Detection Of Rubella-specific IgM Research Articles

Laboratory confirmation of congenital rubella syndrome in South Korea in 2017: A genomic epidemiological investigation

The WHO Regional Verification Commission certified in 2017 that Korea was the first country in the WHO Western Pacific Region to achieve rubella elimination. A suspected congenital rubella syndrome (CRS) was reported to the Korea Centers for Disease Control and Prevention in August 2017. The mother of a new-born had visited Vietnam during her pregnancy. CRS was confirmed based on the detection of rubella-specific IgM and rubella RNA in the urine and throat swab. Rubella virus isolated from the throat swab was classified as genotype 2B, and a phylogenetic analysis indicated that this genotype had been imported from Vietnam. This is the first report of CRS confirmed using virus isolation in Korea. Laboratory surveillance plays a critical role in the elimination of rubella through the provision of laboratory testing data, and characterisation of circulating strains.

Comparison of two commercial ELISA kits for detection of rubella specific IgM in suspected congenital rubella syndrome cases and rubella IgG antibodies in a serosurvey of pregnant women

Enzyme linked immunosorbent assay (ELISA) for antibody identification, is important for laboratory confirmation of rubella infection in different settings. The Enzygnost rubella ELISA, widely used in the World Health Organization (WHO) Global Measles and Rubella Laboratory Network, is expensive and often unavailable. Qualitative and quantitative performance of the Euroimmun ELISA was compared with the Enzygnost ELISA, for detection of rubella specific IgM, using 283 sera collected from suspected congenital rubella syndrome (CRS) patients and IgG antibodies using 435 sera from a serosurvey among pregnant women.Good qualitative agreement was observed for detection of both rubella specific IgM (94.7% agreement and κ of 0.86) and IgG (96.3% agreement and κ of 0.84). Bland–Altman analysis for IgG yielded a mean difference of 0.781 IU/ml with 97.1% values within ±2 SD of the mean difference.Our study findings suggest that Euroimmun ELISA may be considered for detection of rubella specific IgM in suspected CRS cases and rubella specific IgG in surveillance studies.

Laboratory confirmation of congenital rubella syndrome in infants: An eye hospital based investigation

A total of 190 specimens from South Indian children aged 0-59 months with ocular anomalies consistent with suspected congenital rubella syndrome (CRS) were investigated. Twenty-six of the 65 infants (40%) were confirmed as CRS by detection of rubella specific IgM. Rubella RNA was detected in 41 samples from 26 infants by both real-time and block based PCR. The PCR results correlated well with the presence of anti-rubella IgM/IgG (23/27 cases with rubella IgM were PCR positive). Whereas, only 17 of 26 infants met the WHO CRS case definition. Amongst the various specimens tested from the sero-confirmed cases (n = 27), a high percentage of positives were detected in lens (92%) and oral fluid (60%) specimens, when compared to other samples. The quantification of viral load by real-time PCR demonstrated higher copy number of virus in lens samples of 0-11 months infants. The rubella viruses were characterized and revealed the circulation of genotype 2B in three South Indian states. The integrated analysis of clinical manifestations, serological and molecular data in the study has generated baseline information of rubella infection and CRS in infants with ocular anomalies.

Rubéole et grossesse

Rubella usually is a mild disease with, however, serious consequences such as foetal death and a spectrum of birth defects, known as the congenital rubella syndrome. This syndrome may occur as a result of intrauterine infection, particularly during the first 4 months of pregnancy. The syndrome may affect multiple organ systems and common anomalies include cataract, deafness, congenital heart disease and mental retardation. During pregnancy, rubella serology is used to determine the immune status of the patient but it also allows diagnosis of primary infection. This diagnosis is essentially based on the detection of rubella-specific IgM but, if IgM antibody is always detected in recent primary infection, it can also be detected in other situations. Measurement of IgG avidity may help dating rubella. When primary rubella infection occurs during the first 4 months of pregnancy, prenatal diagnosis of foetal infection can be proposed. This diagnosis is based either on the detection of IgM antibody in foetal blood or on the detection of viral genome in amniotic fluid. Post-natal diagnosis of congenital infection is reliably performed by detecting specific-IgM antibody. In fact, if immunization programmes were thoroughly applied, congenital rubella should be eradicated in France since the RA 27/3 vaccine is very efficient and safe.

Congenital rubella in south India: diagnosis using saliva from infants with cataract.

Congenital rubella is a preventable disease which has largely been controlled through immunization in the developed world. Serological surveys in India, however, indicate that up to 45% of women of childbearing age are susceptible to rubella and potentially at risk of infection during pregnancy. The authors tested saliva and blood serum samples from 95 consecutive infants of mean age 6.2 months with congenital cataract presenting to the pediatric department of the Aravind Eye Hospital in 1993-94 to determine whether the detection of rubella specific IgM from saliva is as reliable as from serum for diagnosing rubella infection and whether rubella is an important cause of congenital cataract in south India. 36 children of mean age 7.3 months attending the same clinic over the same period with a diagnosis of watering eyes served as controls. Serum samples were taken from 61 children with cataract, while saliva samples rich in crevicular fluid were collected from all 131 children using the Orasure device. These samples were then tested for the presence of rubella specific IgM by antibody capture. Rubella specific IgM was detected in saliva and serum in 17 paired samples and was absent in 44 paired samples. Saliva testing gave no false positive and no false negative results compared with serum. 25 of the 95 cases had congenital rubella infection confirmed by detection of rubella specific IgM in saliva. However, congenital rubella was suspected clinically in only 19 of the 25 cases. No control had raised rubella specific IgM.

Onset and severity of hearing loss due to congenital rubella infection.

Of 111 children born in 1978-82 with congenital rubella infection, confirmed by the detection of rubella specific IgM shortly after birth, 68 were reported to be hearing impaired when notified to the National Congenital Rubella Surveillance Programme (NCRSP). The average age at which the diagnosis of hearing impairment was confirmed was 11.6 months. Recent audiograms showed a hearing loss that was usually uniform across all frequencies, equal in both ears and severe, averaging 93 dB across the range 250-4000 Hz. Despite the early diagnosis of congenital rubella and the known risk of deafness, only eight of 57 infants had been tested for auditory evoked responses in the first 6 months of life; all eight had severe hearing loss. Evidence of progressive hearing loss was found in only one of the 57 children. Definitive hearing tests (as distinct from screening tests) were frequently delayed until after the first birthday. Newborn babies identified as being at high risk of congenital deafness should have a full audiological assessment in early infancy.

Detection of rubella specific IgM by solid - phase immunosorbent hemagglutination inhibition technic

Detection of rubella specific IgM by solid - phase immunosorbent hemagglutination inhibition technic

Detection of Rubella-specific IgM in Subclinical Rubella Reinfection in Pregnancy

MORGAN-CAPNER, P.; HAMBLING, M. H.; COLEMAN, T. J.; WATKINS, R. P.; STERN, H.; HODGSON, J.; DULAKE, C.; BOSWELL, P. A.; BOOTH, J.; BEST, J. M.; BANATVALA, J. E. Author Information

Specificity and sensitivity of the IgM capture immunoassay: Studies of possible factors inducing false positive or false negative results

The specificity and sensitivity of the IgM-capture immunoassay (IgM-CI) were evaluated for detection of rubella specific IgM and hepatitis B core (HBc) specific IgM. For rubella specific IgM, antibodies bound to the solid phase were detected by haemadsorption and for HBc specific IgM, by using HBc antigen (HBcAg) and radiolabelled IgG anti-HBc. Rheumatoid factor (RF) was found to interfere in the test for HBc specific IgM because IgM-RF bound to the solid phase reacted with aggregated radiolabelled HBc specific IgG. This false positive reaction did not occur when radiolabelled F(ab') 2 was used instead of the whole IgG molecule. HBcAg purified from biological fluids might be coated with host IgG and under these conditions, HBcAg could react with RF. It was also demonstrated that high levels of IgG antibodies could interfere with IgG anti-μ coated-surface by means of non-immunological protein-protein interactions. In fact, IgG did not interfere in the rubella assay, whereas it did in the very sensitive anti-HBc test. To prevent this false-positive reaction, different dilution media were tested. Only the addition of non-specific IgG and fetal calf serum (FCS), to the dilution medium, seems to improve the specificity of the test. Furthermore, in order to decrease this non-specific IgG-IgG interaction and an occasional prozoning phenomenon, the dilution of serum to be tested was taken into account. Parameters considered to decrease sensitivity were also studied. RF, anti-F(ab') 2 antibodies and non-specific IgM did not decrease significantly the sensitivity of the assay.

Detection of rubella virus specific IgM by fast protein liquid chromatography and enzyme-linked immunosorbent assay.

A sensitive and rapid method for the detection of rubella specific IgM by fast protein liquid chromatography and enzyme-linked immunosorbent assay is described.

Trypsinised human O erythrocytes in the detection of rubella-specific IgM by sera fractionation on sucrose density gradient and absorption with staphylococcal protein A.

Detection of rubella virus-specific IgM employing trypsin-treated human group O erythrocytes was evaluated using the method of sera fractionation on sucrose density gradients (SDG) and that of sera absorption with staphylococcal protein A. The former method proved to be highly specific and sensitive in confirming or excluding rubella by demonstration of specific IgM. In contrast, the latter method provided comparable results in only 71.43% of specimens tested by both methods while false-positive or -negative IgM results were obtained in the remaining 28.57% of specimens. In view of these results, therefore, it is recommended that all those specimens found positive for specific IgM by the protein A method must be confirmed by another procedure, possibly that of specific IgM reduction with 2-mercaptoethanol.