Rubella immunity by four different techniques: results of challenge studies

When 42 sera with low or inconsistent levels of haemagglutination-inhibiting (HAI) antibodies were tested by single radial haemolysis (SRH) radioimmunoassay (RIA), and enzyme-linked immunoassay (ELISA), RIA was shown to be the most reliable test for detecting low levels of antibody. SRH, however, was found to be an acceptable alternative screening test for rubella antibodies and was more reliable than HAI. Although SRH plates prepared in our own laboratory failed to detect antibodies in six sera, in five of the six, antibodies were only at a low level (RIA titre 1:20-1:80). OriVir plates (Orion Diagnostica, Finland) failed to detect low levels of antibody in only three sera. There were six (14.3%) sera which were false positives in the HAI test. These women were shown to be seronegative by radioimmunoassay and, when three of these six volunteers were vaccinated, they developed a typical primary immune response which resembled that developed by 43 seronegative women following vaccination. Fifteen of the young women with consistently low HAI titres and one woman who was seronegative by HAI but seropositive by RIA and ELISA were subsequently vaccinated. Six (37.5%) of these women showed no significant rise in titre by any of the tests employed, while ten had a significant rise in titre, detected by at least one test, with a low level of rubella-specific IgM detectable in one.