At a Glance
Why Get Tested?
When to Get Tested?
Prior to or at the beginning of a pregnancy to verify immunity; when a pregnant woman has symptoms of rubella, such as fever and rash; when a newborn shows signs of abnormal development or birth defects that may be caused by an in utero infection; whenever there is need to verify a recent rubella infection or to verify immunity
A blood sample drawn from a vein in the arm of an adult or blood drawn from a heelprick or from the umbilical cord of a newborn
Test Preparation Needed?
The Test Sample
What is being tested?
Rubella is a virus that causes an infection that is usually mild and characterized by fever and rash that last about 2 to 3 days. The Infection is highly contagious but is preventable with a vaccine. This test detects and measures rubella antibodies in the blood that are produced by the body's immune system in response to an infection by the rubella virus.
There are two types of rubella antibodies: IgM and IgG. The first type to appear in the blood after exposure is the IgM rubella antibody. The level of this protein rises and peaks in the blood within about 7 to 10 days after infection and then tapers off over the next few weeks, except in an infected newborn, where it may be detected for several months to a year. The IgG rubella antibody takes a bit longer to appear than the IgM, but once it does, it stays in the bloodstream for life, providing protection against re-infection. The presence of IgM rubella antibodies in the blood indicates a recent infection while the presence of IgG antibodies may indicate a recent or past rubella infection, or indicate that a rubella vaccine (a measles, mumps, rubella vaccine) has been given and is providing adequate protection.
The rubella virus generally causes a mild infection marked by a fine red rash that appears on the face and neck and then travels to the trunk and limbs before disappearing a few days later. The virus is passed through nasal and throat secretions and can cause symptoms such as fever, enlarged lymph nodes, runny nose, red eyes, and joint pain. Symptoms may be so minimal, especially in children, that they are not perceived as being from a viral illness. In most people, rubella goes away within a couple of days without any special medical treatment and causes no further health issues.
The primary concern with rubella infection is when a pregnant woman contracts it for the first time during the first three months of her pregnancy. The developing fetus is most vulnerable to the virus at this time and, if it is passed on to the fetus by the mother, it can cause miscarriage, stillbirth, and/or congenital rubella syndrome (CRS), a group of serious birth defects that will permanently affect the child. CRS can cause delayed development, mental retardation, deafness, cataracts, an abnormally small head, liver problems, and heart defects.
Because of the severe consequences for developing fetuses, a national campaign was started in 1969 to immunize all children in the United States and to work to eradicate rubella infection, first in the U.S. and then throughout the world. Prior to this time, rubella infections would emerge as cyclic outbreaks that lasted for several years. According to the Centers for Disease Control and Prevention (CDC), during the 1962-1965 rubella epidemic, 12.5 million cases of rubella occurred in the United States and there were 20,000 infants born with CRS. Due to vaccination efforts, these numbers have decreased drastically. The latest statistics from the CDC, from 2008, show that there were only 16 cases of rubella recorded in the United States. Each year since 2001, there have been fewer than 25 cases reported. The CDC now declares endemic rubella to be eradicated in the U.S., although the incidence continues to be monitored. People should not become complacent with this reduction, however, and the CDC cautions people to continue to have their children vaccinated. Anyone who has not received the vaccination as a child (and a few that have) may still be vulnerable to rubella infection.
Pregnant women and women considering pregnancy continue to be routinely tested for rubella antibodies to ensure that they have sufficient levels for immunity.
How is the sample collected for testing?
A blood sample is drawn from a vein in the arm of an adult or from a heelprick or the umbilical cord of a newborn.
NOTE: If undergoing medical tests makes you or someone you care for anxious, embarrassed, or even difficult to manage, you might consider reading one or more of the following articles: Coping with Test Pain, Discomfort, and Anxiety, Tips on Blood Testing, Tips to Help Children through Their Medical Tests, and Tips to Help the Elderly through Their Medical Tests.
Another article, Follow That Sample, provides a glimpse at the collection and processing of a blood sample and throat culture.
Is any test preparation needed to ensure the quality of the sample?
No test preparation is needed.
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NOTE: This article is based on research that utilizes the sources cited here as well as the collective experience of the Lab Tests Online Editorial Review Board. This article is periodically reviewed by the Editorial Board and may be updated as a result of the review. Any new sources cited will be added to the list and distinguished from the original sources used.
Sources Used for Current Review
Centers for Disease Control and Prevention. Travelers’ Health, Chapter 3 Infectious Diseases Related To Travel, Rubella. Available online at http://wwwnc.cdc.gov/travel/yellowbook/2012/chapter-3-infectious-diseases-related-to-travel/rubella.htm through http://wwwnc.cdc.gov. Accessed October 2011.
Mayo Clinic Staff (2011 July 9) Rubella. MayoClinic.com [On-line information]. Available online at http://www.mayoclinic.com/print/rubella/DS00332/DSECTION=all&METHOD=print through http://www.mayoclinic.com. Accessed October 2011.
(Updated 2011 January 3). Rubella: Make Sure Your Child Is Fully Immunized. Centers for Disease Control and Prevention [On-line information]. Available online at http://www.cdc.gov/features/rubella/ through http://www.cdc.gov. Accessed October 2011.
Kaneshiro, N. (Updated 2011 May 1). Congenital rubella. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/001658.htm through http://www.nlm.nih.gov. Accessed October 2011.
Kaneshiro, N. (Updated 2011 January 24). Rubella. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/001574.htm through http://www.nlm.nih.gov. Accessed October 2011.
Litwin, C. (Updated 2010 October). Rubella Virus. ARUP Consult [On-line information]. Available online at http://www.arupconsult.com/Topics/RubellaVirus.html?client_ID=LTD through http://www.arupconsult.com. Accessed October 2011.
P Strebel, P. et. al. (2010 December 3). Progress Toward Control of Rubella and Prevention of Congenital Rubella Syndrome — Worldwide, 2009. Medscape Today News from Morbidity & Mortality Weekly Report. 2010;59(40):1307-1310 [On-line information]. Available online at http://www.medscape.com/viewarticle/730825 through http://www.medscape.com. Accessed October 2011.
Ezike, E. and Ang, J. (Updated 2011 October 3). Pediatric Rubella. Medscape Reference [On-line information]. Available online at http://emedicine.medscape.com/article/968523-overview#showall through http://emedicine.medscape.com. Accessed October 2011.
Pagana, K. D. & Pagana, T. J. (© 2011). Mosby’s Diagnostic and Laboratory Test Reference 10th Edition: Mosby, Inc., Saint Louis, MO. Pp 852-853.
(February 18, 2011) Centers for Disease Control and Prevention. FastStats, Measles Morbidity. Available online at http://www.cdc.gov/nchs/fastats/measles.htm through http://www.cdc.gov. Accessed October 2011.
Sources Used in Previous Reviews
Thomas, Clayton L., Editor (1997). Taber's Cyclopedic Medical Dictionary. F.A. Davis Company, Philadelphia, PA [18th Edition].
Pagana, Kathleen D. & Pagana, Timothy J. (2001). Mosby's Diagnostic and Laboratory Test Reference 5th Edition: Mosby, Inc., Saint Louis, MO., Pp 751-752.
(© 2005). Rubella Antibodies, IgG and IgM. ARUP's Guide to Clinical Laboratory Testing. Available online at http://www.arup-lab.com/guides/clt/tests/clt_192b.jsp#1147292 through http://www.aruplab.com.
Ben-Joseph, E. (2003 October, Reviewed). Rubella (German Measles). Familydoctor.org. Available online at http://www.kidshealth.org/PageManager.jsp?dn=familydoctor&lic=44&article_set=22917 through http://www.kidshealth.org
CDC (2005). Achievements in Public Health: Elimination of Rubella and Congenital Rubella Syndrome - United States, 1969-2004. Medscape, from MMWR. 2005; 54 (11): 279-282. Available online at http://www.medscape.com/viewarticle/501956 through http://www.medscape.com
A.D.A.M. editorial, Reviewed (2003 September 26, Reviewed). Previously reviewed by Adam Ratner. Rubella. MedlinePlus Medical Encyclopedia. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/001574.htm through http://www.nlm.nih.gov/medlineplus/encyclopedia.html
Mayo Clinic Staff (2004 June 16). Rubella. MayoClinic.com. Available online at http://www.mayoclinic.com/invoke.cfm?id=DS00332 through http://www.mayoclinic.com
Stevens, L. (2002). Rubella. Medem Medical Library, JAMA Patient Page, from JAMA. 2002; 287:542. Available online at http://www.medem.com/MedLB/article_detaillb.cfm?article_ID=ZZZV5AZLMWC&sub_cat=286 through http://www.medem.com
Hughes, H. and Wharton, M. (2002). K. Rubella. VPD Surveillance Manual, 3rd Edition, Chapter 19, Laboratory Support for the Surveillance of VPDs: 19-16. PDF available for download at http://www.cdc.gov/nip/publications/surv-manual/chpt19_lab_support.pdf through http://www.cdc.gov
Hirsch, Lisa. Rubella (German Measles). (Reviewed July 2006). Familydoctor.org. Available online at http://www.kidshealth.org/PageManager.jsp?dn=familydoctor&lic=44&article_set=22917 through http://www.kidshealth.org. Accessed April 2008.
Averhoff F, et al. Adequacy of surveillance to detect endemic rubella transmission in the United States. Clin Infect Dis. 2006; 43 Suppl 3:S151-7. Available online at http://www.medscape.com/medline/abstract through http://www.medscape.com. Accessed April 2008.
(July 9, 2007) Mayo Clinic Staff. Rubella. MayoClinic.com. Available online at http://www.mayoclinic.com/health/rubella/DS00332/DSECTION=1 through http://www.mayoclinic.com. Accessed April 2008.
(June 20, 2007) Centers for Disease Control and Prevention. Travelers Health: Yellow Book, Chapter 4: Prevention of Specific Infectious Diseases, Rubella. Available online at http://wwwn.cdc.gov/travel/yellowBookCh4-Rubella.aspx through http://wwwn.cdc.gov. Accessed April 2008.
Jin L, Thomas B. Application of molecular and serological assays to case based investigations of rubella and congenital rubella syndrome. J Med Virol. 2007; 79(7):1017-24. Available online at http://www.medscape.com/medline/abstract/17516526 through http://www.medscape.com. Accessed April 2008.
(Updated May 2007) Centers for Disease Control and Prevention. Guidelines for Vaccinating Pregnant Women. Available online at http://www.cdc.gov/vaccines/pubs/preg-guide.htm#rubella through http://www.cdc.gov. Accessed online April 2008.
Centers for Disease Control and Prevention. MMWR (March 21, 2008) 51(53). Summary of Notifiable Diseases - United States 2006. Available online at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5553a1.htm through http://www.cdc.gov. Accessed online April 2008.