Comparison of five different methods of rubella IgM antibody testing

Five tests for the detection of rubella specific IgM antibody were compared. They were the conventional method of sucrose density gradient fractionation, followed by haemagglutination inhibition; an anti-mu capture radioimmunoassay; and three commercially available enzyme linked assays: Rubazyme M, Rubenz M I, and its successor, Rubenz M II. The five methods detected similar numbers of rubella positive samples between seven and 35 days after the onset of symptoms; in the earlier stages, however, the radioimmunoassay and Rubenz M II were more sensitive. All three commercial kits were straightforward to use but produced misleading positive results with sera containing heterophil antibody. In considering sensitivity, specificity, and cost effectiveness together the Rubenz M tests were the most appropriate for routine use. With the recent withdrawal of Rubenz M I from the market only Rubenz M II is now available. If Epstein-Barr virus infection is excluded, Rubenz M II provides a reliable test for the diagnostic laboratory.