Rubella

Evaluation of pregnant women for rubella immunity

Not immune Early Acute phase Acute phase or primary infection Chronic phase or reinfection
Description No symptoms Typical rash and flu-like symptoms or asymptomatic Asymptomatic
Rubella IgM - + + + -
Rubella IgG - - + + +
Rubella IgG Avidity and/or Immunoblot* n.a. Low Low High n.a./High

* performed only in specialized labs.
n.a. not applicable

Adapted from:

  1. Iyanger N, et al. Guidance on the investigation, diagnosis and management of viral rash illness, or exposure to viral rash illness, in pregnancy. Public Health England publications gateway number GW-231. [Internet; updated 2023 Nov 28; cited 2024 Mar 5]. Available from: https://www.gov.uk/government/publications/viral-rash-in-pregnancy.
  2. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention (CDC). Manual for the Surveillance of Vaccine-Preventable Diseases. Chapter 14: Rubella. Surveillance Manual. [Internet; updated 2020 Mar 6; cited 2024 Mar 5]. Available from: https://www.cdc.gov/vaccines/pubs/surv-manual/chpt14-rubella.html.
  3. Lambert N, et al. Rubella. Lancet. 2015;385:2297-2307.
  4. Bouthry E, et al. Rubella and pregnancy: diagnosis, management and outcomes. Prenatal Diagnosis. 2014;34:1246–1253.
  5. Abernathy E, et al. 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. 2009;47:182-188.
  6. Vauloup-Fellous C and Grangeot-Keros L. Humoral immune response after primary rubella virus infection and after vaccination. Clin Vaccine Immunol. 2007;14:644-647.
  7. Banatvala JE and Brown DWG. Rubella. Lancet. 2004;363:1127-1137.
Product Description Tests Product page
Elecsys® Rubella IgM a) Electrochemiluminescence immunoassay (ECLIA) for the qualitative detection of IgM class antibodies to rubella virus in human serum and plasma 100
Elecsys® Rubella IgM b) 300
Elecsys® Rubella IgG a) Electrochemiluminescence immunoassay (ECLIA) for the quantitative detection of IgG class antibodies to rubella virus in human serum and plasma 100
Elecsys® Rubella IgG b) 300

a) for use on the cobas® e 411 analyzer and the cobas® e 601 / 602 modules
b) for use on the cobas® e 402 and cobas® e 801 analytical units

Rubella IgM Rubella IgG Interpretation
- - Susceptible / No current or previous rubella infection; repeat IgM and IgG testing 2 – 3 weeks later; before pregnancy or post-partum vaccination is recommended.
- + Immune; no further testing required. The presence of antibodies at any level is sufficient to confirm immunity6.
+ - Acute or recent rubella infection or false positive/unspecific IgM. Best period for testing is in a serum collected within the first few days after rash onset. Test for other causes, e.g. rheumatoid factor, EBV, CMV, Parvovirus B19. Test a second sample 5 – 10 days later, if available, and perform IgG avidity. A significant rise of the rubella IgG titer from a first to a second sample supports the diagnosis of acute rubella infection.
+ +

* except infants

Adapted from:

  1. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention (CDC). Manual for the Surveillance of Vaccine-Preventable Diseases. Chapter 14: Rubella. Surveillance Manual. [Internet; updated 2020 Mar 6; cited 2024 Mar 5]. Available from: https://www.cdc.gov/vaccines/pubs/surv-manual/chpt14-rubella.html.
  2. Picone O, et al. Determination of rubella virus-specific humoral and cell-mediated immunity in pregnant women with negative or equivocal rubella-specific IgG in routine screening. J Clin Virol. 2019;112:27–33.
  3. Picone O and Grangeot-Keros L. Rubéole et grossesse. EMC-Gynécologie-Obstétrique. 2005;2:343-353.
  • Step 1
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Step 1

Perform IgG test

IgG test
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Step 2

Perform IgG test

IgG test
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Summary

Immunity to rubella. ​​​​​​

No further testing is needed.

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Summary

Susceptible to infection.
Advice, monitoring, and vaccination before pregnancy or after delivery.

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Summary

Confirmation testing required. 
IgM, IgG, and IgG avidity serology and PCR in amniotic fluid.

Back
Next Restart simulation
Step
Result
Interpretation
1
IgG test = ...
waiting for input
1
IgG test = negative
Susceptible to infection.

Repeat IgG test after 2–3 weeks.
1
IgG test = positive
Immunity to rubella.
2
IgG test = ...
waiting for input
2
IgG test = negative
Susceptible to infection.
2
IgG test = positive
Confirmation testing required.
End of test sequence