Single-serum radial hemolysis to detect recent rubella virus infection

In the radial hemolysis test for rubella virus-specific antibodies, sera obtained shortly after primary rubella produce a characteristically altered hemolysis zone, termed soft hemolysis. The occurrence of soft hemolysis was analyzed statistically in 6,723 sera. The specificity of soft hemolysis for infection with rubella virus was 99.0%. Its sensitivity in primary infections was 97.3%, and the predictive value for rubella serodiagnosis (increase in IgG level or detectable IgM) was 91.2%. The temporal association of soft hemolysis with rubella was determined with sera obtained from 129 persons during late convalescence (70-310 days after onset of symptoms). Soft hemolysis disappeared by 190 days after the onset of symptoms and the presence of ordinary hemolysis ruled out primary rubella in the preceding 70-100 days. Soft hemolysis was caused by IgG antibody to rubella virus, and thus represents a new serodiagnostic principle. This technique, together with an Igm assay, allows rapid diagnosis of recent rubella from a single serum sample.