Sign in →

Epic Code LAB8010 Measles (Rubeola) Antibodies, IgM, Serum

Important Note

Viral culture for measles (Rubeola) or mumps virus is not performed at Spectrum Health or at the Michigan Department of Health laboratory. Upper respiratory swabs collected for measles PCR testing are forwarded to the state lab, however, prior approval through coordination with your local Health Department is required. The ordering provider must fill out required State of Michigan order request form and this paperwork must accompany the specimen.

 

Michigan Department of Health: 517-335-8059

https://www.michigan.gov/mdhhs/0,5885,7-339-71551_2945_5103---,00.html

 

Additional Codes

Mayo Code: ROM

Epic Code: LAB 8010

Interface Order Alias: 10244

Cerner: 8529

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Useful For

Determining acute-phase infection with rubeola (measles) virus using IgM antibody testing

 

Aiding in the identification of nonimmune individuals through IgM antibody testing

Specimen Type

Serum


Specimen Required


Container/Tube: 

Preferred: Serum gel

Acceptable: Red top

Specimen Volume: 0.5 mL


Laboratory Test Directory Note:

COLLECTION NOTE: Volumes listed are in serum or plasma, draw approximately 2 1/2 times the requested volume in whole blood.

Specimen Minimum Volume

0.2 mL

Forms

If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.

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
Other Heat-inactivated specimen

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 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 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 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 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 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.

Method Name

Immunofluorescence Assay (IFA)

Report Available

Same day/1 to 3 days

Reporting Name

Measles (Rubeola) Ab, IgM, S

Reference Values

Negative

Reference values apply to all ages.

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.

Method Description

The presence of IgM-class antibody to measles is determined by an indirect immunofluorescence assay (IFA). 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, BION Enterprises, Des Plaines, IL, 4/2012)

Day(s) Performed

Monday through Saturday

Clinical Reference

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. Fifth edition. Edited by EH Lennette, NJ Schmidt. Washington, DC, American Public Health Association, Inc., 1979;665-693

Test Classification

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

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