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Rubeola Antibodies IgG and IgM

Measles is caused by the rubeola virus, which is a single-stranded, enveloped RNA virus that is a member of the genus Morbillivirus in the Paramyxoviridae family. Humans are the only natural hosts of measles virus. Measles virus normally grows in the cells that line the back of the throat and lungs.

 Measles is a disease kills an estimated 164,000 people worldwide each year. In 2021, there were an estimated 9 million cases and 18,000 deaths from measles worldwide. An estimated 61 million measles vaccine doses were postponed or missed due to COVID19 related delays in immunization campaigns in 18 countries. Vaccination delays increase the risk of measles outbreaks.

In the decade before the measles vaccine was licensed in 1963, an average of 549,000 measles cases and 495 measles deaths were reported annually in the United States. Measles was declared eliminated in the U.S. in 2000 due to high 2-dose measles vaccine coverage, but measles cases and outbreaks still occur every year in the United States because measles is still commonly transmitted in many parts of the world. Since 2000, the annual number of cases has ranged from a low of 37 in 2004 to a high of 1,282 in 2019. Most cases involved patients who were unvaccinated.

Measles is one of the most highly contagious diseases that is transmitted by contact with an infected person through coughing and sneezing. Patients are considered to be contagious from 4 days before until 4 days after the rash appears. After an infected person leaves a location, the virus remains contagious for up to 2 hours in the air and on surfaces.

 Measles is an acute viral respiratory illness characterized by a prodrome of high fever, cough, coryza, conjunctivitis and Koplik’s spots, followed by an erythematous rash. Sometimes immunocompromised patients do not develop the rash. Koplik’s spots on the buccal mucosa are considered pathognomonic of measles and may precede onset of rash by several days. The rash usually appears about 14 days after a person is exposed; however, the incubation period ranges from 7 to 21 days. The rash spreads from the head to the trunk to the lower extremities.

People at high risk for severe illness and complications from measles include infants and children aged <5 years, adults aged >20 years, pregnant women and people who are immunocompromised. Complications include otitis media, laryngotracheobronchitis, pneumonia, diarrhea, encephalitis, and death. Approximately one in 10 children with measles also develops an ear infection, 1 in 20 pneumonia, 1 in 1000 encephalitis, and 1 in 1000 die. Subacute sclerosing panencephalitis is a rare fatal neurodegenerative disease that develops 7 to 10 years after measles infection. 

A diagnosis of measles can be confirmed by testing for rubeola/measles-specific IgG and IgM antibodies. The sensitivity of measles IgM assays varies and may be diminished during the first 72 hours after rash onset. If the result is negative for measles IgM and the patient has a generalized rash lasting more than 72 hours, a second serum specimen should be obtained and the measles IgM test should be repeated. Positive IgG results with negative IgM results indicate immunity to infection. Positive IgM results with or without positive IgG indicates recent infection. Negative IgM and IgG results usually indicate non-immunity and absence of current infection. Specimen requirement for measles/rubeola IgG and IgM is one red top tube of blood.

Respiratory specimens can be tested for measles RNA by real time polymerase chain reaction (RT-PCR). Nasopharyngeal swabs should be collected.

Suspected measles patients should be isolated & reported immediately to local and/or state public health departments. Additional information, including vaccine recommendations can be found at http://www.cdc.gov/measles/index.html.

CDC recommends routine childhood immunization with the measles-mumps-rubella-varicella vaccine (MMRV) vaccine starting with the first dose at 12 through 15 months of age and the second dose at 4 through 6 years of age. According to the Centers for Disease Control and Prevention (CDC), one dose of MMRV is 93% effective against measles and two doses are 97% effective.

Reference

https://www.cdc.gov/measles/hcp/index.html

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