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HelpTest Code ROM Measles (Rubeola) Antibodies, IgM, Serum
Reporting Name
Measles (Rubeola) Ab, IgM, SUseful For
Determining acute-phase infection with rubeola (measles) virus using IgM antibody testing
Aiding in the identification of nonimmune individuals through IgM antibody testing
Method Name
Immunofluorescence Assay (IFA)
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
SerumSpecimen Required
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 0.5 mL
Collection Instructions: Centrifuge and aliquot serum into a plastic vial.
Specimen Minimum Volume
0.2 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Refrigerated (preferred) | 14 days | |
| Frozen | 14 days |
Reject Due To
| Gross hemolysis | Gross reject |
| Gross lipemia | Gross reject |
| Heat-inactivated specimen | Reject |
Reference Values
Negative
Reference values apply to all ages.
Day(s) Performed
Monday through Saturday
CPT Code Information
86765
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| ROM | Measles (Rubeola) Ab, IgM, S | 35276-5 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 80979 | Measles (Rubeola) Ab, IgM, S | 35276-5 |
Clinical Information
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 one of 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 below 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, however, 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 aids in identifying nonimmune individuals.
Interpretation
This assay tests only for IgM-class antibody. For both IgM and IgG antibody testing, see ROGM / Measles (Rubeola) Virus Antibody, IgM and IgG (Separate Determinations), Serum.
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
Grossly contaminated, hemolyzed, hyperlipemic, or icteric serum may yield unreliable results. Serum specimens must not be heat-inactivated prior to testing.
A serum specimen collected 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)
Method Description
The presence of IgM-class antibody to measles is determined by an indirect immunofluorescence assay. After removal of IgG by specific immunoglobulin antibody, the serum is incubated with measles 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. AESKU.BION; 09/2019)