Rubella Test

Overview :

The rubella test belongs to a category of blood tests called hemagglutination inhibition (HI) tests. Hemagglutination refers to the clumping or clustering of red blood cells caused by a disease antibody, virus, or certain other substances. Inhibition refers to interference with the clumping process. The presence of rubella antibodies inhibits the cell clumping caused by the rubella virus. Thus, the addition of the virus to a sample of the patient's blood allows a doctor to determine the presence and concentration of rubella antibodies and the patient's immunity to the disease.

When a person is infected with the rubella virus, the body produces both immunoglobulin G (IgG) and immunoglobulin M (IgM) antibodies to fight the infection. Once IgG exists, it persists for a lifetime, but the special IgM antibody usually wanes over six months. The rubella test can either confirm that a recent infection has occurred (both IgG and IgM are present) or that a patient has immunity to rubella (IgG only is present).

When the test is performed to confirm the diagnosis of rubella in a woman already pregnant, two blood samples are drawn. One is drawn during the acute phase of the illness about three days after the rash breaks out, and the second is drawn during the convalescent phase about three weeks later. The specimens are then tested simultaneously by a single laboratory. Alternatively, a pregnant woman with a rash suspected to be rubella can be tested for IgM antibody. If the test shows that IgM antibody is present, then a recent rubella infection has occurred.

Because there have been cases of children born with rubella syndrome even though the mother's blood test indicated that she was sufficiently immune to rubella, some researchers are presently recommending a second test, known as a synthetic peptide enzyme-linked immunosorbent assay (ELISA). This test screens for the presence of rubella virus neutralizing (RVN) antibodies in the mother's blood.