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Home :: Rubella


Also known as: German measles, 3-day measles
Formal name: Rubella antibodies, IgM and IgG

Although rubella (German measles) is generally a mild viral infection in children and young adults, it can produce severe infection in the fetus, resulting in spontaneous abortion, stillbirth, or congenital rubella syndrome. Because rubella infection normally induces immunoglobulin G (IgG) and IgM antibody production, measuring rubella antibodies can determine present infection as well as immunity resulting from past infection. The hemagglutination inhibition test is the most commonly used serologic test for rubella antibodies.


  • To diagnose rubella infection, especially congenital infection.
  • To determine susceptibility to rubella in children and in women of childbearing age.

Patient preparation

  • Explain to the patient that this test diagnoses or evaluates susceptibility to rubella.
  • Inform her that she needn't restrict food or fluids before the test.
  • Tell her that this test requires a blood sample and that if a current infection is suspected, a second blood sample will be needed in 2 to 3 weeks to identify a rise in the titer.
  • Inform her who will perform the venipuncture and when.
  • Reassure her that although she may experience transient discomfort from the needle puncture and the tourniquet, collecting the sample takes less than 3 minutes.

Procedure and posttest care

  • Perform a venipuncture, and collect the sample in a 7-ml red-top tube.
  • If a hematoma develops at the venipuncture site, apply warm soaks.
  • When appropriate, instruct the patient to return for an additional blood test.
  • If a woman of childbearing age is found to be susceptible to rubella (titer of 1:8 or less), explain that vaccination can prevent rubella and that she must wait at least 3 months after the vaccination to become pregnant or risk permanent damage or death to the fetus.
  • If the pregnant patient is found to be susceptible to rubella, instruct her to return for follow-up rubella antibody tests to detect possible subsequent infection.
  • If the test confirms rubella in a pregnant patient, provide emotional support. As needed, refer her for appropriate counseling.
  • Handle the specimen gently to prevent hemolysis

Reference values

An IgG titer less than 10 IU/ml indicates susceptibility to rubella; a titer greater than 10 IU/ml indicates adequate protection against rubella.

IgM results are reported as positive or negative. The presence of IgM class antibody indicates congenital or recent infection.

Abnormal findings

Hemagglutination inhibition antibodies normally appear 2 to 4 days after the onset of the rash, peak in 2 to 3 weeks, and then slowly decline but remain detectable for life. A fourfold or greater rise from the acute to the convalescent titer indicates a recent rubella infection.

Because maternal antibodies cross the placenta and persist in the infant's serum for up to 6 months, congenital rubella can be detected only after this period. An elevated antibody titer in an infant age 6 months or older who has not been exposed to rubella postnatally confirms congenital rubella.

Interfering factors

  • Hemolysis due to rough handling of the sample.

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Disclaimer: website is designed for educational purposes only. It is not intended to treat, diagnose, cure, or prevent any disease. Always take the advice of professional health care for specific medical advice, diagnoses, and treatment. We will not be liable for any complications, or other medical accidents arising from the use of any information on this web site. Please note that medical information is constantly changing. Therefore some information may be out of date.