Chapter 84 : Measles and Rubella Viruses

MyBook is a cheap paperback edition of the original book and will be sold at uniform, low price.

Preview this chapter:
Zoom in

Measles and Rubella Viruses, Page 1 of 2

| /docserver/preview/fulltext/10.1128/9781555816728/9781555814632_Chap84-1.gif /docserver/preview/fulltext/10.1128/9781555816728/9781555814632_Chap84-2.gif


This chapter combines the current laboratory diagnostic methods for measles virus and rubella virus for convenient review and reference. The measles virus genome is 15,894 nucleotides in length and contains six structural genes organized on the single strand of RNA in a gene order consistent with those of most of the paramyxoviruses, i.e., 3'-N, P. M, F, H, L-5'. A recent review by Rota et al. provides an excellent overview of the current status of the molecular epidemiology of measles and the global distribution of the various genotypes. The most common complications associated with measles virus infection are otitis media (7 to 9%), pneumonia (1 to 6%), and diarrhea (6%). Suitable samples for isolation of measles virus or for detection of viral antigen can be whole blood, serum, throat and nasopharyngeal secretions, urine, and, in special circumstances, brain and skin biopsy samples. Characteristic cytopathic effects (CPE) of measles virus infection include multinucleated cells and cellular inclusions (in-tracytoplasmic and intranuclear). The reverse transcriptase PCR (RT-PCR) should be considered for diagnostic use where IgM testing is compromised by the concurrent or recent use of measles virus-containing vaccine as part of an outbreak response or in settings of recent vaccine distribution, such as supplemental immunization activities. Groups of related viruses within the clades have been classified as genotypes. Time course of rubella virus-specific IgM and IgG detection by enzyme-linked immunosorbent assays (ELISAs) in sera of rubella patients.

Citation: Bellini W, Icenogle J. 2011. Measles and Rubella Viruses, p 1372-1387. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch84
Highlighted Text: Show | Hide
Loading full text...

Full text loading...


Image of FIGURE 1

CPE of measles virus when propagated in Vero/hSLAM cells, a cell line that is transfected with a gene encoding the wild-type virus receptor (CDw150) for measles virus. The cell line naturally expresses the simian form of CD46 on the cell surface. (A) Uninfected monolayer of Vero/hSLAM cells; (B) measles virus-infected monolayer of Vero/hSLAM cells with apparent syncytium formation and multinucleated giant cells (arrows).

Citation: Bellini W, Icenogle J. 2011. Measles and Rubella Viruses, p 1372-1387. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch84
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of FIGURE 2

IFA of rubella virus-infected cells using monoclonal antibody to the E2 protein. Vero cells were infected with wild-type rubella virus and 3 days after infection were fixed with cold paraformaldehyde, followed by permeabilization with -20°C methanol. Reaction of infected cells with monoclonal antibody to the E2 protein (monoclonal antibody 24–26; Meridian Life Science, Saco, ME) was followed by detection of bound monoclonal antibody with Alexa Fluor 488-conjugated, highly cross-absorbed goat anti-mouse IgG (Molecular Probes Inc., Eugene, OR). Cell nuclei were visualized by staining with propidium iodide. About 25% of the cells which stained with propidium iodide were positive for E2 protein.

Citation: Bellini W, Icenogle J. 2011. Measles and Rubella Viruses, p 1372-1387. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch84
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of FIGURE 3

Time course of rubella virus-specific IgM and IgG detection by ELISA in sera of rubella patients. Commercial IgM capture ELISA (A) and IgG indirect ELISA (B) were used to detect rubella virus-specific antibodies at the indicated number of days after onset of symptoms (usually rash); antibody index and ISR are the commercial test designations for the ratio of the optical density obtained for the test serum to the optical density obtained for a standard (cutoff) serum. The minimum signal considered positive in each test is indicated by a dashed line. Only results from patients who tested positive for IgM to rubella virus at some time after the onset of symptoms are shown.

Citation: Bellini W, Icenogle J. 2011. Measles and Rubella Viruses, p 1372-1387. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch84
Permissions and Reprints Request Permissions
Download as Powerpoint


1. Abernathy, E.,, C. Cabezas,, H. Sun,, Q. Zheng,, M.-H. Chen,, C. Castillo-Solorzano,, A. C. Ortiz,, F. Osores,, L. Oliveira,, A. Whittembury,, J. K. Andrus,, R. F. Helfand,, and J. Icenogle. 2009. Confirmation of rubella within 4 days of rash onset: comparison of rubella virus RNA detection in oral fluid with immunoglobulin M detection in serum or oral fluid. J. Clin. Microbiol. 47: 182 188.
2. Albrecht, P.,, K. Herrmann,, and G. R. Burns. 1981. Role of virus strain in conventional and enhanced measles plaque neutralization test. J. Virol. Methods 3: 251 260.
3. Angel, J. B.,, P. Walpita,, R. A. Lerch,, M. S. Sidhu,, M. Masurekar,, R. A. DeLellis,, J. T. Noble,, D. R. Snydman,, and S. A. Udem. 1998. Vaccine-associated measles pneumonitis in an adult with AIDS. Ann. Intern. Med. 129: 104 106.
4. Arista, S.,, D. Ferraro,, A. Cascio,, E. Vizzi,, and R. di Stefano. 1995. Detection of IgM antibodies specific for measles virus by capture and indirect enzyme immunoassays. Res. Virol. 146: 225 232.
5. Atkinson, W. L.,, W. A. Orenstein,, and S. Krugman. 1992. The resurgence of measles in the United States, 1989-1990. Annu. Rev. Med. 43: 451 463.
6. Banatvala, J. E.,, and D. W. G. Brown. 2004. Rubella. Lancet 363: 1127 1137.
7. Bellini, W. J.,, and P. A. Rota,. 1999. Measles (rubeola) virus, p. 603 621. In E. H. Lennette, and T. F. Smith (ed.), Laboratory Diagnosis of Viral Infections, 3rd ed. Marcel Dekker, Inc., New York, NY.
8. Bellini, W. J.,, J. S. Rota,, L. E. Lowe,, R. S. Katz,, P. R. Dyken,, S. R. Zaki,, W.-J. Shieh,, and P. A. Rota. 2005. Subacute sclerosing panencephalitis: more cases of this fatal disease are prevented by measles immunization than previously recognized. J. Infect. Dis. 192: 1686 1693.
9. Best, J. M.,, S. O’Shea,, G. Tipples,, N. Davies,, S. M. Al- Khusaiby,, A. Krause,, L. M. Hesketh,, L. Jin,, and G. Enders. 2002. Interpretation of rubella serology in pregnancy: pitfalls and problems. Br. Med. J. 325: 147 148.
10. Best, J. M.,, J. P. Icenogle,, and D. W. G. Brown,. 2009. Rubella, p. 561 592. In A. J. Zuckerman,, J. E. Banatvala,, B. D. Schoub,, P. D. Griffiths,, and P. Mortimer (ed.), Principles and Practice of Clinical Virology, 6th ed. Wiley-Blackwell, Singapore, Singapore.
11. Bitnun, A.,, P. Shannon,, A. Durward,, P. A. Rota,, W. J. Bellini,, C. Graham,, E. Wang,, E. L. Ford-Jones,, P. Cox,, L. Becker,, M. Fearon,, M. Petric,, and R. Tellier. 1999. Measles inclusion body encephalitis caused by the vaccine strain of measles virus. Clin. Infect. Dis. 29: 855 861.
12. Bosma, T. J.,, K. M. Corbett,, S. O’Shea,, J. E. Banatvala,, and J. M. Best. 1995. PCR for detection of rubella virus RNA in clinical samples. J. Clin. Microbiol. 33: 1075 1079.
13. Brodsky, A. L. 1972. Atypical measles: severe illness in recipients of killed measles virus vaccine upon exposure to natural infection. JAMA 222: 1415 1416.
14. Brown, D.,, M. Ramsey,, A. Richards,, and E. Miller. 1994. Salivary diagnosis of measles: a study of notified cases in the United Kingdom, 1991-3. Br. Med. J.. 308: 1015 1017.
15. Castillo-Solórzano, C.,, and J. K. Andrus. 2004. Rubella elimination and improving health care for women. Emerg. Infect. Dis. 10: 2017 2021.
16. Centers for Disease Control. 1981. Measles encephalitis— United States, 1962-1979. MMWR Morb. Mortal. Wkly. Rep. 30: 362364.
17. Centers for Disease Control and Prevention. 2001. Control and prevention of rubella: evaluation and management of suspected outbreaks, rubella in pregnant women, and surveillance for congenital rubella syndrome. MMWR Morb. Mortal. Wkly. Rep. 50( RR-12): 123.
18. Centers for Disease Control and Prevention. 2001. Notice to readers: revised ACIP recommendation for avoiding pregnancy after receiving a rubella-containing vaccine. MMWR Morb. Mortal. Wkly. Rep. 50: 1117.
19. Centers for Disease Control and Prevention. 2005. Achievements in public health: elimination of rubella and congenital rubella syndrome—United States, 1969-2004. MMWR Morb. Mortal. Wkly. Rep. 54: 279282.
20. Centers for Disease Control and Prevention. 2005. Global Measles and Rubella Laboratory Network, January 2004-June 2005. MMWR Morb. Mortal. Wkly. Rep. 54: 11001104.
21. Centers for Disease Control and Prevention. 2008. Multistate measles outbreak associated with an international youth sporting event—Pennsylvania, Michigan, and Texas, August-September, 2007. MMWR Morb. Mortal. Wkly. Rep. 57: 169173.
22. Centers for Disease Control and Prevention. 2008. Outbreak of measles—San Diego, California, January-February 2008. MMWR Morb. Mortal. Wkly. Rep. 57: 203206.
23. Centers for Disease Control and Prevention. 2008. Recommendations from an ad hoc meeting of the WHO measles and rubella laboratory network (LabNet) on use of alternative diagnostic samples for measles and rubella surveillance. MMWR Morb. Mortal. Wkly. Rep. 57: 657660.
24. Centers for Disease Control and Prevention. 2008. Update: measles—United States, January-July 2008. MMWR Morb. Mortal. Wkly. Rep. 57: 893896.
25. Centers for Disease Control and Prevention. 2008. Progress in measles control and mortality reduction, 2000-2007. MMWR Morb. Mortal. Wkly. Rep. 57: 13031306.
26. Chantler, J.,, J. S. Wolinsky,, and A. Tingle,. 2001. Rubella virus, p. 963 990. In D. M. Knipe,, P. M. Howley,, D. E. Griffin,, R. A. Lamb,, M. A. Martin,, B. Roizman,, and S. E. Straus (ed.), Fields Virology, 4th ed. Lippincott Williams and Wilkins, Philadelphia, PA.
27. Chen, M.-H.,, Z. Zhen,, Y. Zhang,, S. Favors,, W. Xu,, D. A. Featherstone,, and J. P. Icenogle. 2007. An indirect immunocolorimetric assay to detect rubella virus infected cells. J. Virol. Methods 146: 414 418.
28. Chen, R. T.,, L. E. Markowitz,, P. Albrecht,, J. A. Stewart,, L. M. Mofenson,, S. R. Preblud,, and W. A. Orenstein. 1990. Measles antibody: reevaluation of protective titers. J. Infect. Dis. 162: 1036 1042.
29. Chernesky, M. A.,, and J. B. Mahony,. 1999. Rubella virus, p. 964 969. In P. R. Murray,, E. J. Baron,, M. A. Pfaller,, F. C. Tenover,, and R. H. Yolken (ed.), Manual of Clinical Microbiology, 7th ed. ASM Press, Washington, DC.
30. Cohen, B. J.,, R. P. Parry,, D. Doblas,, D. Samuel,, L. Warrener,, N. Andrews,, and D. Brown. 2006. Measles immunity testing: comparison of two measles IgG ELISAs with plaque reduction neutralisation assay. J. Virol. Methods 131: 209 212.
31. Cohen, B. J.,, S. Audet,, N. Andrews,, J. Beeler, and on Behalf of the WHO Working Group on Measles Plaque Reduction Neutralization Test. 2007. Plaque reduction neutralization test for measles antibodies: description of a standardised laboratory method for use in immunogenicity studies of aerosol vaccination. Vaccine 26: 59 66.
32. Condorelli, F.,, G. Scalia,, A. Stivala,, R. Gallo,, A. Marino,, C. M. Battaglini,, and A. Castro. 1994. Detection of immunoglobulin G to measles virus, rubella virus, and mumps virus in serum samples and in microquantities of whole blood dried on filter paper. J. Virol. Methods 49: 25 36.
33. Condorelli, F.,, A. Stivala,, R. Gallo,, A. Marino,, C. M. Battaglini,, A. Messina,, G. Russo,, A. Castro,, and G. Scalia. 1998. Use of a microquantity enzyme immunoassay in a largescale study of measles, mumps, and rubella immunity in Italy. Eur. J. Clin. Microbiol. Infect. Dis. 17: 49 52.
34. Cooper, L. Z. 1985. The history and medical consequences of rubella. Rev. Infect. Dis. 7: S2 S10.
35. Cooray, S.,, L. Warrener,, and L. Jin. 2006. Improved RTPCR for diagnosis and epidemiological surveillance of rubella. J. Clin. Virol. 35: 73 80.
36. Cutts, F. T.,, and E. Vynnycky. 1999. Modeling the incidence of congenital rubella syndrome in developing countries. Int. J. Epidemiol. 28: 1176 1184.
37. Davis, W. J.,, H. E. Larson,, J. P. Simsarian,, P. D. Parkman,, and H. M. Meyer, Jr. 1971. A study of rubella immunity and resistance to infection. JAMA 215: 600 608.
38. de Sousa, V. A.,, C. S. Pannuti,, L. M. Sumita,, and P. Albrecht. 1991. Enzyme-linked immunosorbent assay (ELISA) for measles antibody. A comparison with hemagglutination inhibition, immunofluorescence and plaque neutralization tests. Rev. Inst. Med. Trop. São Paulo 33: 32 36.
39. de Souza, V. A.,, C. S. Pannuti,, L. M. Sumita,, and H. F. de Andrade. 1997. Enzyme-linked immunosorbent assay-IgG antibody avidity test for single sample serologic evaluation of measles vaccines. J. Med. Virol. 52: 275 279.
40. de Souza, V. A.,, L. M. Sumita,, M. E. Otsubo,, K. Trakei,, and C. S. Pannuti. 1995. Enzyme linked immunosorbent assay for rubella antibodies: a simple method of antigen production. A preliminary report. Rev. Inst. Med. Trop. São Paulo 37: 357 359.
41. De Swart, R. L.,, Y. Nur,, A. Abdallah,, H. Kruining,, H. S. Mubarak,, S. A. Ibrahim,, B. Van Den Hoogen,, J. Groen,, and A. D. Osterhaus. 2001. Combination of reverse transcriptase PCR analysis and immunoglobulin M detection on filter paper blood samples allows diagnostic and epidemiological studies of measles. J. Clin. Microbiol. 39: 270 273.
42. Edmonson, M. D. B.,, G. Addiss,, J. T. McPherson,, J. L. Berg,, S. R. Circo,, and J. P. Davis. 1990. Mild measles and secondary vaccine failure during a sustained outbreak in a highly vaccinated population. JAMA 263: 2467 2471.
43. Enders, G. 1985. Serologic test combinations for safe detection of rubella infections. Rev. Infect. Dis. 7: S113 S122.
44. Erdman, D. D.,, L. J. Anderson,, D. R. Adams,, J. A. Stewart,, L. E. Markowitz,, and W. J. Bellini. 1991. Evaluation of monoclonal antibody-based capture enzyme immunoassays for detection of specific antibodies to measles virus. J. Clin. Microbiol. 29: 1466 1471.
45. Erdman, D. D.,, J. L. Heath,, J. C. Watson,, L. E. Markowitz,, and W. J. Bellini. 1993. Immunoglobulin M antibody response to measles virus following primary and secondary vaccination and natural infection. J. Med. Virol. 41: 44 48.
46. Esolen, L. M.,, B. J. Ward,, T. R. Moench,, and D. E. Griffin. 1993. Infection of monocytes during measles. J. Infect. Dis. 168: 47 52.
47. Frey, T. K.,, and E. S. Abernathy. 1993. Identification of strain-specific nucleotide sequences in the RA27/3 rubella virus vaccine. J. Infect. Dis. 168: 854 864.
48. Frey, T. K.,, E. S. Abernathy,, T. J. Bosma,, W. G. Starkey,, K. M. Corbett,, J. M. Best,, S. Katow,, and S. C. Weaver. 1998. Molecular analysis of rubella virus epidemiology across three continents, North America, Europe, and Asia, 1961-1997. J. Infect. Dis. 178: 642 650.
49. Fujino, M.,, N. Yoshida,, S. Yamaguchi,, N. Hosaka,, Y. Ota,, T. Notomi,, and T. Nakayama. 2005. A simple method for the detection of measles virus genome by loop-mediated isothermal amplification (LAMP). J. Med. Virol. 76: 406 413.
50. Gershon, A.,, and S. Krugman,. 1979. Measles virus, p. 665 693. In E. H. Lennette, and N. J. Schmidt (ed.), Diagnostic Procedures for Viral, Rickettsial and Chlamydial Infections. American Public Health Association, Washington, DC.
51. Gibbs, F. A.,, E. L. Gibbs,, P. R. Carpenter,, and H. W. Spies. 1959. Electroencephalographic abnormality to “ uncomplicated” childhood diseases. JAMA 72: 1050 1055.
52. Gregg, N. M. 1941. Congenital cataract following German measles in the mother. Trans. Ophthalmol. Soc. Aust. 3: 35 46.
53. Griffin, D. E.,, and W. J. Bellini,. 1996. Measles virus, p. 1267 1312. In B. N. Fields,, D. M. Knipe,, and P. M. Howley (ed.), Fields Virology, 3rd ed., vol. I. Lippincott-Raven Publishers, Philadelphia, PA.
54. Haralambieva, I. H.,, I. G. Ovsyannikova,, R. A. Vierkant,, and G. A. Poland. 2008. Development of a novel efficient fluorescent-based plaque reduction microneutralization assay for measles virus immunity. Clin. Vaccine Immunol. 15: 1054 1059.
55. Helfand, R. F.,, C. Cabezas,, E. Abernathy,, C. Castillo- Solorzano,, A. C. Ortiz,, H. Sun,, F. Osores,, L. Oliveira,, A. Whittembury,, M. Charles,, J. Andrus,, and J. Icenogle. 2007. Comparison of detection of rubella-specific IgM and IgG in dried blood spots and sera collected during a rubella outbreak in Peru. Clin. Vaccine Immunol. 14: 1522 1525.
56. Helfand, R. F.,, J. L. Heath,, L. J. Anderson,, E. F. Maes,, D. Guris,, and W. J. Bellini. 1997. Diagnosis of measles with an IgM capture EIA: the optimal timing of specimen collection after rash onset. J. Infect. Dis. 175: 195 199.
57. Helfand, R. F.,, S. Kebede,, J. P. Alexander,, W. Alemu,, J. L. Heath,, H. E. Gary,, L. J. Anderson,, H. Beyene,, and W. J. Bellini. 1996. Comparative detection of measles-specific IgM in oral fluid and serum from children by an antibody-capture IgM EIA. J. Infect. Dis. 173: 1470 1474.
58. Helfand, R. F.,, H. L. Keyserling,, I. Williams,, A. Murray,, J. Mei,, C. Moscatiello,, J. Icenogle,, and W. J. Bellini. 2001. Comparative detection of measles and rubella IgM and IgG derived from filter paper blood and serum samples. J. Med. Virol. 65: 751 757.
59. Helfand, R. F.,, D. K. Kim,, H. E. Gary,, G. L. Edwards,, G. P. Bisson,, M. J. Papania,, J. L. Heath,, D. L. Schaff,, W. J. Bellini,, S. C. Redd,, and L. J. Anderson. 1998. Nonclassic measles infections in an immune population exposed to measles during a college bus trip. J. Med. Virol. 56: 337 341.
60. Hofmann, J.,, M. Kortung,, B. Pustowoit,, R. Faber,, U. Piskazeck,, and U. G. Liebert. 2000. Persistent fetal rubella vaccine virus infection following inadvertent vaccination during early pregnancy. J. Med. Virol. 61: 155 158.
61. Hornig, M.,, T. Briese,, T. Buie,, M. L. Bauman,, G. Lauwers,, U. Siemetzki,, K. Hummel,, P. A. Rota,, W. J. Bellini,, J. J. O’Leary,, O. Sheils,, E. Alden,, L. Pickering,, and W. I. Lipkin. 2008. Lack of association between measles virus vaccine and autism with enteropathy: a case-control study. PLoS One 3: e3140.
62. Horstmann, D. M., 1991. Rubella, p. 617 631. In A. S. Evens (ed.), Viral Infections of Humans: Epidemiology and Control. Plenum Medical Book Company, New York, NY.
63. Hummel, K. B.,, D. D. Erdman,, J. L. Heath,, and W. J. Bellini. 1992. Baculovirus expression of the nucleoprotein gene of measles virus and utility of the recombinant protein in diagnostic enzyme immunoassays. J. Clin. Microbiol. 30: 2874 2880.
64. Hummel, K. B.,, L. Lowe,, W. J. Bellini,, and P. A. Rota. 2006. Development of quantitative gene-specific real-time RT-PCR assays for the detection of measles virus in clinical specimens. J. Virol. Methods 132: 166 173.
65. Hutchins, S. S.,, L. E. Markowitz,, P. Mead,, D. Mixon,, J. Sheline,, N. Greenberg,, S. R. Preblud,, W. A. Orenstein,, and H. F. Hull. 1990. A school-based measles outbreak: the effect of a selective revaccination policy and risk factors for vaccine failure. Am. J. Epidemiol. 132: 157 168.
66. Hyde, T. B.,, R. Nandy,, C. J. Hickman,, J. R. Langidrik,, P. M. Strebel,, M. J. Papania,, J. F. Seward,, and W. J. Bellini. 2009. Laboratory confirmation of measles in elimination settings: experience from the Republic of the Marshall Islands, 2003. Bull. W. H. O. 87: 93 98.
67. Icenogle, J. P.,, T. K. Frey,, E. Abernathy,, S. E. Reef,, D. Schnurr,, and J. A. Stewart. 2006. Genetic analysis of rubella viruses found in the United States between 1966 and 2004: evidence that indigenous rubella viruses have been eliminated. Clin. Infect. Dis. 43( Suppl. 3): S127 S132
68. Jenkerson, S. A.,, M. Beller,, J. P. Middaugh,, and D. D. Erdman. 1995. False positive rubeola IgM tests. N. Engl. J. Med. 332: 1103 1104.
69. Jin, L.,, A. Vyse,, and D. W. Brown. 2002. The role of RT-PCR assay of oral fluid for diagnosis and surveillance of measles, mumps and rubella. Bull. W. H. O. 80: 76 77.
70. Johnson, R. T.,, D. E. Griffin,, R. L. Hirsch,, J. S. Wolinsky,, S. Roedenbeck,, I. Lindo de Soriano,, and A. Vaisberg. 1984. Measles encephalomyelitis—clinical and immunologic studies. N. Engl. J. Med. 310: 137 141.
71. Katow, S. 1998. Rubella virus genome diagnosis during pregnancy and mechanism of congenital rubella. Intervirology 41: 163 169.
72. Katow, S.,, and A. Sugiura. 1985. Antibody response to individual rubella virus proteins in congenital and other rubella virus infections. J. Clin. Microbiol. 21: 449 451.
73. Katz, M.,, and H. Koprowski. 1973. The significance of failure to isolate infectious viruses in cases of subacute sclerosing panencephalitis. Arch. Gesamte Virusforsch. 41: 390 393.
74. Kellenberg, J.,, S. Buseman,, K. Wright,, J. F. Modlin,, E. A. Talbot,, J. T. Montero,, S. Reef,, E. Abernathy,, J. Icenogle,, and R. Plotinsky. 2005. Brief report: imported case of congenital rubella syndrome—New Hampshire, 2005. MMWR Morb. Mortal. Wkly. Rep. 54: 1160 1161.
75. Kobune, F.,, H. Sakata,, and A. Sugiura. 1990. Marmoset lymphoblastoid cells as a sensitive host for isolation of measles virus. J. Virol. 64: 700 705.
76. LaBoccetta, A. C.,, and A. S. Tornay. 1964. Measles encephalitis. Report of 61 cases. Am. J. Dis. Child. 107: 247 255.
77. Lee, J.-Y.,, and D. S. Bowden. 2000. Rubella virus replication and links to teratogenicity. Clin. Microbiol. Rev. 13: 571 587.
78. Mercader, S.,, D. Featherstone,, and W. J. Bellini. 2006. Comparison of available methods to elute serum from dried blood spot samples for measles serology. J. Virol. Methods 137: 140 149.
79. Minnich, L. L.,, F. Goodenough,, and C. G. Ray. 1991. Use of immunofluorescence to identify measles virus infections. J. Clin. Microbiol. 29: 1148 1150.
80. Minussi, L.,, R. Mohrdieck,, M. Bercini,, T. Ranieri,, M. T. V. Sanseverino,, W. Momino,, S. M. Callegari-Jacques,, and L. Schuler-Faccini. 2008. Prospective evaluation of pregnant women vaccinated against rubella in southern Brazil. Reprod. Toxicol. 25: 120 123.
81. Modlin, J. F.,, J. T. Jabbour,, J. J. Witte,, and N. A. Halsey. 1977. Epidemiologic studies of measles, measles vaccine, and subacute sclerosing panencephalitis. Pediatrics 59: 505 512.
82. Monafo, W. J.,, D. B. Haslam,, R. L. Roberts,, S. Zaki,, W. J. Bellini,, and C. M. Coffin. 1994. Disseminated measles infection following vaccination in a child with a congenital immune deficiency. J. Pediatr. 124: 273 276.
83. Mubareka, S.,, H. Richards,, M. Gray,, and G. A. Tipples. 2007. Evaluation of commercial rubella immunoglobulin G avidity assays. J. Clin. Microbiol. 45: 231 233.
84. Mustafa, M. M.,, S. D. Weitman,, N. J. Winick,, W. J. Bellini,, C. F. Timmons,, and J. D. Siegel. 1993. Subacute measles encephalitis in the young immunocompromised host: report of two cases diagnosed by polymerase chain reaction and treated with ribavirin and review of the literature. Clin. Infect. Dis. 16: 654 660.
85. Nakayama, T.,, T. Mori,, S. Yamaguchi,, S. Sonoda,, S. Asamura,, R. Yamashita,, Y. Takeuchi,, and T. Urano. 1995. Detection of measles virus genome directly from clinical samples by reverse transcriptase-polymerase chain reaction and genetic variability. Virus Res. 35: 1 16.
86. Naniche, D.,, G. Varior-Krishnan,, F. Cervoni,, T. F. Wild,, B. Rossi,, C. Rabourdin-Combe,, and D. Gerlier. 1993. Human membrane cofactor protein (CD46) acts as a cellular receptor for measles virus. J. Virol. 67: 6025 6032.
87. Nedeljkovic, J.,, T. Jovanovic,, and C. Oker-Blom. 2001. Maturation of IgG avidity to individual rubella virus structural proteins. J. Clin. Virol. 22: 47 54.
88. Nokes, D. J.,, F. Enquselassie,, W. Nigatu,, A. J. Vyse,, B. J. Cohen,, D. W. Brown,, and F. T. Cutts. 2001. Has oral fluid the potential to replace serum for the evaluation of population immunity levels? A study of measles, rubella and hepatitis B in rural Ethiopia. Bull. W. H. O. 79: 588 595.
89. Ono, N.,, H. Tatsuo,, Y. Hidaka,, T. Aoki,, H. Minagawa,, and Y. Yanagi. 2001. Measles viruses on throat swabs from measles patients use signaling-lymphocyte activation molecule (CDw150) but not CD46 as a cellular receptor. J. Virol. 75: 4399 4401.
90. Parkman, P. D.,, and E. L. Buescher. 1962. Recovery of rubella virus from army recruits. Proc. Soc. Exp. Biol. Med.. 111: 225 230.
91. Parry, J. V.,, K. R. Perry,, and P. P. Mortimer. 1987. Sensitive assays for viral antibodies in saliva: an alternative to tests on serum. Lancet ii: 72 75.
92. Parry, J. V.,, K. R. Perry,, S. Panday,, and P. P. Mortimer. 1989. Diagnosis of hepatitis A and B by testing saliva. J. Med. Virol.. 28: 255 260.
93. Paunio, M.,, K. Hedman,, I. Davidkin,, and H. Peltola. 2003. IgG avidity to distinguish secondary from primary vaccination failures: prospects for a more effective global measles elimination strategy. Expert Opin. Pharmacother. 4: 1215 1225.
94. Perry, K.,, D. Brown,, J. Parry,, S. Panday,, C. Pipkin,, and A. Richards. 1993. Detection of measles, mumps, and rubella antibodies in saliva using antibody capture radioimmunoassay. J. Med. Virol. 40: 235 240.
95. Plotkin, S. A., 1999. Rubella vaccine, p. 409 439. In S. A. Plotkin, and W. A. Orenstein (ed.), Vaccines, 3rd ed. W. B. Saunders, Philadelphia, PA.
96. Plotkin, S. A. 2001. Rubella eradication. Vaccine 19: 3311 3319.
97. Punnarugsa, V.,, and V. Mungmee. 1991. Detection of rubella virus immunoglobulin G (IgG) and IgM antibodies in whole blood on Whatman paper: comparison with detection in sera. J. Clin. Microbiol. 29: 2209 2212
98. Ramsay, M. E.,, R. Brugha,, D. W. Brown,, B. J. Cohen,, and E. Miller. 1998. Salivary diagnosis of rubella: a study of notified cases in the United Kingdom, 1991-4. Epidemiol. Infect. 120: 315 319.
99. Ratnam, S.,, V. Gadag,, R. West,, J. Burris,, E. Oates,, F. Stead,, and N. Bouilianne. 1995. Comparison of commercial enzyme immunoassay kits with plaque reduction neutralization test for detection of measles virus antibody. J. Clin. Microbiol. 33: 811 815.
100. Ratnam, S.,, G. Tipples,, C. Head,, M. Fauvel,, M. Fearon,, and B. J. Ward. 2000. Performance of indirect immunoglobulin M (IgM) serology tests and IgM capture assays for laboratory diagnosis of measles. J. Clin. Microbiol. 38: 99 104.
101. Reef, S. E.,, T. K. Frey,, K. Theall,, E. Abernathy,, C. L. Burnett,, J. Icenogle,, M. M. McCauley,, and M. Wharton. 2002. The changing epidemiology of rubella in the 1990s: on the verge of elimination and new challenges for control and prevention. JAMA 287: 464 472.
102. Reef, S. E.,, S. Plotkin,, J. F. Cordero,, M. Katz,, L. Cooper,, B. Schwartz,, L. Zimmerman-Swain,, M. C. Danovaro- Holliday,, and M. Wharton. 2000. Preparing for elimination of congenital rubella syndrome (CRS): summary of a workshop on CRS elimination in the United States. Clin. Infect. Dis. 31: 85 95.
103. Riddell, M. A.,, D. Chibo,, H. A. Kelly,, M. G. Catton,, and C. G. Birch. 2001. Investigation of optimal specimen type and sampling time for detection of measles virus RNA during a measles epidemic. J. Clin. Microbiol. 39: 375 376.
104. Risco, C.,, J. L. Carrascosa,, and T. K. Frey. 2003. Structural maturation of rubella virus in the Golgi complex. Virology 312: 261 269.
105. Robertson, S. E.,, L. E. Markowitz,, D. A. Berry,, E. F. Dini,, and W. A. Orenstein. 1992. A million dollar measles outbreak: epidemiology, risk factors, and a selective revaccination strategy. Public Health Rep. 107: 24 31.
106. Rota, J. S.,, W. J. Bellini,, and P. A. Rota,. 2000. Measles, p. 168 193. In R. C. A. Thompson (ed.), Molecular Epidemiology of Infectious Diseases. Kluwer Academic & Lippincott Raven Publishers, London, United Kingdom.
107. Rota, P. A.,, A. L. Khan,, E. Durigon,, T. Yuran,, Y. S. Villamarzo,, and W. J. Bellini. 1995. Detection of measles virus in RNA in urine specimens from vaccine recipients. J. Clin. Microbiol. 33: 2485 2488.
108. Rota, P. A.,, J. S. Rota,, S. Redd,, M. Papania,, and W. J. Bellini. 2004. Genetic analysis of measles viruses isolated in the United States between 1989 and 2001: absence of an endemic genotype since 1994. J. Infect. Dis. 189( Suppl. 1): 160 164.
109. Rota, P. A.,, D. A. Featherstone,, and W. J. Bellini. 2008. Molecular epidemiology of measles virus. Curr. Top. Microbiol. Immunol. 330: 129 150.
110. Samuel, D.,, K, Sasnauskas,, L. Jin,, A. Gedvilaite,, R. Slibinskas,, S. Beard,, A. Zvirbliene,, S. A. Oliveira,, J. Staniulis,, B. Cohen,, and D. Brown. 2003. Development of a measles specific IgM ELISA for use with serum and oral fluid samples using recombinant measles nucleoprotein produced in Saccharomyces cerevisiae. J. Clin. Virol. 28: 121 129.
111. Sanders, J.,, and C. Niehaus. 1985. Screening for rubella IgG and IgM using an EIA test applied to dried blood on filter paper. J. Pediatr. 106: 457 461.
112. Schneider-Schaulies, S.,, and W. J. Bellini,. 2005. Morbilliviruses: measles virus, p. 712 743. In B. M. J. Mahy, and V. ter Meulen (ed.), Topley and Wilson’s Microbiology and Microbial Infections, 10th ed., vol. 1 and 2. Virology. Hodder Arnold Publishers, London, United Kingdom.
113. Shepard, T. H. 1995. Catalogue of Teratogenic Agents, 8th ed. Johns Hopkins University Press, Baltimore, MD.
114. Shimizu, H.,, C. A. McCarthy,, M. F. Smaron,, and J. C. Burns. 1993. Polymerase chain reaction for detection of measles virus in clinical samples. J. Clin. Microbiol. 31: 1034 1039.
115. Sidhu, M. S.,, J. Crowley,, A. Lowenthal,, D. Karcher,, J. Menonna,, S. Cook,, S. Udem,, and P. Dowling. 1994. Defective measles virus in human subacute sclerosing panencephalitis brain. Virology 202: 631 641.
116. Skendzel, L. P. 1996. Rubella immunity. Defining the level of protective antibody. Am. J. Clin. Pathol. 106: 170 174.
117. Smaron, M. F.,, E. Saxon,, L. Wood,, C. McCarthy,, and J. A. Morello. 1991. Diagnosis of measles by fluorescent antibody and culture of nasopharyngeal secretions. J. Virol. Methods 33: 223 229.
118. Takahashi, S.,, F. Machikawa,, A. Noda,, T. Oda,, and T. Tachikawa. 1998. Detection of immunoglobulin G and A antibodies to rubella virus in urine and antibody responses to vaccine- induced infection. Clin. Diagn. Lab. Immunol. 5: 24 27.
119. Tatsuo, H.,, N. Ono,, K. Tanaka,, and Y. Yanagi. 2000. SLAM (CDw150) is a cellular receptor for measles virus. Nature 406: 893 897.
120. Taylor, B.,, E. Miller,, R. Lingam,, N. Andrews,, A. Simmons,, and J. Stowe. 2002. Measles, mumps and rubella vaccination and bowel problems or developmental regression in children with autism: population study. Br. Med. J. 324: 393 396.
121. Thomas, H. I. J.,, E. Barrett,, L. M. Hesketh,, A. Wynne,, and P. Morgan-Capner. 1999. Simultaneous IgM reactivity by EIA against more than one virus in measles, parvovirus B19 and rubella infection. J. Clin. Virol. 14: 107 118.
122. Tipples, G. A.,, R. Hamkar,, T. Mohktari-Azad,, M. Gray,, J. Ball,, C. Head,, and S. Ratnam. 2004. Evaluation of rubella IgM enzyme immunoassays. J. Clin. Virol. 30: 233 238.
123. Tuokko, H. 1984. Comparison of nonspecific reactivity in indirect and reverse immunoassays for measles and mumps immunoglobulin M antibodies. J. Clin. Microbiol. 20: 972 976.
124. Tuokko, H. 1995. Detection of acute measles infections by indirect and mu-capture enzyme immunoassays for immunoglobulin M antibodies and measles immunoglobulin G antibody avidity enzyme immunoassay. J. Med. Virol. 45: 306 311.
125. Uhlmann, V.,, C. M. Martin,, O. Sheils,, L. Pilkington,, I. Silva,, A. Killalea,, S. B. Murch,, J. Walker-Smith,, M. Thomson,, A. J. Wakefield,, and J. J. O’Leary. 2002. Potential viral pathogenic mechanism for new variant inflammatory bowel disease. J. Clin. Pathol. Mol. Pathol. 55: 84 90.
126. Veitorp, M.,, and J. Leerhoy. 1981. Rubella IgG antibody detection by ELISA using capillary blood samples collected on filter paper and in microtainer tubes. Acta Pathol. Microbiol. Scand. Sect. B 89: 369 370.
127. Wakefield, A. J.,, S. H. Murch,, A. Anthony,, J. Linnell,, D. M. Casson,, M. Malik,, M. Berelowitz,, A. P. Dhillon,, M. A. Thomson,, P. Harvey,, A. Valentine,, S. E. Davies,, and J. A. Walker-Smith. 1998. Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. Lancet 351: 637 641. (Retraction, 375: 445, 2010.)
128. Wassilak, S. G.,, R. H. Bernier,, H. L. Herrmann,, W. A. Orenstein,, K. J. Bart,, and R. Amler. 1984. Measles seroconfirmation using dried capillary blood specimens in filter paper. Pediatr. Infect. Dis. 3: 117 121.
129. Webster, W. S. 1998. Teratogen update: congenital rubella. Teratology 58: 13 23.
130. Weller, T. H.,, and F. A. Neva. 1962. Propagation in tissue culture of cytopathic agents from patients with rubella-like illness. Proc. Soc. Exp. Biol. Med. 111: 215 225.
131. World Health Organization. 2007. Update of standard nomenclature for wild-type rubella viruses, 2007. Wkly. Epidemiol. Rec. 82: 209224.
131.a. World Health Organization. 2007. Manual for the Laboratory Diagnosis of Measles and Rubella Virus Infection, 2nd ed. World Health Organization, Geneva, Switzerland. http://www.who.int/immunization_monitoring/LabManualFinal.pdf.
132. Zaki, S. R.,, and W. J. Bellini,. 1997. Measles, p. 233 244. In D. H. Connor,, F. W. Chandler,, D. A. Schwartz,, H. J. Manz,, and E. E. Lack (ed.), Pathology of Infectious Diseases. Appleton and Lange Publishers, Stamford, CT.
133. Zhu, Z.,, W. Xu,, E. A. Abernathy,, M.-H. Chen,, Q. Zheng,, T. Wang,, Z. Zhang,, C. Li,, C. Wang,, W. He,, S. Zhou,, and J. Icenogle. 2007. Comparison of four methods using throat swabs to confirm rubella virus infection. J. Clin. Microbiol. 45: 2847 2852.


Generic image for table

Interpretation of measles virus EIA results

Modified from reference .

MCV, measles virus-containing vaccine.

IgG level depends on timing of specimen collection.

Rare occurrence; do not consider contagious unless clinical presentation is consistent with measles.

If result is IgM negative, it is helpful to rule out wild-type measles virus infection.

Citation: Bellini W, Icenogle J. 2011. Measles and Rubella Viruses, p 1372-1387. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch84
Generic image for table

Timing of biological markers of rubella virus infection

Times and percentages given are approximate and are meant to guide typical specimen collection. Percentages vary depending on the sensitivity of the assay used. Note that the times listed in the third column were chosen to help guide specimen collection and may not be the earliest time when >90% of cases are positive.

After maximum number of cases are positive for a given criterion, the approximate time for 50% of cases to become negative.

“Alternative” specimens, OMT and DBS, have been evaluated for detection of virus (OMT) and IgM (OMT and DBS). See references , and .

v Data taken from reference .

Information given is for fetal infection in the first trimester.

Declining maternal IgG and developing IgG response in a CRS patient lead to high (steady) or increasing IgG levels in the CRS patient through the first year of life.

Citation: Bellini W, Icenogle J. 2011. Measles and Rubella Viruses, p 1372-1387. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch84

This is a required field
Please enter a valid email address
Please check the format of the address you have entered.
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error