Specimen Required

Serology: Suitable specimens are individual samples (human sera or EDTA/heparinized/citrated plasma) obtained by standard laboratory techniques.

Specimen Minimum Volume

0.6ml

Transport Temperature

*The samples should be stored for not more than 3 days at 2-8^°C.

**For longer delay, freeze at -70^°C and transport on dry ice.

Reject Due To

Useful For

Anti-Measles IgG is an indicator of successful Measles virus vaccination or indicator of prior Measles virus exposure.

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 positive result does not differentiate active/past infection from successful vaccination. If anti-measles IgM is non-reactive it can be assumed that the patient was infected with measles virus in the past, was vaccinated in the past or has received immunoglobin.

Non-reactive: No evidence of successful vaccination. A negative result does not exclude active infection. If exposure is suspected despite a non-reactive finding, a second specimen should be collected ≥ 3 weeks after suspected exposure. Anti-measles IgM should be tested for suspected acute infection. Anti-measles IgG seroconversion from non-reactive to reactive is evidence of recent infection, successful vaccination, or from the administration of hyperimmune globulin, such as is recommended for recent mealses infections in HIV-positive children.

Indeterminate: Specimen produced results near the cut-off (indeterminate), please submit a follow up specimen ≥1 week if clinically indicated. There is insufficient evidence of successful vaccination.

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/IgG: package insert. Siemens Healthcare Diagnostics Products GmbH.

Method Description

IgG Enzyme-linked immunosorbent assay (ELISA)

Performing Laboratory Location

Newfoundland & Labrador Public Health Laboratory

St. John’s