Test ID: ROP
Rubeola (Measles) Antibodies, IgG and IgM (Separate Determinations), Serum
Secondary ID 
A test code used for billing and in test definitions created prior to November 2011
NY State Approved Indicates the status of NY State approval and if the test is orderable for NY State clients.
Useful For Suggests clinical disorders or settings where the test may be helpful
Determining acute-phase infection with rubeola (measles) virus
As an aid in identifying nonimmune individuals
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 |
|---|---|---|---|
| ROSC | Rubeola (Measles) Ab, IgG, S | Yes | Yes |
| ROM | Rubeola (Measles) Ab, IgM, S | Yes | Yes |
Method Name A short description of the method used to perform the test
ROSC/80262: Enzyme Immunoassay (EIA)
ROM/80979: Immunofluorescence Assay (IFA)
Reporting Name A shorter/abbreviated version of the Published Name for a test; an abbreviated test name
Aliases Lists additional common names for a test, as an aid in searching
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.
Container/Tube:
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.
Reject Due To Identifies specimen types and conditions that may cause the specimen to be rejected
| Hemolysis | Mild OK; Gross reject |
| Lipemia | Mild OK; Gross reject |
| Icterus | NA |
| Other | NA |
Specimen Stability Information Provides a description of the temperatures required to transport a specimen to the laboratory. Alternate acceptable temperature(s) are also included.
| Specimen Type | Temperature | Time |
|---|---|---|
| Serum | Refrigerated (preferred) | 14 days |
| Frozen | 14 days |
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, immunocompromised, 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.
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)
Individuals who are immune to rubeola will have positive IgG test results by the EIA method and negative IgM test results by the IFA method. Those who are nonimmune will have negative test results by both methods. Recent infection with measles virus will be indicated by a positive IgM antibody result. The EIA test sensitivity is 96.9% and specificity is 100%. Similar performance characteristics are provided by the IFA test.
Interpretation Provides information to assist in interpretation of the test results
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)
Clinical Reference 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. Anomalous antibody responses in viral infection: specific stimulation or polyclonal activation? J Clin Microbiol 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
Method Description Describes how the test is performed and provides a method-specific reference
The presence or absence of IgG class antibody to rubeola is determined by an enzyme-linked immunosorbent assay (ELISA).
In the Immunosimplicity (IS) Measles IgG ELISA test, diluted specimens are incubated with measles antigen bound to the solid surface of a microtiter well. If IgG antibodies against measles are present in the specimen, they will bind to the antigen forming antigen-antibody complexes. Residual specimen is eliminated by aspiration and washing. Conjugate (horseradish peroxidase-labeled antihuman IgG) is added and will bind to these complexes. Unbound conjugate is removed by aspiration and washing. Substrate is then added and incubated. In the presence of bound enzyme, the substrate is converted to an end product. The absorbance of this end product can be read spectrophotometrically at 450 nm (reference 600-630 nm) and is directly proportional to the concentration of IgG antibodies to measles antigen present in the specimen. (Package insert: Immunosimplicity [Is] Measles IgG Enzyme Immunoassay Test Kit. Diamedix Corporation, Miami, FL; Herrman KL: Antibody detection. In Laboratory Diagnosis of Infectious Diseases Principles and Practice. Edited by EH Lennette, P Halonen, FA Murphy. New York, Springer-Verlag, 1988, pp 76-101)
The presence of IgM class antibody to rubeola is determined by an immunofluorescence assay (IFA). After removal of IgG by specific immunoglobulin antibody, the serum is reacted with rubeola- infected substrate cells on a slide. Specific fluorescence indicating the presence of IgM antibodies to rubeola in the specimen can be detected by an immunofluorescence microscope. (Package insert: Measles Virus Antigen Substrate Slide, BION Enterprises, Des Plaines IL)
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 Friday; 9 a.m. and 3 p.m., Saturday, Sunday; Varies
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.
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
Test Classification Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer's instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR), Investigation Use Only (IUO) product, or a Research Use Only (RUO) product.
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.
86765 x 2
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 | Rubeola (Measles) Ab, IgM, S | 21503-8 |
| ROSC | Rubeola (Measles) Ab, IgG, S | 35275-7 |
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