of high fever, cough, coryza, conjunctivitis, and malaise. Koplik spots may also be apparent on the buccal mucosa and can last for 12 to 72 hours.(1,2) Following this phase, a maculopapular, erythematous rash develops beginning behind the ears and on the forehead and spreading centrifugally to involve the trunk and extremities.
Immunocompromised individuals, pregnant women, and those with nutritional deficiencies, are particularly at risk for serious complications following measles infection, which include pneumonia and central nervous system involvement.(1,3)
Following implementation of the national measles vaccination program in 1963, the incidence of measles infection has fallen to <0.5 cases per 1,000,000 population and the virus is no longer considered endemic in the United States.(4) Measles outbreaks continue to occur in the United States due to exposure of nonimmune individuals or those with waning immunity to infected travelers. The measles outbreak in 2011 throughout Western Europe emphasizes the persistence of the virus in the worldwide population and the continued need for national vaccination programs.(5)
The diagnosis of measles infection is often based on clinical presentation alone. The presence of IgM-class antibodies suggests recent infection, but should not be used alone to diagnose measles infection. Screening for IgG-class antibodies to measles virus will aid in identifying nonimmune individuals.
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 negative or positive)
Vaccinated: positive (> or =1.1 AI)
Unvaccinated: negative (< or =0.8 AI)
The presence of IgM-class antibodies, with or without the presence of IgG-class antibodies to measles virus may support a clinical diagnosis of recent/acute phase infection with the virus. IgM results alone should not be used to diagnose measles virus infection.
The absence of IgM-class antibodies suggests lack of an acute phase infection with measles virus. However serology may be negative for IgM-class antibodies in early disease, and results should be interpreted in the context of clinical findings.
Testing for IgM-class antibodies to measles should be limited to patients with clinically compatible disease.
The presence of detectable IgG-class antibodies, in the absence of IgM-class antibodies, indicates prior exposure to the measles virus through infection or immunization. These individuals are considered immune to measles infection.
The absence of detectable IgG-class antibodies suggests the lack of a specific immune response to immunization or no prior exposure to the measles virus. These individuals are considered nonimmune to measles virus infection.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
A serum specimen drawn during the acute phase of infection or soon after vaccination may yield negative for IgM- or IgG-class antibodies.
Rare heterotypic IgM responses to measles virus have been reported in patients with rubella virus, chronic active hepatitis, systemic lupus, and infectious mononucleosis.(6)
IgG-class antibodies to measles virus may be present in serum specimens from individuals who have received blood products within the past several months, but who have not been immunized or have experienced past infection with this virus
To evaluate the accuracy of the BioPlex Measles IgG multiplex flow immunoassay (MFI), 500 prospective serum samples were analyzed in a blinded fashion by the Diamedix Measles IgG EIA (Diamedix, Miami, FL) and the BioPlex Measles IgG assay. Samples with discordant results after initial testing were repeated by both assays during the same freeze/thaw cycle. Further discrepancies were evaluated by the SeraQuest Measles IgG EIA (Quest Int., Doral, FL). The results are summarized below:
Diamedix Measles IgG EIA
BioPlex Measles IgG
(a) This sample tested negative by the SeraQuest Measles IgG EIA
(b) All 10 samples tested positive by the SeraQuest Measles IgG EIA
Sensitivity: 94.6% (420/444); 95% Confidence Intervals (95% CI): 92.1%-96.4%
Specificity: 96.4% (27/28); 95% CI: 80.8%-100.0%
Overall Percent Agreement: 91.6% (458/500); 95% CI: 88.8%-93.8%
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
1. Perry RT, Halsey NA: The clinical significance of measles-a review. J Infect Diseases 2004;189(Supp 1):S4-S16
2. Babbott FL, Gordon JE: Modern measles. Am J Med Sci 1954;228:334-361
3. Liebert UG: Measles virus infections of the central nervous system. Intervirology 1997;40:176-184
4. Morbidity and Mortality Weekly Report: Measles-United States, 1999. 2000;49(25):557-560
5. Morbidity and Mortality Weekly Report: Increased Transmission and Outbreaks of Measles-European Region 2011;60(47):1605-1610
6. Cremer NE, Devlin VL, Riggs JL, Hagens SJ: Anomalous antibody responses in viral infection: specific stimulation or polyclonal activation? J Clin Microbiol 1984;20:468-472
Method Description Describes how the test is performed and provides a method-specific reference
The presence of IgM-class antibody to rubeola is determined by an indirect immunofluorescence assay (IFA). Serum is incubated with VZV antigen, which is adhered to a glass microscope slide. Antibodies, if present, will bind to the antigen forming stable antigen-antibody complexes. If no antibodies are present, the complexes will not be formed and the serum components will be washed away. Fluorescein-labeled antihuman-IgM antibody is added to the reaction side and binds to IgM antibodies, if present. This results in a positive reaction of bright apple-green fluorescence when viewed with a fluorescence microscope.(Package insert: Measles Virus Antigen Substrate Slide, BION Enterprises, Des Plaines, IL)
The BioPlex 2200 Measles IgG assay uses multiplex flow immunoassay technology. Briefly, serum samples are mixed and incubated at 37 degrees C with sample diluent and dyed beads coated with measles antigen. After a wash cycle, antihuman-IgG antibody conjugated to phycoerythrin (PE) is added to the mixture and incubated at 37 degrees C. Excess conjugate is removed in another wash cycle and the beads are resuspended in wash buffer. The bead mixture then passes through a detector that identifies the bead based on dye fluorescence and determines the amount of antibody captured by the antigen based on the fluorescence of the attached PE. Raw data is calculated in relative fluorescence intensity.
Three additional dyed beads, an internal standard bead, a serum verification bead, and a reagent blank bead, are present in each reaction mixture to verify detector response, the addition of serum to the reaction vessel and the absence of significant nonspecific binding in serum.(Package insert: BioPlex 2200 System MMRV IgG, Bio-Rad Laboratories Clinical Diagnostics Group, Hercules, CA)
Day(s) and Time(s) Test Performed Outlines the days and times the test is performed. This field reflects the day and time the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time required before the test is performed. Some tests are listed as continuously performed, which means assays are performed several times during the day.
Monday through Saturday, 9 a.m.
Analytic Time Defines the amount of time it takes the laboratory to setup and perform the test. This is defined in number of days. The shortest interval of time expressed is "same day/1 day," which means the results may be available the same day that the sample is received in the testing laboratory. One day means results are available 1 day after the sample is received in the laboratory.
Same day/1 day
Maximum Laboratory Time Defines the maximum time from specimen receipt at Mayo Medical Laboratories until the release of the test result
Specimen Retention Time Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location The location of the laboratory that performs the test
CPT Code Information Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Medical Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
LOINC® Code Information Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the result codes returned for this test or profile.
|Result ID||Reporting Name||LOINC Code|
|80979||Measles (Rubeola) Ab, IgM, S||21503-8|
|ROG||Measles (Rubeola) Ab, IgG, S||In Process|
|DEXG3||Measles IgG Antibody Index||In Process|