Useful For

Anti-Measles IgM is useful for the serological diagnosis of acute-phase measles virus infection.

Indications for Testing 

·  Monitoring of illness associated with measles virus

·  Aid in the differential diagnosis of erythematous rash

Clinical/Interpretive

Useful For

Anti-Measles IgM is useful for the serological diagnosis of acute-phase measles virus infection.

Clinical Information

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 causes high fever, a runny nose, cough, conjunctivitis and a rash that usually lasts from 1-2 weeks. The red blotchy rash appears on the third to seventh day, starting on the face and then becomes more generalized. Complications may result from viral replication or bacterial infections. They can include pneumonia, otitis media, laryngeotracheobronchitis, diarrhea and encephalitis. Encephalitis while rare can occur with a case fatality rate of about 10% and result in permanent disability in about 25%. Very rarely a fatal brain disease called sub acute sclerosing panencephalitis develops years later.

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. 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.  

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. One of the most highly communicable of all infectious diseases measles transmission is by direct contact with infectious droplets or by airborne spread and less commonly by articles freshly soiled with nose and throat secretions. Infants who are born to mothers who have had the disease are immune for about 6-9 months.

Link to disease control/immunization manual

Reference Values

Nonreactive

Interpretation

Reactive: A reactive result may occur with measles infection or after vaccination. The majority of acutely infected individuals will have reactive anti-measles IgM on the first day of rash presentation. Anti-measles IgM can persist for 3 months post infection. Specific anti-measles IgM is found in cases of chronic active hepatic inflammation not caused by hepatitis B virus.

Non-reactive: A non-reactive result does not exclude early active infection. If clinically indicated submit a follow-up specimen ≥ 7 days after initial non-reactive test. Anti-measles IgM may not be detected in previously vaccinated acutely infected individuals. To confirm active infection virus detection is recommended (see viral culture/link to viral culture).

Indeterminate: Specimen produced results near the cut-off (indeterminate), please submit a follow up specimen ≥1 week to resolve.

Clinical Reference

Bellini, W. J., and Icenogle, J. P. 2007. Measles and Rubella Viruses, p. 1378-1391. In Murray, P. R., Baron, E. J., Jorgensen, J. H., Landry, M. L., and Pfaller, M. A. Manual of Clinical Microbiology, 9^th ed., vol. 2. ASM Press, American Society for Microbiology, Washington, DC.

Gershon, A. A. 2010. Measles Virus (Rubeola), p. 2229-2236. In Mandell, D., Bennett, J. E., and Dolin, R. Principles and practice of infectious diseases, 7^th ed., vol. 2. Churchill Livingstone, Elsevier, Philadelphia, PA.

Siemens. 2008. Enzygnost® Anti-Measles Virus/IgM: package insert. Siemens Healthcare Diagnostics Products GmbH.