Test Catalog

Test Id : ROGM

Measles (Rubeola) Virus Antibody, IgM and IgG, Serum

Useful For
Suggests clinical disorders or settings where the test may be helpful

Laboratory diagnosis of measles virus infection

 

Determination of immune status of individuals to the measles virus using IgG antibody testing

 

Documentation of previous infection with measles virus in an individual without a previous record of immunization to measles virus

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
ROM Measles (Rubeola) Ab, IgM, S Yes Yes
ROPG Measles (Rubeola) Ab, IgG, S Yes Yes

Method Name
A short description of the method used to perform the test

ROM: Immunofluorescence Assay (IFA)

ROPG: Multiplex Flow Immunoassay (MFI)

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

Measles (Rubeola) Ab, IgM and IgG,S

Aliases
Lists additional common names for a test, as an aid in searching

Measles Virus

Rubeola (Measles) Ab, IgG, IgM, S

Rubeola Antibodies, IgG and IgM (Separate Determinations), Serum

Rubeola Antibody

Specimen Type
Describes the specimen type validated for testing

Serum

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Specimen Volume: 1 mL

Forms

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

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the Testing Laboratory

0.6 mL

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

Gross hemolysis Reject
Gross lipemia Reject
Heat-inactivated specimen Reject

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 14 days
Frozen 14 days

Useful For
Suggests clinical disorders or settings where the test may be helpful

Laboratory diagnosis of measles virus infection

 

Determination of immune status of individuals to the measles virus using IgG antibody testing

 

Documentation of previous infection with measles virus in an individual without a previous record of immunization to measles virus

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

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.

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.

IMMUNOGLOBULIN M

Negative

Reference values apply to all ages.

 

IMMUNOGLOBULIN G

Vaccinated: positive (> or =1.1 AI)

Unvaccinated: negative (< or =0.8 AI)

Reference values apply to all ages.

Interpretation
Provides information to assist in interpretation of the test results

This assay tests for both IgM and IgG-class antibodies. 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
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

A serum specimen collected during the acute phase of infection or soon after vaccination may yield negative for IgM- or IgG-class antibodies.

 

Rare heterotypic IgM responses to measles virus have been reported in patients with rubella virus, chronic active hepatitis, systemic lupus, and infectious mononucleosis.(6)

 

IgG-class antibodies to measles virus may be present in serum specimens from individuals who have received blood products within the past several months, but who have not been immunized or have experienced past infection with this virus.

Supportive Data

Immunoglobulin G:

To evaluate the accuracy of the BioPlex Measles IgG multiplex flow immunoassay (MFI), 500 prospective serum samples were analyzed in a blinded fashion by the Diamedix Measles IgG EIA and the BioPlex Measles IgG assay. Samples with discordant results after initial testing were repeated by both assays during the same freeze/thaw cycle. Further discrepancies were evaluated by the SeraQuest Measles IgG EIA . The results are summarized below:

 

 

Diamedix measles IgG EIA

BioPlex measles IgG

 

Positive

Negative

Equivocal

Positive

420

1(a)

0

Negative

10(b)

27

17

Equivocal

14

0

11

(a) This sample tested negative by the SeraQuest Measles IgG EIA

(b) All 10 samples tested positive by the SeraQuest Measles IgG EIA

Sensitivity: 94.6% (420/444); 95% CI: 92.1%-96.4%

Specificity: 96.4% (27/28); 95% CI: 80.8%-100.0%

Overall Percent Agreement: 91.6% (458/500); 95% CI: 88.8%-93.8%

Clinical Reference
Recommendations for in-depth reading of a clinical nature

1. Perry RT, Halsey NA: The clinical significance of measles-a review. J Infect Dis. 2004;189(Supp 1):S4-S16

2. Babbott FL, Gordon JE: Modern measles. Am J Med Sci. 1954;228:334-361

3. Liebert UG: Measles virus infections of the central nervous system. Intervirology. 1997;40:176-184

4. Centers for Disease Control and Prevention (CDC): Measles-United States, 1999. MMWR Morb Mortal Wkly Rep. 2000;49(25):557-560

5. Centers for Disease Control and Prevention (CDC):  Increased Transmission and Outbreaks of Measles-European Region. MMWR Morb Mortal Wkly Rep. 2011;60(47):1605-1610

6. 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

Method Description
Describes how the test is performed and provides a method-specific reference

Immunoglobulin M:

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;04/2012)

 

IgG:

The BioPlex 2200 Measles IgG assay uses multiplex flow immunoassay technology. Briefly, serum samples are mixed and incubated at 37 degrees C with sample diluent and dyed beads coated with measles antigen. After a wash cycle, antihuman-IgG antibody conjugated to phycoerythrin (PE) is added to the mixture and incubated at 37 degrees C. Excess conjugate is removed in another wash cycle and the beads are resuspended in wash buffer. The bead mixture then passes through a detector that identifies the bead based on dye fluorescence and determines the amount of antibody captured by the antigen based on the fluorescence of the attached PE. Raw data is calculated in relative fluorescence intensity.

 

Three additional dyed beads, an internal standard bead, a serum verification bead, and a reagent blank bead, are present in each reaction mixture to verify detector response, the addition of serum to the reaction vessel and the absence of significant nonspecific binding in serum.(Package insert: BioPlex 2200 System MMRV IgG. Bio-Rad Laboratories; 11/30/2018)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Monday through Saturday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

Same day/1 to 3 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

14 days

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their Regional Manager. For assistance, contact Customer Service.

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 instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

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
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

86765-Rubeola IgM

86765-Rubeola IgG

LOINC® Information

Test Id Test Order Name Order LOINC Value
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.
ROGM Measles (Rubeola) Ab, IgM and IgG,S 90253-6
Result Id Test Result Name Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
80979 Measles (Rubeola) Ab, IgM, S 35276-5
ROG Measles (Rubeola) Ab, IgG, S 35275-7
DEXG3 Measles IgG Antibody Index 5244-9

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Create a PDF

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports